| NDC-11 (Package) | NDC-9 (Product) | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Class | Minor Class | Administration Route | Package Effective Date | Package Discontinuation Date | Status |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00006-4121-02 | 00006-4121 | Human Papillomavirus 9-valent Vaccine, Recombinant | GARDASIL 9 | 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Dec 10, 2014 | In Use | |
| 00185-0933-86 | 00185-0933 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Nov 21, 2015 | Feb 28, 2020 | No Longer Used |
| 61919-0464-30 | 61919-0464 | Ondansetron | Ondansetron | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jan 1, 2014 | In Use | ||
| 70518-3511-00 | 70518-3511 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Sep 6, 2022 | In Use | |
| 72189-0542-90 | 72189-0542 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Mar 11, 2024 | In Use | |
| 70518-1585-03 | 70518-1585 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Aug 1, 2023 | In Use | |
| 25021-0201-68 | 25021-0201 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Apr 30, 2013 | Sep 13, 2019 | In Use |
| 55154-6976-05 | 55154-6976 | ONDANSETRON | Ondansetron | 2.0 mg/mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Intramuscular, Intravenous | Oct 16, 2008 | In Use | |
| 60505-1311-04 | 60505-1311 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Nov 11, 2008 | Nov 1, 2010 | No Longer Used | |
| 89141-0448-01 | 89141-0448 | Ondansetron | Zuplenz | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 2, 2010 | Feb 23, 2021 | In Use |
| 55513-0025-01 | 55513-0025 | Darbepoetin alfa | Aranesp | 100.0 ug/.5mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Feb 18, 2011 | In Use | ||
| 50090-1201-00 | 50090-1201 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Nov 28, 2014 | In Use | |
| 68071-2909-01 | 68071-2909 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jan 6, 2023 | In Use | |
| 16714-0160-01 | 16714-0160 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 6, 2021 | In Use | |
| 55513-0924-91 | 55513-0924 | Filgrastim | Neupogen | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Oct 2, 2000 | In Use | |
| 25021-0814-30 | 25021-0814 | Leucovorin Calcium | Leucovorin Calcium | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 15, 2012 | In Use | |
| 21695-0834-12 | 21695-0834 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jun 25, 2007 | In Use | |
| 70518-0397-01 | 70518-0397 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Apr 10, 2017 | In Use | |
| 16714-0915-01 | 16714-0915 | LEVOLEUCOVORIN | LEVOLEUCOVORIN | 250.0 mg/25mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 26, 2018 | In Use | |
| 61786-0095-10 | 61786-0095 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Nov 12, 2014 | Feb 17, 2016 | No Longer Used |
| 00006-4109-02 | 00006-4109 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 55513-0148-10 | 55513-0148 | Epoetin alfa | Epogen | 4000.0 [iU]/mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Aug 16, 1993 | In Use | ||
| 68001-0610-25 | 68001-0610 | Zoledronic acid | Zoledronic acid | 4.0 mg/5mL | Ancillary Therapy | Bisphosphonate | Intravenous | Feb 28, 2024 | In Use | ||
| 16714-0221-30 | 16714-0221 | Granisetron Hydrochloride | Granisetron Hydrochloride | 1.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 29, 2008 | Aug 31, 2021 | No Longer Used |
| 71288-0418-10 | 71288-0418 | Fosaprepitant | Fosaprepitant | 150.0 mg/5mL | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Intravenous | Nov 15, 2019 | Mar 30, 2023 | No Longer Used |
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