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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
83831-0147-05 83831-0147 Leucovorin calcium VYKOURA 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Feb 3, 2026 In Use
65293-0373-25 65293-0373 ONDANSETRON HYDROCHLORIDE Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov 18, 2009 Jan 31, 2015 In Use
70518-2650-00 70518-2650 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Mar 25, 2020 In Use
83831-0148-35 83831-0148 Leucovorin calcium VYKOURA 350.0 mg/35mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Feb 3, 2026 In Use
55150-0126-20 55150-0126 Ondansetron Hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec 21, 2012 In Use
35356-0197-65 35356-0197 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 10, 2010 Jun 30, 2025 No Longer Used
55513-0023-01 55513-0023 Darbepoetin alfa Aranesp 60.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb 18, 2011 In Use
63629-4306-07 63629-4306 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 20, 2010 In Use
00944-2655-04 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G Jan 3, 2011 Aug 26, 2015 In Use
49884-0868-05 49884-0868 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
54868-4138-00 54868-4138 Dolasetron mesylate Anzemet Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 11, 1997 Jun 30, 2010 No Longer Used
43598-0771-11 43598-0771 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use
00904-6208-46 00904-6208 Ondansetron, Ondansetron hydrochloride Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 1, 2008 Sep 30, 2014 No Longer Used
67457-0889-10 67457-0889 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 5, 2019 In Use
68084-0921-25 68084-0921 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 3, 2015 In Use
55513-0053-04 55513-0053 Darbepoetin alfa Aranesp 150.0 ug/.75mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sep 11, 2006 In Use
55513-0710-21 55513-0710 Denosumab Prolia 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Mar 5, 2024 In Use
68001-0247-01 68001-0247 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 13, 2014 Feb 27, 2018 In Use
68083-0278-01 68083-0278 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 20, 2018 In Use
00143-2422-01 00143-2422 Ondansetron Hydrochloride Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 1, 2008 Dec 31, 2014 In Use
58118-0458-09 58118-0458 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Jun 26, 2017 No Longer Used
17478-0547-01 17478-0547 Granisetron Hydrochloride Granisetron Hydrochloride 0.1 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Oct 1, 2009 In Use
00143-9165-01 00143-9165 Denosumab-qbde ENOBY 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jan 8, 2026 In Use
69539-0181-01 69539-0181 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Feb 10, 2020 In Use
52125-0334-14 52125-0334 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Aug 11, 2014 Apr 27, 2017 No Longer Used

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