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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
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2020 In Use
00591-3592-60 00591-3592 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 7, 2005 May 31, 2019 No Longer Used
25021-0828-50 25021-0828 Leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Apr 15, 2018 In Use
55513-0478-01 55513-0478 Epoetin alfa Epogen 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Mar 3, 1997 In Use
55111-0172-90 55111-0172 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 28, 2007 In Use
16714-0159-01 16714-0159 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 6, 2021 In Use
55513-0520-06 55513-0520 Palifermin Kepivance Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Dec 15, 2004 Dec 15, 2009 No Longer Used
58160-0830-52 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Jul 25, 2011 Nov 29, 2016 No Longer Used
71930-0017-52 71930-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 6, 2020 In Use
55154-5685-00 55154-5685 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jul 8, 2011 Aug 31, 2015 No Longer Used
82009-0061-05 82009-0061 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov 21, 2022 In Use
58118-0356-04 58118-0356 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 Jun 26, 2017 No Longer Used
58468-0181-01 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Mar 15, 2010 Dec 31, 2013 No Longer Used
00006-0462-01 00006-0462 Aprepitant Emend 125.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Mar 26, 2003 In Use
00006-4119-02 00006-4119 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 May 22, 2019 In Use
25021-0813-10 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
25021-0816-30 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
70771-1152-00 70771-1152 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 5, 2017 In Use
51672-4110-05 51672-4110 Ondansetron Hydrochloride Ondansetron Hydrochloride 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 28, 2011 In Use
61314-0312-10 61314-0312 filgrastim-sndz Zarxio 480.0 ug/.8mL, 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sep 3, 2015 Feb 28, 2021 No Longer Used
00173-0489-00 00173-0489 Ondansetron Hydrochloride Zofran 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 5, 1997 Jun 30, 2019 No Longer Used
50090-1523-01 50090-1523 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human 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
70518-2363-00 70518-2363 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct 16, 2019 In Use
55513-0126-01 55513-0126 Epoetin alfa Epogen 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 30, 1989 In Use
00185-0932-86 00185-0932 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 21, 2015 Mar 31, 2020 No Longer Used

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