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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
71731-5111-01 71731-5111 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Mar 16, 2021 In Use
55513-0058-01 55513-0058 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent Feb 18, 2011 Mar 31, 2009 No Longer Used
00093-5740-65 00093-5740 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 1, 2015 Dec 31, 2022 No Longer Used
68788-0822-01 68788-0822 Ondansetron Hydrochloride Ondansetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 May 10, 2011 No Longer Used
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
67296-0902-02 67296-0902 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 1, 2021 In Use
55513-0520-01 55513-0520 Palifermin Kepivance Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Dec 15, 2004 Dec 15, 2009 No Longer Used
55154-6976-05 55154-6976 ONDANSETRON Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Oct 16, 2008 In Use
68001-0649-37 68001-0649 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 10, 2025 In Use
62856-0798-01 62856-0798 Palonosetron hydrochloride Aloxi 0.075 mg/1.5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 28, 2014 Jun 30, 2018 In Use
50090-1015-04 50090-1015 ondansetron hydrochloride Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 28, 2014 Mar 31, 2019 In Use
68788-9519-09 68788-9519 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 6, 2014 May 21, 2020 No Longer Used
68001-0285-40 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 1, 2016 Feb 1, 2021 No Longer Used
59676-0320-00 59676-0320 Erythropoietin Procrit 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug 8, 2011 In Use
00781-3010-95 00781-3010 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Jun 27, 2007 Mar 31, 2017 No Longer Used
25021-0201-69 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 30, 2013 Sep 13, 2019 In Use
16714-0221-12 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
80425-0072-05 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
55150-0266-05 55150-0266 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Sep 26, 2016 In Use
00074-6479-32 00074-6479 Cyclosporine Modified Gengraf 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Sep 16, 2017 No Longer Used
55111-0153-01 55111-0153 Ondansetron Hydrochloride ONDANSETRON 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 26, 2006 In Use
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
00093-5742-19 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 1, 2015 Jan 31, 2023 No Longer Used
68788-9559-05 68788-9559 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 27, 2013 In Use
68382-0074-77 68382-0074 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 5, 2017 In Use

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