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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
67457-0529-20 67457-0529 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 23, 2019 In Use
52125-0334-16 52125-0334 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov 25, 2013 Nov 26, 2013 No Longer Used
55390-0121-10 55390-0121 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec 26, 2006 Jul 31, 2012 No Longer Used
63304-0458-30 63304-0458 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 In Use
49349-0810-02 49349-0810 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 14, 2011 Sep 27, 2013 No Longer Used
00006-4109-06 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 May 6, 2011 In Use
25021-0828-50 25021-0828 Leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Apr 15, 2018 In Use
63187-0256-10 63187-0256 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 28, 2022 In Use
55390-0051-10 55390-0051 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote May 1, 1996 Aug 31, 2013 No Longer Used
55513-0209-91 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 2, 2000 In Use
66220-0017-03 66220-0017 Amifostine Ethyol 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Aug 1, 2016 Oct 31, 2020 No Longer Used
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
67457-0208-50 67457-0208 Dexrazoxane Dexrazoxane Hydrochloride Ancillary Therapy Chemoprotective Detoxifying Agent Nov 18, 2011 In Use
31722-0962-60 31722-0962 dronabinol DRONABINOL 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Feb 10, 2020 In Use
00172-7310-00 00172-7310 Cyclosporine Modified Cyclosporine Modified 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Mar 29, 2005 Mar 31, 2017 No Longer Used
69097-0195-67 69097-0195 Granisetron Hydrochloride Granisetron Hydrochloride 0.1 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec 31, 2007 Apr 30, 2020 No Longer Used
60505-0381-05 60505-0381 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 13, 2008 Jan 5, 2014 No Longer Used
55513-0209-20 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 1, 2025 In Use
51862-0460-01 51862-0460 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 18, 2016 In Use
59676-0304-02 59676-0304 Erythropoietin Procrit 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 1, 1989 Jan 8, 2014 In Use
49884-0869-05 49884-0869 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
00006-4045-01 00006-4045 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
61786-0095-02 61786-0095 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 14, 2015 Feb 23, 2017 No Longer Used
00781-2322-68 00781-2322 Aprepitant Aprepitant 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Dec 27, 2016 In Use
00069-0109-01 00069-0109 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 10, 2011 Dec 31, 2017 No Longer Used

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