| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 55513-0002-04 | 55513-0002 | Darbepoetin alfa | Aranesp | 25.0 ug/mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Sep 11, 2006 | In Use | ||
| 51672-4138-00 | 51672-4138 | Granisetron Hydrochloride | Granisetron Hydrochloride | 1.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | May 28, 2010 | May 28, 2010 | 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 |
| 52125-0569-38 | 52125-0569 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Feb 27, 2013 | May 8, 2016 | No Longer Used |
| 58160-0830-34 | 58160-0830 | Human Papillomavirus Bivalent Vaccine, Recombinant | Cervarix | 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Mar 20, 2012 | Nov 29, 2016 | No Longer Used |
| 49884-0324-62 | 49884-0324 | Ondansetron | Zuplenz | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 5, 2010 | Nov 30, 2012 | No Longer Used | |
| 68084-0921-25 | 68084-0921 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Nov 3, 2015 | In Use | |
| 71837-5843-05 | 71837-5843 | SARGRAMOSTIM | Leukine | 250.0 ug/mL | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | Intravenous, Subcutaneous | Sep 1, 2023 | 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 | |
| 55513-0023-01 | 55513-0023 | Darbepoetin alfa | Aranesp | 60.0 ug/.3mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Feb 18, 2011 | In Use | ||
| 55513-0005-01 | 55513-0005 | Darbepoetin alfa | Aranesp | 100.0 ug/mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Sep 11, 2006 | In Use | ||
| 68001-0285-36 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 42291-0280-10 | 42291-0280 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Jan 31, 2014 | Feb 5, 2015 | In Use |
| 53097-0573-60 | 53097-0573 | Dronabinol | MARINOL | 10.0 mg/1 | Ancillary Therapy | Antiemetic | CB1/CB2 | Oral | Mar 3, 2021 | In Use | |
| 55390-0148-10 | 55390-0148 | Granisetron Hydrochloride | Granisetron Hydrochloride | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oct 28, 2014 | Nov 30, 2009 | No Longer Used | ||
| 67457-0430-10 | 67457-0430 | Pamidronate Disodium | Pamidronate Disodium | 3.0 mg/mL | Ancillary Therapy | Bisphosphonate | Intravenous | Nov 1, 2008 | In Use | ||
| 50090-1015-02 | 50090-1015 | ondansetron hydrochloride | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Nov 28, 2014 | Mar 31, 2019 | In Use |
| 50090-2285-00 | 50090-2285 | Dutasteride | Dutasteride | 0.5 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Jan 12, 2016 | Dec 31, 2019 | 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 | ||
| 00024-5843-01 | 00024-5843 | Sargramostim | Leukine | 250.0 ug/mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Nov 5, 2013 | Dec 30, 2021 | No Longer Used |
| 55648-0662-01 | 55648-0662 | Granisetron Hydrochloride | Granisetron Hydrochloride | 0.1 mg/mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Intravenous | Mar 3, 2008 | In Use | |
| 54569-6124-01 | 54569-6124 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | May 9, 2016 | In Use | |
| 25021-0816-67 | 25021-0816 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Dec 1, 2013 | Jan 31, 2022 | In Use |
| 00574-0792-01 | 00574-0792 | pilocarpine hydrchloride | pilocarpine hydrchloride | 5.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agonist | Oral | Aug 24, 2020 | Jan 31, 2026 | In Use |
| 70518-1585-00 | 70518-1585 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Oct 24, 2018 | Nov 19, 2024 | In Use |
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