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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
61314-0866-02 61314-0866 Pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Mar 3, 2025 In Use
52584-0451-82 52584-0451 Metoclopramide Hydrochloride Reglan 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intramuscular, intravenous, Intravenous Aug 1, 2010 Sep 1, 2012 No Longer Used
16729-0298-05 16729-0298 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Oct 20, 2016 In Use
68084-0921-25 68084-0921 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 3, 2015 In Use
69639-0103-01 69639-0103 Palonosetron hydrochloride Aloxi 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov 1, 2018 Nov 1, 2022 No Longer Used
69097-0830-37 69097-0830 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 5, 2019 In Use
59353-0003-10 59353-0003 Epoetin alfa-epbx RETACRIT 3000.0 [iU]/mL, 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 18, 2018 In Use
59353-0004-10 59353-0004 Epoetin alfa-epbx RETACRIT 4000.0 [iU]/mL, 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 18, 2018 In Use
59353-0010-10 59353-0010 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL, 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 18, 2018 In Use
59353-0220-10 59353-0220 Epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL, 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov 9, 2020 In Use
70518-2895-00 70518-2895 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sep 25, 2020 In Use
63459-0912-11 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 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
35356-0755-65 35356-0755 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 31, 2007 Oct 11, 2019 In Use
25000-0011-07 25000-0011 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Apr 27, 2017 In Use
64380-0763-05 64380-0763 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 10, 2016 In Use
57237-0077-30 57237-0077 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 12, 2010 In Use
63187-0065-20 63187-0065 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 1, 2014 In Use
51079-0582-01 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug 27, 1997 No Longer Used
80425-0072-03 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
00527-1450-06 00527-1450 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral May 18, 2018 In Use
70860-0777-20 70860-0777 Ondansetron hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Mar 1, 2018 Feb 28, 2023 No Longer Used
21695-0835-30 21695-0835 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 In Use
57902-0860-03 57902-0860 Samarium SM 153 Lexidronam Quadramet 50.0 mCi/mL Ancillary Therapy Radiopharmaceutical Samarium Sm 153 Intravenous May 19, 1997 In Use
72205-0026-01 72205-0026 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 5, 2019 Jan 15, 2025 No Longer Used

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