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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category (Ascending) Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
31722-0165-31 31722-0165 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous July 29, 2021 In Use
68001-0517-36 68001-0517 fosaprepitant fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Aug. 23, 2021 In Use
72266-0235-01 72266-0235 Dexrazoxane for Injection Dexrazoxane 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Nov. 1, 2021 In Use
63629-8862-01 63629-8862 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Sept. 30, 2021 In Use
63629-8861-01 63629-8861 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Sept. 30, 2021 In Use
51662-1539-01 51662-1539 ONDANSETRON ONDANSETRON 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 6, 2021 In Use
64764-0800-28 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
64764-0800-56 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
36000-0326-02 36000-0326 palonosetron hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 12, 2021 In Use
42747-0726-01 42747-0726 Granisetron Sancuso 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Sept. 12, 2008 In Use
42747-0726-72 42747-0726 Granisetron Sancuso 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Sept. 12, 2008 In Use
80425-0072-01 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0072-02 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0072-03 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0072-04 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0072-05 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-01 80425-0075 Ondansetron HCL, Ondansetron HCl 8mg Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-02 80425-0075 Ondansetron HCL, Ondansetron HCl 8mg Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-03 80425-0075 Ondansetron HCL, Ondansetron HCl 8mg Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-04 80425-0075 Ondansetron HCL, Ondansetron HCl 8mg Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
00093-5741-19 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 In Use
00093-5741-65 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 In Use
00093-5742-19 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 In Use
00093-5742-65 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 In Use
00173-0712-02 00173-0712 Dutasteride Avodart 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 10, 2002 April 30, 2018 In Use

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