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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
25021-0813-66 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Jul 31, 2020 In Use
25021-0814-30 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
25021-0814-67 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Dec 31, 2020 In Use
25021-0815-30 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Sep 30, 2020 In Use
25021-0816-30 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 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
25021-0820-05 25021-0820 Methylprednisolone acetate Methylprednisolone acetate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intrasynovial, Soft Tissue Nov 15, 2021 In Use
25021-0820-10 25021-0820 Methylprednisolone acetate Methylprednisolone acetate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intrasynovial, Soft Tissue Nov 15, 2021 In Use
25021-0821-05 25021-0821 Methylprednisolone acetate Methylprednisolone acetate 80.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intrasynovial, Soft Tissue Nov 15, 2021 In Use
25021-0824-06 25021-0824 Topotecan Hydrochloride Topotecan Hydrochloride 4.0 mg/4mL Chemotherapy Topoisomerase I Inhibitor Camptothecin Analogs Intravenous Jun 27, 2011 Mar 31, 2017 In Use
25021-0826-66 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Sep 1, 2015 Nov 30, 2018 In Use
25021-0826-67 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Sep 1, 2015 In Use
25021-0826-82 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Mar 2, 2013 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
29336-0610-12 29336-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical Sep 24, 2010 Jan 31, 2015 No Longer Used
29336-0610-24 29336-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical Jun 24, 2011 Jun 24, 2011 No Longer Used
30237-8900-06 30237-8900 Sipuleucel-T Provenge 50000000.0 1/1 Immunotherapy Immunomodulator Prostatic Acid Phosphatase Intravenous Apr 29, 2010 In Use
30698-0017-01 30698-0017 Bromocriptine Mesylate Parlodel Chemotherapy Dopamine Agonist Ergot Derivative Oral Jun 28, 1978 Apr 23, 2014 No Longer Used
30698-0017-30 30698-0017 Bromocriptine Mesylate Parlodel Chemotherapy Dopamine Agonist Ergot Derivative Oral Jun 28, 1978 Apr 23, 2014 No Longer Used
30698-0102-30 30698-0102 Bromocriptine Mesylate Parlodel Chemotherapy Dopamine Agonist Ergot Derivative Oral Jun 28, 1978 Apr 23, 2014 No Longer Used
30698-0120-05 30698-0120 Dolasetron mesylate Anzemet 50.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 11, 1997 May 24, 2021 In Use
30698-0121-05 30698-0121 Dolasetron mesylate Anzemet 100.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 11, 1997 May 24, 2021 In Use
30698-0201-01 30698-0201 Bromocriptine Mesylate Parlodel 5.0 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral Apr 28, 2014 In Use
30698-0201-30 30698-0201 Bromocriptine Mesylate Parlodel 5.0 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral Apr 28, 2014 In Use

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