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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Ascending) Package Effective Date Package Discontinuation Date Status
68001-0418-38 68001-0418 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 26, 2019 In Use
68001-0417-37 68001-0417 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 26, 2019 In Use
68001-0416-36 68001-0416 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 26, 2019 In Use
51662-1367-01 51662-1367 Metoclopramide Metoclopramide 10.0 mg/2mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Oct. 14, 2019 In Use
51662-1469-01 51662-1469 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 14, 2019 In Use
51662-1366-01 51662-1366 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 8, 2019 In Use
51662-1377-01 51662-1377 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous May 21, 2020 In Use
72572-0520-25 72572-0520 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 18, 2019 In Use
67157-0111-05 67157-0111 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular In Use
67157-0111-25 67157-0111 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular Dec. 2, 2016 Dec. 2, 2016 In Use
55150-0311-00 55150-0311 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 1250.0 mg/5mL Hormonal Therapy Progestin Intramuscular May 9, 2019 Oct. 9, 2019 In Use
55150-0311-01 55150-0311 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 1250.0 mg/5mL Hormonal Therapy Progestin Intramuscular May 9, 2019 In Use
55150-0311-05 55150-0311 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 1250.0 mg/5mL Hormonal Therapy Progestin Intramuscular May 9, 2019 In Use
68727-0900-03 68727-0900 asparaginase erwinia chrysanthemi (recombinant)-rywn Rylaze 20.0 mg/mL Chemotherapy Miscellaneous Agent Enzyme Intramuscular June 30, 2021 In Use
55154-2872-05 55154-2872 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 19, 2010 Aug. 31, 2013 No Longer Used
70518-0654-00 70518-0654 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous July 31, 2017 March 8, 2018 No Longer Used
70518-0956-00 70518-0956 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Jan. 12, 2018 March 7, 2018 No Longer Used
25021-0828-50 25021-0828 Leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous April 15, 2018 In Use
00409-5255-25 00409-5255 Metoclopramide Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Nov. 14, 2022 In Use
51662-1261-01 51662-1261 Hydrocortisone Sodium Succinate SOLU-CORTEF 100.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Sept. 3, 2018 In Use
51662-1261-03 51662-1261 Hydrocortisone Sodium Succinate SOLU-CORTEF 100.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Nov. 10, 2022 In Use
00574-0870-05 00574-0870 Estradiol Valerate Estradiol Valerate 20.0 mg/mL Hormonal Therapy Estrogen Intramuscular March 31, 2010 In Use
00574-0872-05 00574-0872 Estradiol Valerate Estradiol Valerate 40.0 mg/mL Hormonal Therapy Estrogen Intramuscular March 31, 2010 In Use
55154-5118-05 55154-5118 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Sept. 7, 1982 In Use
55154-5118-08 55154-5118 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Sept. 7, 1982 In Use

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