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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
00310-4715-11 00310-4715 IV Solution Stabilizer for Lumoxiti IV Solution Stabilizer for Lumoxiti 6.5 mg/mL Ancillary Therapy Excipient Intravenous Oct. 24, 2018 In Use
60505-4631-03 60505-4631 Cyclosporine CycloSPORINE, Modfied 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 5, 2019 Aug. 31, 2023 In Use
70518-1966-00 70518-1966 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 19, 2019 In Use
70518-2256-00 70518-2256 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 7, 2019 In Use
63850-0004-01 63850-0004 Ondansetron Tablets Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
78206-0153-01 78206-0153 FINASTERIDE PROSCAR 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral June 1, 2021 In Use
78206-0153-02 78206-0153 FINASTERIDE PROSCAR 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral June 1, 2021 In Use
00093-9018-65 00093-9018 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 8, 2021 In Use
00093-9019-65 00093-9019 Cyclosporine Cyclosporine 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 8, 2021 In Use
00093-9020-65 00093-9020 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 8, 2021 In Use
42806-0133-21 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 1, 2021 In Use
42806-0133-24 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 1, 2021 In Use
71205-0908-00 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-11 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-30 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-60 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-90 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
72205-0083-01 72205-0083 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous May 12, 2020 In Use
70625-0300-01 70625-0300 Fosaprepitant Dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 5, 2019 In Use
70625-0311-01 70625-0311 FOSAPREPITANT FOSAPREPITANT 150.0 mg/mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 3, 2021 In Use
72603-0106-01 72603-0106 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 Oct. 1, 2022 No Longer Used
63323-0317-01 63323-0317 Granisetron hydrochloride Granisetron 0.1 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 20, 2009 May 31, 2016 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
42858-0868-06 42858-0868 DRONABINOL DRONABINOL 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral June 26, 2018 In Use
42858-0867-06 42858-0867 DRONABINOL DRONABINOL 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral June 26, 2018 In Use
42543-0139-90 42543-0139 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral June 29, 2018 June 30, 2018 No Longer Used
68382-0641-06 68382-0641 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 16, 2018 April 26, 2019 No Longer Used
68382-0641-16 68382-0641 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 16, 2018 April 26, 2019 No Longer Used
53345-0037-01 53345-0037 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral April 25, 2018 In Use
51013-0190-09 51013-0190 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 29, 2018 In Use
51013-0190-30 51013-0190 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 29, 2018 In Use
70771-1347-03 70771-1347 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 16, 2018 In Use
70771-1347-09 70771-1347 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 16, 2018 In Use
70771-1152-01 70771-1152 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 In Use
70771-1152-00 70771-1152 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 In Use
70771-1152-04 70771-1152 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 In Use
70771-1152-03 70771-1152 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 In Use
67046-0695-30 67046-0695 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 30, 2018 Sept. 11, 2018 No Longer Used
68382-0074-01 68382-0074 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 In Use
68382-0074-06 68382-0074 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 In Use
68382-0074-10 68382-0074 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 In Use
68382-0074-30 68382-0074 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 Dec. 3, 2019 In Use
68382-0074-77 68382-0074 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 5, 2017 In Use
67457-0863-01 67457-0863 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous March 21, 2018 In Use
47781-0622-22 47781-0622 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous March 29, 2018 March 1, 2020 In Use
47781-0622-91 47781-0622 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous March 29, 2018 March 1, 2020 In Use
68083-0161-10 68083-0161 Mesna Injection Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec. 20, 2017 In Use
68083-0161-01 68083-0161 Mesna Injection Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec. 20, 2017 In Use

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