NDC-11 (Package) | NDC-9 (Product) | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Class (Ascending) | Minor Class | Administration Route | Package Effective Date | Package Discontinuation Date | Status |
---|---|---|---|---|---|---|---|---|---|---|---|
69315-0184-01 | 69315-0184 | Leucovorin calcium | Leucovorin calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0184-03 | 69315-0184 | Leucovorin calcium | Leucovorin calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0185-12 | 69315-0185 | Leucovorin calcium | Leucovorin calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0185-24 | 69315-0185 | Leucovorin calcium | Leucovorin calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0186-24 | 69315-0186 | Leucovorin calcium | Leucovorin calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0187-25 | 69315-0187 | Leucovorin calcium | Leucovorin calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
72893-0004-01 | 72893-0004 | Levoleucovorin | KHAPZORY | 175.0 mg/3.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan. 2, 2019 | In Use | |
00781-3201-94 | 00781-3201 | Levoleucovorin | Levoleucovorin | 175.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | April 23, 2015 | April 30, 2023 | No Longer Used |
42806-0134-34 | 42806-0134 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan. 1, 2021 | In Use | |
42806-0134-24 | 42806-0134 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan. 1, 2021 | In Use | |
62756-0581-40 | 62756-0581 | Amifostine | Amifostine | 50.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | March 14, 2008 | March 31, 2012 | No Longer Used |
62756-0581-42 | 62756-0581 | Amifostine | Amifostine | 50.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | March 14, 2008 | March 31, 2012 | No Longer Used |
63323-0710-50 | 63323-0710 | Leucovorin Calcium | Leucovorin Calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sept. 18, 2010 | In Use | |
63323-0710-59 | 63323-0710 | Leucovorin Calcium | Leucovorin Calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sept. 18, 2010 | In Use | |
63323-0711-00 | 63323-0711 | Leucovorin Calcium | Leucovorin Calcium | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sept. 18, 2010 | In Use | |
66220-0017-03 | 66220-0017 | Amifostine | Ethyol | 500.0 mg/10mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Aug. 1, 2016 | Oct. 31, 2020 | No Longer Used |
68001-0285-22 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 1, 2016 | Feb. 1, 2021 | No Longer Used |
68001-0285-28 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 1, 2016 | Feb. 1, 2021 | No Longer Used |
68001-0285-29 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Oct. 25, 2016 | Feb. 1, 2021 | No Longer Used |
68001-0285-36 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 1, 2016 | Feb. 1, 2021 | No Longer Used |
68001-0285-37 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 1, 2016 | Feb. 1, 2021 | No Longer Used |
68001-0285-38 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 1, 2016 | Oct. 25, 2016 | No Longer Used |
68001-0285-39 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 1, 2016 | Oct. 25, 2016 | No Longer Used |
68001-0285-40 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 1, 2016 | Feb. 1, 2021 | No Longer Used |
68001-0286-38 | 68001-0286 | Leucovorin Calcium | Leucovorin | 20.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 1, 2016 | Feb. 1, 2021 | No Longer Used |
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