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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class (Ascending) Administration Route Package Effective Date Package Discontinuation Date Status
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
68001-0286-39 68001-0286 Leucovorin Calcium Leucovorin 20.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 1, 2016 Feb. 1, 2021 No Longer Used
16714-0915-01 16714-0915 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
45963-0762-57 45963-0762 Levoleucovorin Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Feb. 14, 2017 July 31, 2019 In Use
67457-0600-20 67457-0600 Levoleucovorin LEVOLEUCOVORIN CALCIUM 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Oct. 21, 2015 April 30, 2019 No Longer Used
67457-0601-30 67457-0601 Levoleucovorin LEVOLEUCOVORIN CALCIUM 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Oct. 21, 2015 April 30, 2019 No Longer Used
68152-0101-00 68152-0101 Levoleucovorin Fusilev 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 15, 2008 Feb. 28, 2019 No Longer Used
68152-0102-01 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 15, 2011 Feb. 28, 2019 No Longer Used
68152-0102-02 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 15, 2011 Feb. 28, 2019 No Longer Used
68152-0112-01 68152-0112 levoleucovorin KHAPZORY 175.0 mg/3.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan. 2, 2019 In Use
68152-0114-01 68152-0114 levoleucovorin KHAPZORY 300.0 mg/6mL Ancillary Therapy Antiemetic Antidote Intravenous Jan. 2, 2019 In Use
50742-0464-50 50742-0464 Leucovorin Calcium Leucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Nov. 23, 2018 In Use
72893-0006-01 72893-0006 Levoleucovorin KHAPZORY 300.0 mg/6mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan. 2, 2019 Oct. 31, 2023 No Longer Used
51079-0582-01 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug. 27, 1997 No Longer Used
51079-0582-05 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug. 27, 1997 June 30, 2023 No Longer Used
00703-5140-01 00703-5140 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Feb. 1, 1994 Sept. 30, 2023 No Longer Used
00703-5145-01 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous June 12, 1997 Sept. 30, 2023 No Longer Used
00703-5145-91 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 13, 2013 April 30, 2023 No Longer Used
14335-0340-01 14335-0340 Levoleucovorin injection LEVOLEUCOVORIN CALCIUM 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous May 31, 2023 In Use
14335-0341-01 14335-0341 Levoleucovorin injection LEVOLEUCOVORIN CALCIUM 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intravenous May 31, 2023 In Use
70436-0116-82 70436-0116 Leucovorin calcium Leucovorin Calcium 50.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 10, 2023 In Use
70436-0117-80 70436-0117 Leucovorin calcium Leucovorin Calcium 100.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 10, 2023 In Use
70436-0118-80 70436-0118 Leucovorin calcium Leucovorin Calcium 200.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 10, 2023 In Use
70436-0120-80 70436-0120 Leucovorin calcium Leucovorin Calcium 500.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 10, 2023 In Use
70436-0209-80 70436-0209 Levoleucovorin injection LEVOLEUCOVORIN CALCIUM 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 1, 2023 In Use
70436-0210-80 70436-0210 Levoleucovorin injection LEVOLEUCOVORIN CALCIUM 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 1, 2023 In Use
71288-0160-10 71288-0160 Leucovorin calcium Leucovorin calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 19, 2023 In Use
71288-0161-20 71288-0161 Leucovorin calcium Leucovorin calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 19, 2023 In Use
71288-0162-30 71288-0162 Leucovorin calcium Leucovorin calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 19, 2023 In Use
71288-0163-30 71288-0163 Leucovorin calcium Leucovorin calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 19, 2023 In Use
71288-0164-50 71288-0164 Leucovorin calcium Leucovorin calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 19, 2023 In Use
00555-0882-02 00555-0882 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Oct. 19, 1998 In Use
49884-0724-01 49884-0724 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Feb. 24, 1999 In Use
54868-4773-00 54868-4773 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral April 11, 2003 In Use
54868-4773-01 54868-4773 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral April 11, 2003 In Use
54868-4773-02 54868-4773 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral April 11, 2003 In Use
54868-4773-03 54868-4773 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral April 11, 2003 In Use
54868-4773-04 54868-4773 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral April 11, 2003 In Use
55154-7143-00 55154-7143 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Aug. 12, 2008 In Use
70518-0916-00 70518-0916 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Dec. 20, 2017 In Use
70518-0916-01 70518-0916 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Dec. 18, 2019 In Use
69315-0164-01 69315-0164 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral July 9, 2020 In Use
42291-0321-01 42291-0321 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral July 23, 2013 In Use
24535-0831-01 24535-0831 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Aug. 20, 2017 In Use
00003-0830-50 00003-0830 Hydroxyurea Hydrea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral June 1, 2009 March 31, 2025 In Use
70518-3615-00 70518-3615 HYDROXYUREA HYDROXYUREA 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Jan. 10, 2023 In Use
10135-0702-01 10135-0702 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Jan. 28, 2022 In Use
60429-0265-01 60429-0265 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Oct. 26, 2012 Dec. 31, 2024 In Use
68084-0284-01 68084-0284 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Sept. 17, 2008 In Use
68084-0284-11 68084-0284 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Aug. 13, 2008 In Use
00074-0561-11 00074-0561 Venetoclax Venclexta 10.0 mg/1 Chemotherapy Enzyme Inhibitor BCL-2 Oral April 11, 2016 In Use
00074-0561-14 00074-0561 Venetoclax Venclexta 10.0 mg/1 Chemotherapy Enzyme Inhibitor BCL-2 Oral April 11, 2016 In Use
00074-0566-07 00074-0566 Venetoclax Venclexta 50.0 mg/1 Chemotherapy Enzyme Inhibitor BCL-2 Oral April 11, 2016 In Use
00074-0566-11 00074-0566 Venetoclax Venclexta 50.0 mg/1 Chemotherapy Enzyme Inhibitor BCL-2 Oral April 11, 2016 In Use
00074-0579-28 00074-0579 Venetoclax Venclexta Chemotherapy Enzyme Inhibitor BCL-2 Oral April 11, 2016 In Use
00074-0576-11 00074-0576 Venetoclax Venclexta 100.0 mg/1 Chemotherapy Enzyme Inhibitor BCL-2 Oral April 11, 2016 In Use
00074-0576-22 00074-0576 Venetoclax Venclexta 100.0 mg/1 Chemotherapy Enzyme Inhibitor BCL-2 Oral April 11, 2016 In Use
00074-0576-30 00074-0576 Venetoclax Venclexta 100.0 mg/1 Chemotherapy Enzyme Inhibitor BCL-2 Oral June 15, 2022 In Use
00074-0576-34 00074-0576 Venetoclax Venclexta 100.0 mg/1 Chemotherapy Enzyme Inhibitor BCL-2 Oral Nov. 21, 2018 In Use
57894-0111-01 57894-0111 ciltacabtagene autoleucel CARVYKTI 100000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous Feb. 28, 2022 In Use
57894-0111-02 57894-0111 ciltacabtagene autoleucel CARVYKTI 100000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous Feb. 28, 2022 In Use
59572-0515-01 59572-0515 idecabtagene vicleucel Abecma 300000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous March 26, 2021 In Use
59572-0515-02 59572-0515 idecabtagene vicleucel Abecma 300000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous March 26, 2021 In Use
59572-0515-03 59572-0515 idecabtagene vicleucel Abecma 300000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous March 26, 2021 In Use
00173-0896-01 00173-0896 Belantamab Blenrep 50.0 mg/mL Immunotherapy Drug Antibody Conjugate BCMA Intravenous Aug. 5, 2020 June 30, 2024 In Use
57894-0449-01 57894-0449 Teclistamab TECVAYLI 10.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct. 25, 2022 In Use
57894-0450-01 57894-0450 Teclistamab TECVAYLI 90.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct. 25, 2022 In Use
63539-0252-02 63539-0252 Elranatamab-bcmm Elrexfio 44.0 mg/1.1mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Aug. 15, 2023 In Use
00069-4494-02 00069-4494 Elranatamab-bcmm Elrexfio 76.0 mg/1.9mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Aug. 15, 2023 In Use
00069-2522-02 00069-2522 Elranatamab-bcmm Elrexfio 44.0 mg/1.1mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Aug. 15, 2023 In Use
00003-0524-11 00003-0524 Dasatinib Sprycel 70.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral June 27, 2006 In Use
00003-0527-11 00003-0527 Dasatinib Sprycel 20.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral June 27, 2006 In Use
00003-0528-11 00003-0528 Dasatinib Sprycel 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral June 27, 2006 In Use
00003-0855-22 00003-0855 Dasatinib Sprycel 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 28, 2010 In Use
00003-0857-22 00003-0857 Dasatinib Sprycel 140.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 28, 2010 In Use
54868-5759-00 54868-5759 Dasatinib Sprycel 70.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 12, 2007 In Use
00078-0401-34 00078-0401 Imatinib Mesylate Gleevec 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral May 15, 2001 In Use
00093-7629-98 00093-7629 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 4, 2016 In Use
00093-7630-56 00093-7630 Imatinib Mesylate Imatinib Mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 4, 2016 In Use
47335-0472-13 47335-0472 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 1, 2016 In Use
47335-0472-81 47335-0472 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 1, 2016 In Use
47335-0472-83 47335-0472 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 1, 2016 In Use
47335-0472-88 47335-0472 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 1, 2016 In Use
54868-5289-00 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5289-01 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5289-02 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5289-03 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5289-04 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5427-00 54868-5427 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Nov. 9, 2005 June 30, 2013 No Longer Used
54868-5427-01 54868-5427 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Nov. 9, 2005 June 30, 2013 No Longer Used
54868-5427-02 54868-5427 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Nov. 9, 2005 June 30, 2013 No Longer Used
54868-5427-03 54868-5427 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Nov. 9, 2005 June 30, 2013 No Longer Used
60429-0926-30 60429-0926 Imatinib Mesylate Imatinib Mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 30, 2016 In Use
60505-2900-00 60505-2900 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 5, 2016 In Use
60505-2900-01 60505-2900 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 5, 2016 In Use
60505-2900-03 60505-2900 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 5, 2016 In Use
60505-2900-08 60505-2900 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 5, 2016 In Use
60505-2900-09 60505-2900 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 5, 2016 In Use
60505-2901-00 60505-2901 Imatinib Mesylate Imatinib Mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 5, 2016 In Use

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