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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
00404-9930-02 00404-9930 ONDANSETRON ONDANSETRON 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Jan. 13, 2022 In Use
00404-9957-02 00404-9957 Methylprednisolone Sodium Succinate Solu-Medrol 125.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Jan. 12, 2022 In Use
00404-9958-01 00404-9958 Methylprednisolone Sodium Succinate Solu-Medrol 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Jan. 12, 2022 In Use
25021-0813-10 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 15, 2012 In Use
25021-0813-66 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 July 31, 2020 In Use
25021-0814-30 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 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 Sept. 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 Sept. 30, 2020 In Use
25021-0816-30 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 15, 2012 In Use

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