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 |
---|---|---|---|---|---|---|---|---|---|---|---|
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 | |
25021-0816-67 | 25021-0816 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Dec. 1, 2013 | Jan. 31, 2022 | In Use |
60687-0227-11 | 60687-0227 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan. 24, 2017 | In Use | |
60687-0227-94 | 60687-0227 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan. 24, 2017 | In Use | |
70121-1572-01 | 70121-1572 | Levoleucovorin | Levoleucovorin Calcium | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sept. 8, 2017 | In Use | |
67457-0528-10 | 67457-0528 | LEUCOVORIN CALCIUM | LEUCOVORIN CALCIUM | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 23, 2019 | In Use | |
67457-0529-20 | 67457-0529 | LEUCOVORIN CALCIUM | LEUCOVORIN CALCIUM | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 23, 2019 | In Use | |
00591-4130-54 | 00591-4130 | Levoleucovorin | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Feb. 6, 2017 | May 31, 2019 | No Longer Used |
71288-0105-18 | 71288-0105 | Levoleucovorin calcium | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 16, 2019 | In Use | |
71288-0105-25 | 71288-0105 | Levoleucovorin calcium | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 16, 2019 | In Use | |
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 | |
72266-0120-01 | 72266-0120 | Levoleucovorin | levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | June 25, 2019 | In Use | |
72266-0121-01 | 72266-0121 | Levoleucovorin | levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | June 25, 2019 | 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 | |
50742-0494-17 | 50742-0494 | Levoleucovorin | LEVOLEUCOVORIN | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 8, 2018 | July 31, 2021 | In Use |
50742-0495-25 | 50742-0495 | Levoleucovorin | LEVOLEUCOVORIN | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 8, 2018 | June 30, 2021 | In Use |
25021-0828-50 | 25021-0828 | Leucovorin calcium | Leucovorin Calcium | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | April 15, 2018 | In Use | |
71288-0104-10 | 71288-0104 | Levoleucovorin calcium | Levoleucovorin | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 22, 2019 | April 30, 2024 | In Use |
16714-0890-01 | 16714-0890 | LEVOLEUCOVORIN | LEVOLEUCOVORIN | 175.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sept. 26, 2018 | In Use | |
51079-0581-01 | 51079-0581 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb. 26, 1996 | In Use | |
51079-0581-06 | 51079-0581 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb. 26, 1996 | In Use | |
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 | |
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 | |
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 |
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