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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date (Ascending) Status
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
71288-0409-05 71288-0409 Palonosetron Hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Aug. 14, 2023 In Use
72189-0430-10 72189-0430 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 3, 2023 In Use
72189-0430-20 72189-0430 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 3, 2023 In Use
72189-0430-21 72189-0430 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 3, 2023 In Use
72189-0430-05 72189-0430 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 3, 2023 In Use
80425-0346-01 80425-0346 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 31, 2023 In Use

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