NDC-11 (Package) | NDC-9 (Product) | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Class | Minor Class (Descending) | Administration Route | Package Effective Date | Package Discontinuation Date | Status |
---|---|---|---|---|---|---|---|---|---|---|---|
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 | |
14335-0340-01 | 14335-0340 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 31, 2023 | In Use |
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