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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 (Ascending) Package Discontinuation Date Status
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
72694-0515-01 72694-0515 Calaspargase Pegol Asparlas 750.0 U/mL Chemotherapy Miscellaneous Agent Enzyme Intravenous Sept. 27, 2019 In Use
50090-0627-03 50090-0627 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Sept. 30, 2019 In Use
23155-0649-41 23155-0649 CARMUSTINE CARMUSTINE Chemotherapy Alkylating Agent Nitrosourea Intravenous Oct. 1, 2019 In Use
63187-0300-28 63187-0300 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2019 In Use
50268-0476-15 50268-0476 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct. 2, 2019 In Use
60760-0277-10 60760-0277 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 2, 2019 In Use
00310-7720-10 00310-7720 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Oct. 8, 2019 March 31, 2023 No Longer Used

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