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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
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
62559-0921-14 62559-0921 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0921-51 62559-0921 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0922-14 62559-0922 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0922-51 62559-0922 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0923-14 62559-0923 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used

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