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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Ascending) Package Effective Date Package Discontinuation Date Status
71288-0160-10 71288-0160 Leucovorin calcium Leucovorin calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 19, 2023 In Use
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
80425-0232-01 80425-0232 Dexamethasone Sodium Phosphate, Povidine Iodine DoubleDex Kit 10.0 mg/ml Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous, Topical May 12, 2023 In Use
67457-0886-05 67457-0886 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular Sept. 22, 2017 June 30, 2024 In Use
82449-0200-03 82449-0200 Ondansetron hydrochloride Ondansetron hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sept. 30, 2023 In Use
82449-0201-01 82449-0201 Ondansetron hydrochloride Ondansetron hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sept. 30, 2023 In Use
70534-0002-01 70534-0002 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Nov. 21, 2019 In Use
00781-3532-12 00781-3532 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Nov. 1, 2023 In Use
70518-2023-00 70518-2023 Methylprednisolone sodium succinate SOLU-MEDROL 125.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous April 15, 2019 July 10, 2020 In Use
70518-2023-01 70518-2023 Methylprednisolone sodium succinate SOLU-MEDROL 125.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous April 15, 2019 July 10, 2020 In Use
70518-2023-02 70518-2023 Methylprednisolone sodium succinate SOLU-MEDROL 125.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Aug. 27, 2021 Aug. 30, 2021 In Use
70529-0045-01 70529-0045 Dexamethasone Sodium Phosphate Viadox 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Aug. 1, 2018 In Use
70529-0045-02 70529-0045 Dexamethasone Sodium Phosphate Viadox 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Aug. 1, 2018 In Use
70529-0045-05 70529-0045 Dexamethasone Sodium Phosphate Viadox 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Aug. 1, 2018 In Use
70518-0532-00 70518-0532 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous May 15, 2017 Jan. 12, 2018 No Longer Used
70518-0532-01 70518-0532 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous May 17, 2017 Jan. 12, 2018 No Longer Used
00703-3154-01 00703-3154 Bleomycin Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous June 30, 2000 July 31, 2023 No Longer Used
00703-3155-01 00703-3155 Bleomycin Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous June 30, 2000 Aug. 31, 2023 No Longer Used
00703-5140-01 00703-5140 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Feb. 1, 1994 Sept. 30, 2023 No Longer Used
00703-5145-01 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous June 12, 1997 Sept. 30, 2023 No Longer Used
00703-5145-91 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 13, 2013 April 30, 2023 No Longer Used
25021-0462-74 25021-0462 fulvestrant fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Aug. 1, 2019 April 30, 2023 In Use

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