NDC-11 (Package) | NDC-9 (Product) | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Class (Descending) | Minor Class | Administration Route | Package Effective Date | Package Discontinuation Date | Status |
---|---|---|---|---|---|---|---|---|---|---|---|
16714-0890-01 | 16714-0890 | LEVOLEUCOVORIN | LEVOLEUCOVORIN | 175.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sept. 26, 2018 | In Use | |
51079-0581-01 | 51079-0581 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb. 26, 1996 | In Use | |
51079-0581-06 | 51079-0581 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb. 26, 1996 | In Use | |
69315-0184-01 | 69315-0184 | Leucovorin calcium | Leucovorin calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
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 | |
67457-0207-25 | 67457-0207 | Dexrazoxane | Dexrazoxane Hydrochloride | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Nov. 18, 2011 | In Use | |||
67457-0208-50 | 67457-0208 | Dexrazoxane | Dexrazoxane Hydrochloride | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Nov. 18, 2011 | In Use | |||
51991-0942-98 | 51991-0942 | Dexrazoxane Hydrochloride | Dexrazoxane | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | June 26, 2017 | Aug. 31, 2024 | 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 | |
14335-0341-01 | 14335-0341 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 31, 2023 | In Use | |
70436-0116-82 | 70436-0116 | Leucovorin calcium | Leucovorin Calcium | 50.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 10, 2023 | In Use | |
70436-0117-80 | 70436-0117 | Leucovorin calcium | Leucovorin Calcium | 100.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 10, 2023 | In Use | |
70436-0118-80 | 70436-0118 | Leucovorin calcium | Leucovorin Calcium | 200.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 10, 2023 | In Use | |
70436-0120-80 | 70436-0120 | Leucovorin calcium | Leucovorin Calcium | 500.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 10, 2023 | In Use | |
70436-0209-80 | 70436-0209 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 1, 2023 | In Use | |
70436-0210-80 | 70436-0210 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 1, 2023 | In Use | |
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 | |
51079-0582-01 | 51079-0582 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Aug. 27, 1997 | No Longer Used | |
51079-0582-05 | 51079-0582 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Aug. 27, 1997 | June 30, 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 |
72893-0006-01 | 72893-0006 | Levoleucovorin | KHAPZORY | 300.0 mg/6mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan. 2, 2019 | Oct. 31, 2023 | No Longer Used |
68083-0388-01 | 68083-0388 | Dexrazoxane for Injection | Dexrazoxane | 250.0 mg/25mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Dec. 16, 2019 | In Use | |
00003-7125-11 | 00003-7125 | nivolumab and relatlimab-rmbw | OPDUALAG | 12.0 mg/mL, 4.0 mg/mL | Immunotherapy | Checkpoint Inhibitor, Monoclonal Antibody | PD-1, LAG3 | Intravenous | March 18, 2022 | In Use | |
44087-3535-01 | 44087-3535 | Avelumab | Bavencio | 20.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | PD-L1 | Intravenous | March 23, 2017 | In Use | |
00003-2327-11 | 00003-2327 | Ipilimumab | Yervoy | 5.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | CTLA-4 | Intravenous | March 25, 2011 | In Use | |
00003-2328-22 | 00003-2328 | Ipilimumab | Yervoy | 5.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | CTLA-4 | Intravenous | March 25, 2011 | In Use | |
00006-3029-02 | 00006-3029 | Pembrolizumab | Keytruda | 50.0 mg/2mL | Immunotherapy | Checkpoint Inhibitor | PD-1 | Intravenous | Sept. 4, 2014 | Dec. 21, 2015 | In Use |
00003-3756-14 | 00003-3756 | nivolumab | OPDIVO | 10.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | PD-1 | Intravenous | Aug. 30, 2021 | In Use | |
00310-4500-12 | 00310-4500 | Durvalumab | Imfinzi | 120.0 mg/2.4mL | Immunotherapy | Checkpoint Inhibitor | PD-L1 | Intravenous | May 1, 2017 | In Use | |
00310-4611-50 | 00310-4611 | Durvalumab | Imfinzi | 500.0 mg/10mL | Immunotherapy | Checkpoint Inhibitor | PD-L1 | Intravenous | May 1, 2017 | In Use | |
61755-0008-01 | 61755-0008 | cemiplimab-rwlc | LIBTAYO | 50.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | PD-1 | Intravenous | Sept. 28, 2018 | In Use | |
00003-3772-11 | 00003-3772 | Nivolumab | Opdivo | 10.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | PD-1 | Intravenous | Dec. 22, 2014 | In Use | |
00003-3774-12 | 00003-3774 | Nivolumab | Opdivo | 10.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | PD-1 | Intravenous | Dec. 22, 2014 | In Use | |
00006-3026-02 | 00006-3026 | Pembrolizumab | Keytruda | 25.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | PD-1 | Intravenous | Jan. 15, 2015 | In Use | |
00006-3026-04 | 00006-3026 | Pembrolizumab | Keytruda | 25.0 mg/mL | Immunotherapy | Checkpoint Inhibitor | PD-1 | Intravenous | Aug. 1, 2019 | In Use | |
50242-0917-01 | 50242-0917 | Atezolizumab | Tecentriq | 1200.0 mg/20mL | Immunotherapy | Checkpoint Inhibitor | PD-L1 | Intravenous | May 18, 2016 | In Use |
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