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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Descending) Package Effective Date Package Discontinuation Date Status
25021-0201-68 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous April 30, 2013 Sept. 13, 2019 In Use
25021-0201-69 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous April 30, 2013 Sept. 13, 2019 In Use
25021-0813-10 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 15, 2012 In Use
25021-0813-66 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 July 31, 2020 In Use
25021-0814-30 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 15, 2012 In Use
25021-0814-67 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 Dec. 31, 2020 In Use
25021-0815-30 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 15, 2012 In Use
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 Sept. 30, 2020 In Use
25021-0816-30 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 15, 2012 In Use
25021-0816-67 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 Jan. 31, 2022 In Use
25021-0826-66 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Sept. 1, 2015 Nov. 30, 2018 In Use
25021-0826-67 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Sept. 1, 2015 In Use
25021-0826-82 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous March 2, 2013 In Use
23155-0549-31 23155-0549 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous June 15, 2012 In Use
23155-0550-31 23155-0550 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 9, 2015 In Use
25021-0777-02 25021-0777 ondansetron hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Aug. 30, 2012 In Use
50090-1892-00 50090-1892 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous June 22, 2015 July 31, 2017 No Longer Used
55150-0125-02 55150-0125 Ondansetron Hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 21, 2012 In Use
55150-0126-20 55150-0126 Ondansetron Hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 21, 2012 In Use
55154-2876-05 55154-2876 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 26, 2006 In Use
55154-2877-05 55154-2877 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 26, 2006 In Use
60505-6130-00 60505-6130 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous May 26, 2016 In Use
60505-6130-05 60505-6130 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous May 26, 2016 In Use
63323-0373-02 63323-0373 ONDANSETRON HYDROCHLORIDE Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 18, 2009 In Use
63323-0374-20 63323-0374 ONDANSETRON HYDROCHLORIDE Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 18, 2009 In Use
67184-0507-01 67184-0507 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sept. 8, 2014 In Use
67184-0507-05 67184-0507 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sept. 8, 2014 In Use
68083-0113-01 68083-0113 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sept. 25, 2009 In Use
68083-0114-01 68083-0114 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous June 15, 2012 In Use
76045-0103-20 76045-0103 ONDANSETRON HYDROCHLORIDE Ondansetron 4.0 mg/2mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 10, 2015 In Use
67184-0540-01 67184-0540 Fosaprepitant dimeglumine FOSAPREPITANT DIMEGLUMINE 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 8, 2020 In Use
25021-0802-10 25021-0802 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan. 15, 2010 Dec. 31, 2014 No Longer Used
25021-0803-10 25021-0803 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan. 15, 2010 Dec. 31, 2014 No Longer Used
42023-0167-01 42023-0167 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous May 7, 2013 March 16, 2020 No Longer Used
52584-0450-39 52584-0450 Metoclopramide Hydrochloride Metoclopramide 10.0 mg/2mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intramuscular, intravenous, Intravenous Aug. 1, 2010 Jan. 17, 2017 No Longer Used
52584-0451-82 52584-0451 Metoclopramide Hydrochloride Reglan 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intramuscular, intravenous, Intravenous Aug. 1, 2010 Sept. 1, 2012 No Longer Used
55154-0452-05 55154-0452 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Dec. 9, 2010 March 31, 2013 No Longer Used
67457-0148-00 67457-0148 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous April 3, 2012 Sept. 30, 2016 No Longer Used
67457-0148-10 67457-0148 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous April 3, 2012 Sept. 30, 2016 No Longer Used
68083-0195-01 68083-0195 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec. 5, 2016 In Use
76126-0075-01 76126-0075 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous July 19, 2014 Sept. 1, 2017 No Longer Used
70121-1572-01 70121-1572 Levoleucovorin Levoleucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 8, 2017 In Use
67457-0610-10 67457-0610 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 1, 2008 June 30, 2018 No Longer Used
63323-0318-01 63323-0318 GRANISETRON HYDROCHLORIDE Granisetron 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 20, 2009 In Use
63323-0734-10 63323-0734 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 19, 2002 Aug. 27, 2015 No Longer Used
67457-0390-54 67457-0390 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous March 10, 2014 In Use
67457-0528-10 67457-0528 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 23, 2019 In Use
67457-0529-20 67457-0529 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 23, 2019 In Use
00078-0846-19 00078-0846 Tisagenlecleucel Kymriah 2000000.0 1/1 Immunotherapy CAR-T CD19 Intravenous Aug. 30, 2017 In Use
63323-0172-05 63323-0172 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 15, 2009 Oct. 31, 2012 In Use

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