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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category (Descending) Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
42806-0359-25 42806-0359 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
50742-0183-24 50742-0183 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 30, 2020 In Use
50742-0184-25 50742-0184 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 30, 2020 In Use
60687-0428-01 60687-0428 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 26, 2019 In Use
60687-0428-65 60687-0428 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 20, 2020 In Use
68001-0437-25 68001-0437 Zoledronic acid Zoledronic acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous June 29, 2020 In Use
00074-6463-32 00074-6463 Cyclosporine Modified Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Aug. 31, 2017 No Longer Used
00074-6479-32 00074-6479 Cyclosporine Modified Gengraf 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Sept. 16, 2017 No Longer Used
00093-0233-19 00093-0233 Ondansetron Hydrochloride Ondansetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 16, 2009 Oct. 31, 2015 No Longer Used
00093-0233-33 00093-0233 Ondansetron Hydrochloride Ondansetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 3, 2007 Jan. 31, 2015 No Longer Used
00093-0233-56 00093-0233 Ondansetron Hydrochloride Ondansetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 3, 2007 Oct. 31, 2015 No Longer Used
00093-0233-93 00093-0233 Ondansetron Hydrochloride Ondansetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 21, 2010 Aug. 31, 2013 No Longer Used
00093-7236-19 00093-7236 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 16, 2009 July 31, 2016 No Longer Used
00093-7236-33 00093-7236 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 3, 2007 Jan. 31, 2014 No Longer Used
00093-7236-56 00093-7236 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 3, 2007 July 31, 2016 No Longer Used
00093-7236-93 00093-7236 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 14, 2010 Jan. 31, 2014 No Longer Used
00093-7301-19 00093-7301 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 23, 2010 Jan. 13, 2013 No Longer Used
00093-7301-56 00093-7301 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 3, 2007 Feb. 23, 2010 No Longer Used
00093-7301-65 00093-7301 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 23, 2010 Jan. 13, 2013 No Longer Used
00093-7302-03 00093-7302 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 23, 2010 Nov. 30, 2012 No Longer Used
00093-7302-19 00093-7302 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 23, 2010 Nov. 30, 2012 No Longer Used
00093-7302-35 00093-7302 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 3, 2007 Feb. 23, 2010 No Longer Used
00093-7302-56 00093-7302 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 3, 2007 Feb. 23, 2010 No Longer Used
00093-7302-65 00093-7302 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 23, 2010 Nov. 30, 2012 No Longer Used
00093-7355-01 00093-7355 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 15, 2006 Aug. 5, 2013 In Use
00093-7355-05 00093-7355 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 14, 2008 In Use
00093-7355-56 00093-7355 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 15, 2006 In Use
00093-7355-98 00093-7355 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb. 22, 2007 In Use
00172-7310-00 00172-7310 Cyclosporine Modified Cyclosporine Modified 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 March 31, 2017 No Longer Used
00172-7310-46 00172-7310 Cyclosporine Modified Cyclosporine Modified 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 March 31, 2017 No Longer Used
00172-7311-00 00172-7311 Cyclosporine Modified Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral April 28, 2005 Feb. 28, 2017 No Longer Used
00172-7311-46 00172-7311 Cyclosporine Modified Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral April 28, 2005 Feb. 28, 2017 No Longer Used
00172-7312-00 00172-7312 Cyclosporine Modified Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 March 31, 2017 No Longer Used
00172-7312-46 00172-7312 Cyclosporine Modified Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 March 31, 2017 No Longer Used
00378-1003-39 00378-1003 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 30, 2008 April 12, 2010 No Longer Used
00378-1003-90 00378-1003 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 30, 2008 April 12, 2010 No Longer Used
00378-1003-94 00378-1003 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 30, 2008 Nov. 30, 2012 No Longer Used
00378-3151-01 00378-3151 Finasteride Finasteride Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 1, 2007 Nov. 4, 2015 No Longer Used
00378-3151-05 00378-3151 Finasteride Finasteride Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral July 30, 2010 Feb. 4, 2011 No Longer Used
00378-3151-77 00378-3151 Finasteride Finasteride Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 1, 2007 Nov. 4, 2015 No Longer Used
00378-3151-93 00378-3151 Finasteride Finasteride Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 1, 2007 Nov. 4, 2015 No Longer Used
00378-6868-01 00378-6868 Anagrelide Hydrochloride Anagrelide Hydrochloride Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Feb. 28, 2011 Oct. 29, 2010 No Longer Used
00378-6868-05 00378-6868 Anagrelide Hydrochloride Anagrelide Hydrochloride Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Feb. 28, 2011 Jan. 31, 2014 No Longer Used
00378-6869-01 00378-6869 Anagrelide Hydrochloride Anagrelide Hydrochloride Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Feb. 28, 2011 March 4, 2011 No Longer Used
00378-6869-05 00378-6869 Anagrelide Hydrochloride Anagrelide Hydrochloride Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Feb. 28, 2011 Jan. 31, 2014 No Longer Used
00781-3010-72 00781-3010 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous June 27, 2007 March 31, 2017 No Longer Used
00781-3010-95 00781-3010 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous June 27, 2007 March 31, 2017 No Longer Used
10019-0906-03 10019-0906 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 19, 2010 July 31, 2013 No Longer Used
10019-0906-04 10019-0906 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 19, 2010 July 31, 2011 No Longer Used
10019-0906-05 10019-0906 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 19, 2010 July 31, 2011 No Longer Used

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