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NDC-11 (Package) (Ascending) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
25021-0778-66 25021-0778 Granisetron Hydrochloride Granisetron Hydrochloride 0.1 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 31, 2013 Jan. 31, 2017 No Longer Used
25021-0779-01 25021-0779 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec. 1, 2010 June 1, 2019 No Longer Used
25021-0779-04 25021-0779 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec. 1, 2010 Oct. 15, 2012 No Longer Used
25021-0781-04 25021-0781 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec. 1, 2010 Aug. 1, 2019 No Longer Used
25021-0782-20 25021-0782 ondansetron hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Aug. 30, 2012 Nov. 30, 2021 No Longer Used
25021-0783-05 25021-0783 palonosetron hydrochloride palonosetron hydrochloride 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous June 15, 2018 In Use
25021-0784-10 25021-0784 Fosaprepitant Dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Dec. 15, 2019 In Use
25021-0788-74 25021-0788 Palonosetron Hydrochloride Palonosetron Hydrochloride 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec. 15, 2018 In Use
25021-0801-66 25021-0801 Zoledronic Acid Zoledronic Acid 0.8 mg/mL Ancillary Therapy Bisphosphonate Intravenous Dec. 29, 2014 In Use
25021-0801-67 25021-0801 Zoledronic Acid Zoledronic Acid 0.8 mg/mL Ancillary Therapy Bisphosphonate Intravenous Sept. 1, 2015 Oct. 31, 2018 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
25021-0807-05 25021-0807 Methylprednisolone Sodium Succinate Methylprednisolone Sodium Succinate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous March 15, 2017 Dec. 31, 2018 In Use
25021-0808-10 25021-0808 Methylprednisolone Sodium Succinate Methylprednisolone Sodium Succinate 125.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous March 15, 2017 Dec. 31, 2018 In Use
25021-0810-30 25021-0810 Methylprednisolone Sodium Succinate Methylprednisolone Sodium Succinate 1.0 g/16mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous March 15, 2017 Oct. 31, 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
25021-0820-05 25021-0820 Methylprednisolone acetate Methylprednisolone acetate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intrasynovial, Soft Tissue Nov. 15, 2021 In Use
25021-0820-10 25021-0820 Methylprednisolone acetate Methylprednisolone acetate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intrasynovial, Soft Tissue Nov. 15, 2021 In Use
25021-0821-05 25021-0821 Methylprednisolone acetate Methylprednisolone acetate 80.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intrasynovial, Soft Tissue Nov. 15, 2021 In Use
25021-0824-06 25021-0824 Topotecan Hydrochloride Topotecan Hydrochloride 4.0 mg/4mL Chemotherapy Topoisomerase I Inhibitor Camptothecin Analogs Intravenous June 27, 2011 March 31, 2017 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
25021-0828-50 25021-0828 Leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous April 15, 2018 In Use
29336-0610-12 29336-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 24, 2010 Jan. 31, 2015 No Longer Used
29336-0610-24 29336-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical June 24, 2011 June 24, 2011 No Longer Used
30237-8900-06 30237-8900 Sipuleucel-T Provenge 50000000.0 1/1 Immunotherapy Immunomodulator Prostatic Acid Phosphatase Intravenous April 29, 2010 In Use
30698-0017-01 30698-0017 Bromocriptine Mesylate Parlodel Chemotherapy Dopamine Agonist Ergot Derivative Oral June 28, 1978 April 23, 2014 No Longer Used
30698-0017-30 30698-0017 Bromocriptine Mesylate Parlodel Chemotherapy Dopamine Agonist Ergot Derivative Oral June 28, 1978 April 23, 2014 No Longer Used
30698-0102-30 30698-0102 Bromocriptine Mesylate Parlodel Chemotherapy Dopamine Agonist Ergot Derivative Oral June 28, 1978 April 23, 2014 No Longer Used
30698-0120-05 30698-0120 Dolasetron mesylate Anzemet 50.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 11, 1997 May 24, 2021 In Use
30698-0121-05 30698-0121 Dolasetron mesylate Anzemet 100.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 11, 1997 May 24, 2021 In Use
30698-0201-01 30698-0201 Bromocriptine Mesylate Parlodel 5.0 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral April 28, 2014 In Use
30698-0201-30 30698-0201 Bromocriptine Mesylate Parlodel 5.0 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral April 28, 2014 In Use
30698-0202-01 30698-0202 Bromocriptine Mesylate Parlodel 2.5 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral April 28, 2014 In Use
30698-0202-30 30698-0202 Bromocriptine Mesylate Parlodel 2.5 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral April 28, 2014 In Use
31722-0131-30 31722-0131 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 7, 2016 In Use
31722-0131-90 31722-0131 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 7, 2016 In Use
31722-0165-31 31722-0165 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous July 29, 2021 In Use
31722-0257-01 31722-0257 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0257-28 31722-0257 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0258-01 31722-0258 LENALIDOMIDE LENALIDOMIDE 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0258-28 31722-0258 LENALIDOMIDE LENALIDOMIDE 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use

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