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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date (Ascending) Status
00555-0485-04 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
00555-0485-27 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
54868-3310-00 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-01 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-02 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-03 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-04 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-5915-00 54868-5915 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 8, 2008 In Use
63323-0733-10 63323-0733 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Sept. 5, 2001 In Use
63323-0733-11 63323-0733 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Sept. 5, 2001 In Use
23155-0240-41 23155-0240 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Jan. 3, 2014 In Use
23155-0240-42 23155-0240 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Jan. 3, 2014 In Use
23155-0240-43 23155-0240 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Jan. 3, 2014 In Use
69639-0101-01 69639-0101 Netupitant and Palonosetron Akynzeo 300.0 mg/1, 0.5 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Oral Oct. 13, 2014 In Use
69639-0101-04 69639-0101 Netupitant and Palonosetron Akynzeo 300.0 mg/1, 0.5 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Oral Oct. 13, 2014 In Use
00054-0064-47 00054-0064 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 26, 2006 In Use
16590-0545-30 16590-0545 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 27, 2009 In Use
16729-0298-05 16729-0298 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Oct. 20, 2016 In Use
50436-0133-01 50436-0133 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 2, 2007 In Use
50436-0134-01 50436-0134 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2017 In Use
53217-0300-05 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-06 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-10 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-12 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-13 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-15 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-20 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-30 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-31 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
53217-0300-60 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
54569-6124-00 54569-6124 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 9, 2016 In Use
54569-6124-01 54569-6124 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 9, 2016 In Use
54569-6124-02 54569-6124 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 9, 2016 In Use
54569-6208-00 54569-6208 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 10, 2016 In Use
54569-6208-01 54569-6208 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 10, 2016 In Use
54569-6208-02 54569-6208 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 10, 2016 In Use
54868-5749-00 54868-5749 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 16, 2007 In Use
54868-5749-01 54868-5749 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 16, 2007 In Use
69238-1174-03 69238-1174 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
69238-1175-03 69238-1175 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
69238-1176-03 69238-1176 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
70020-1911-01 70020-1911 Ixabepilone Ixempra Chemotherapy Antitumor Antibiotic Epothilones Intravenous Oct. 16, 2007 In Use
00078-0671-19 00078-0671 Lapatinib TYKERB 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR/HER2 Oral Aug. 3, 2016 In Use
00078-0249-15 00078-0249 Letrozole Femara 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral July 31, 1997 In Use
54868-4151-00 54868-4151 Letrozole Femara 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Feb. 10, 2005 In Use
54868-6252-00 54868-6252 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral May 4, 2011 In Use
63323-0772-30 63323-0772 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 4, 2011 In Use
65841-0744-06 65841-0744 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 3, 2011 In Use
65841-0744-10 65841-0744 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 3, 2011 In Use
65841-0744-30 65841-0744 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 3, 2011 In Use

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