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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 (Ascending) Package Discontinuation Date Status
00054-4496-13 00054-4496 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
00054-4496-25 00054-4496 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
00054-4497-05 00054-4497 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
00054-4497-10 00054-4497 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
00054-4498-10 00054-4498 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
00054-4499-11 00054-4499 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
00054-8496-19 00054-8496 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
00173-0130-93 00173-0130 Melphalan Hydrochloride Alkeran Chemotherapy Alkylating Agent Nitrogen Mustard March 16, 1993 May 31, 2012 No Longer Used
59572-0301-01 59572-0301 Melphalan Hydrochloride Alkeran Chemotherapy Alkylating Agent Nitrogen Mustard March 16, 1993 Nov. 2, 2009 No Longer Used
00591-5442-10 00591-5442 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 18, 1993 In Use
17156-0524-01 17156-0524 Strontium Chloride Sr-89 Metastron 1.0 mCi/mL Ancillary Therapy Radiopharmaceutical Strontium Sr 89 Intravenous June 18, 1993 Jan. 10, 2019 In Use
55513-0144-01 55513-0144 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 16, 1993 In Use
55513-0144-10 55513-0144 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 16, 1993 In Use
55513-0148-01 55513-0148 Epoetin alfa Epogen 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 16, 1993 In Use
55513-0148-10 55513-0148 Epoetin alfa Epogen 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 16, 1993 In Use
00591-5443-10 00591-5443 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 11, 1993 In Use
55154-0450-05 55154-0450 Metoclopramide Hydrochloride Metoclopramide Hydrochloride 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intravenous Dec. 10, 1993 In Use
00004-0239-09 00004-0239 Granisetron Kytril Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Dec. 29, 1993 July 31, 2010 No Longer Used
00004-0240-09 00004-0240 Granisetron Kytril Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Dec. 29, 1993 Nov. 30, 2011 No Longer Used
00004-0242-08 00004-0242 Granisetron Kytril Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Dec. 29, 1993 July 31, 2008 No Longer Used
54868-0218-00 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-01 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-02 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-03 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-04 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-05 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-06 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-07 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-08 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
54868-0218-09 54868-0218 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 19, 1994 In Use
00703-5140-01 00703-5140 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Feb. 1, 1994 In Use
54482-0301-01 54482-0301 Pegaspargase Oncaspar 750.0 [iU]/mL Chemotherapy Miscellaneous Agent Enzyme Intramuscular, Intravenous Feb. 1, 1994 Nov. 30, 2016 No Longer Used
00944-3810-01 00944-3810 Pegaspargase Oncaspar 750.0 [iU]/mL Chemotherapy Miscellaneous Agent Enzyme Intramuscular, Intravenous Feb. 1, 1994 May 16, 2020 No Longer Used
61703-0304-36 61703-0304 Cytarabine Cytarabine 20.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Feb. 28, 1994 In Use
54868-3004-01 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 Nov. 7, 2011 In Use
54868-3004-02 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 In Use
54868-3004-03 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 In Use
54868-3004-04 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 In Use
54868-3004-05 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 In Use
00944-2656-03 00944-2656 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
00944-2658-04 00944-2658 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
00944-2620-02 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 July 18, 2015 In Use
00944-2620-03 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sept. 2, 2015 In Use
00944-2620-04 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sept. 2, 2015 In Use
00944-2623-02 00944-2623 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2625-03 00944-2625 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2627-04 00944-2627 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2655-03 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 May 10, 1994 In Use
54868-2522-00 54868-2522 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous June 8, 1994 In Use
54868-2522-01 54868-2522 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous June 8, 1994 In Use

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