NDC-11 (Package) | NDC-9 (Product) | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Class | Minor Class (Ascending) | Administration Route | Package Effective Date | Package Discontinuation Date | Status |
---|---|---|---|---|---|---|---|---|---|---|---|
69315-0184-03 | 69315-0184 | Leucovorin calcium | Leucovorin calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0185-12 | 69315-0185 | Leucovorin calcium | Leucovorin calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0185-24 | 69315-0185 | Leucovorin calcium | Leucovorin calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0186-24 | 69315-0186 | Leucovorin calcium | Leucovorin calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
69315-0187-25 | 69315-0187 | Leucovorin calcium | Leucovorin calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | In Use | |
72893-0004-01 | 72893-0004 | Levoleucovorin | KHAPZORY | 175.0 mg/3.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan. 2, 2019 | In Use | |
00781-3201-94 | 00781-3201 | Levoleucovorin | Levoleucovorin | 175.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | April 23, 2015 | April 30, 2023 | No Longer Used |
42806-0134-34 | 42806-0134 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan. 1, 2021 | In Use | |
42806-0134-24 | 42806-0134 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan. 1, 2021 | In Use | |
14335-0340-01 | 14335-0340 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 31, 2023 | In Use | |
14335-0341-01 | 14335-0341 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 31, 2023 | In Use | |
70436-0116-82 | 70436-0116 | Leucovorin calcium | Leucovorin Calcium | 50.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 10, 2023 | In Use | |
70436-0117-80 | 70436-0117 | Leucovorin calcium | Leucovorin Calcium | 100.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 10, 2023 | In Use | |
70436-0118-80 | 70436-0118 | Leucovorin calcium | Leucovorin Calcium | 200.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 10, 2023 | In Use | |
70436-0120-80 | 70436-0120 | Leucovorin calcium | Leucovorin Calcium | 500.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 10, 2023 | In Use | |
70436-0209-80 | 70436-0209 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 1, 2023 | In Use | |
70436-0210-80 | 70436-0210 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 1, 2023 | In Use | |
71288-0160-10 | 71288-0160 | Leucovorin calcium | Leucovorin calcium | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 19, 2023 | In Use | |
71288-0161-20 | 71288-0161 | Leucovorin calcium | Leucovorin calcium | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 19, 2023 | In Use | |
71288-0162-30 | 71288-0162 | Leucovorin calcium | Leucovorin calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 19, 2023 | In Use | |
71288-0163-30 | 71288-0163 | Leucovorin calcium | Leucovorin calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 19, 2023 | In Use | |
71288-0164-50 | 71288-0164 | Leucovorin calcium | Leucovorin calcium | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | July 19, 2023 | In Use | |
51079-0582-01 | 51079-0582 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Aug. 27, 1997 | No Longer Used | |
51079-0582-05 | 51079-0582 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Aug. 27, 1997 | June 30, 2023 | No Longer Used |
00703-5140-01 | 00703-5140 | Leucovorin Calcium | Leucovorin Calcium | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Feb. 1, 1994 | Sept. 30, 2023 | No Longer Used |
00703-5145-01 | 00703-5145 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | June 12, 1997 | Sept. 30, 2023 | No Longer Used |
00703-5145-91 | 00703-5145 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | May 13, 2013 | April 30, 2023 | No Longer Used |
72893-0006-01 | 72893-0006 | Levoleucovorin | KHAPZORY | 300.0 mg/6mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan. 2, 2019 | Oct. 31, 2023 | No Longer Used |
00555-0882-02 | 00555-0882 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct. 19, 1998 | In Use | |
49884-0724-01 | 49884-0724 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Feb. 24, 1999 | In Use | |
54868-4773-00 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | April 11, 2003 | In Use | |
54868-4773-01 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | April 11, 2003 | In Use | |
54868-4773-02 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | April 11, 2003 | In Use | |
54868-4773-03 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | April 11, 2003 | In Use | |
54868-4773-04 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | April 11, 2003 | In Use | |
55154-7143-00 | 55154-7143 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug. 12, 2008 | In Use | |
70518-0916-00 | 70518-0916 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec. 20, 2017 | In Use | |
70518-0916-01 | 70518-0916 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec. 18, 2019 | In Use | |
69315-0164-01 | 69315-0164 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | July 9, 2020 | In Use | |
24535-0831-01 | 24535-0831 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug. 20, 2017 | In Use | |
42291-0321-01 | 42291-0321 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | July 23, 2013 | In Use | |
10135-0702-01 | 10135-0702 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jan. 28, 2022 | In Use | |
00003-0830-50 | 00003-0830 | Hydroxyurea | Hydrea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | June 1, 2009 | March 31, 2025 | In Use |
70518-3615-00 | 70518-3615 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jan. 10, 2023 | In Use | |
60429-0265-01 | 60429-0265 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct. 26, 2012 | Dec. 31, 2024 | In Use |
68084-0284-01 | 68084-0284 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Sept. 17, 2008 | In Use | |
68084-0284-11 | 68084-0284 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug. 13, 2008 | In Use | |
00074-0561-11 | 00074-0561 | Venetoclax | Venclexta | 10.0 mg/1 | Chemotherapy | Enzyme Inhibitor | BCL-2 | Oral | April 11, 2016 | In Use | |
00074-0561-14 | 00074-0561 | Venetoclax | Venclexta | 10.0 mg/1 | Chemotherapy | Enzyme Inhibitor | BCL-2 | Oral | April 11, 2016 | In Use | |
00074-0566-07 | 00074-0566 | Venetoclax | Venclexta | 50.0 mg/1 | Chemotherapy | Enzyme Inhibitor | BCL-2 | Oral | April 11, 2016 | In Use |
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