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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 Status
80175-0017-01 80175-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2018 In Use
80175-0017-03 80175-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2018 In Use
80175-0017-05 80175-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2018 In Use
80175-0017-06 80175-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2018 In Use
67184-0507-01 67184-0507 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sept. 8, 2014 In Use
67184-0507-05 67184-0507 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sept. 8, 2014 In Use
68083-0113-01 68083-0113 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sept. 25, 2009 In Use
68083-0114-01 68083-0114 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous June 15, 2012 In Use
68462-0105-30 68462-0105 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
68462-0105-33 68462-0105 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
68462-0106-30 68462-0106 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
68462-0106-33 68462-0106 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
68788-8937-01 68788-8937 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 16, 2015 Feb. 7, 2019 No Longer Used
68788-8937-03 68788-8937 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 16, 2015 Feb. 7, 2019 No Longer Used
76045-0103-20 76045-0103 ONDANSETRON HYDROCHLORIDE Ondansetron 4.0 mg/2mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 10, 2015 In Use
77651-1112-01 77651-1112 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 19, 2020 In Use
67184-0540-01 67184-0540 Fosaprepitant dimeglumine FOSAPREPITANT DIMEGLUMINE 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 8, 2020 In Use
44206-0456-21 44206-0456 HUMAN IMMUNOGLOBULIN G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 In Use
44206-0456-94 44206-0456 HUMAN IMMUNOGLOBULIN G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 In Use
44206-0457-22 44206-0457 Human Immunoglobulin G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 In Use
44206-0457-95 44206-0457 Human Immunoglobulin G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 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
35356-0210-30 35356-0210 Dutasteride Avodart 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 26, 2012 Dec. 31, 2016 No Longer Used
42023-0167-01 42023-0167 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous May 7, 2013 March 16, 2020 No Longer Used
50090-1094-02 50090-1094 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 28, 2014 Oct. 31, 2016 No Longer Used
50090-1414-00 50090-1414 Finasteride Finasteride 1.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 28, 2014 April 30, 2016 No Longer Used
52584-0450-39 52584-0450 Metoclopramide Hydrochloride Metoclopramide 10.0 mg/2mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intramuscular, intravenous, Intravenous Aug. 1, 2010 Jan. 17, 2017 No Longer Used
52584-0451-82 52584-0451 Metoclopramide Hydrochloride Reglan 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intramuscular, intravenous, Intravenous Aug. 1, 2010 Sept. 1, 2012 No Longer Used
54092-0063-01 54092-0063 Anagrelide hydrochloride Agrylin 0.5 mg/1, 0.5 mg/1 Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral March 14, 1997 In Use
55154-0452-05 55154-0452 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Dec. 9, 2010 March 31, 2013 No Longer Used
55154-2396-00 55154-2396 cyclosporine Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 March 31, 2016 No Longer Used
55154-3418-00 55154-3418 cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 Nov. 30, 2015 No Longer Used
55513-0025-01 55513-0025 Darbepoetin alfa Aranesp 100.0 ug/.5mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use
55513-0025-04 55513-0025 Darbepoetin alfa Aranesp 100.0 ug/.5mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 14, 2006 In Use
55513-0057-01 55513-0057 Darbepoetin alfa Aranesp 25.0 ug/.42mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use
55513-0057-04 55513-0057 Darbepoetin alfa Aranesp 25.0 ug/.42mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 26, 2006 In Use
55513-0098-01 55513-0098 Darbepoetin alfa Aranesp 10.0 ug/.4mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Oct. 6, 2015 In Use
55513-0098-04 55513-0098 Darbepoetin alfa Aranesp 10.0 ug/.4mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 26, 2006 In Use
55513-0192-01 55513-0192 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Feb. 20, 2015 In Use
55513-0209-01 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0209-10 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0209-91 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
59676-0302-00 59676-0302 Erythropoietin Procrit 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0302-01 59676-0302 Erythropoietin Procrit 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0302-02 59676-0302 Erythropoietin Procrit 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 Jan. 8, 2014 In Use
59676-0303-00 59676-0303 Erythropoietin Procrit 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0303-01 59676-0303 Erythropoietin Procrit 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0303-02 59676-0303 Erythropoietin Procrit 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 Jan. 8, 2014 In Use
59676-0304-00 59676-0304 Erythropoietin Procrit 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use

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