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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name (Ascending) Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
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
00173-0635-35 00173-0635 Chlorambucil Leukeran Chemotherapy Alkylating Agent Nitrogen Mustard Oral Feb. 13, 1985 June 30, 2014 No Longer Used
54868-1126-00 54868-1126 Chlorambucil Leukeran Chemotherapy Alkylating Agent Nitrogen Mustard Oral Feb. 13, 1985 June 30, 2012 No Longer Used
54868-1126-01 54868-1126 Chlorambucil Leukeran Chemotherapy Alkylating Agent Nitrogen Mustard Oral Feb. 13, 1985 June 30, 2012 No Longer Used
54868-1126-02 54868-1126 Chlorambucil Leukeran Chemotherapy Alkylating Agent Nitrogen Mustard Oral Feb. 13, 1985 June 30, 2012 No Longer Used
54868-1126-03 54868-1126 Chlorambucil Leukeran Chemotherapy Alkylating Agent Nitrogen Mustard Oral Feb. 13, 1985 June 30, 2012 No Longer Used
54868-1126-04 54868-1126 Chlorambucil Leukeran Chemotherapy Alkylating Agent Nitrogen Mustard Oral Feb. 13, 1985 June 30, 2012 No Longer Used
76388-0635-25 76388-0635 Chlorambucil Leukeran 2.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Feb. 13, 1985 Sept. 30, 2023 No Longer Used
76388-0635-50 76388-0635 Chlorambucil Leukeran 2.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Feb. 13, 1985 Oct. 31, 2017 No Longer Used
50419-0002-33 50419-0002 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Sept. 5, 1991 Sept. 21, 2012 No Longer Used
50419-0050-14 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 5, 1991 Sept. 21, 2012 No Longer Used
50419-0050-30 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 5, 1991 Sept. 21, 2012 No Longer Used
54868-3188-00 54868-3188 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Dec. 1, 1996 June 30, 2012 No Longer Used
58468-0181-01 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 15, 2010 Dec. 31, 2013 No Longer Used
58468-0181-02 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 15, 2010 Dec. 31, 2013 No Longer Used
58468-0180-01 58468-0180 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Aug. 5, 2013 June 30, 2016 No Longer Used
58468-0180-02 58468-0180 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 15, 2010 June 30, 2016 No Longer Used
00024-5843-01 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Nov. 5, 2013 Dec. 30, 2021 No Longer Used
00024-5843-05 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 1, 1991 Dec. 30, 2021 No Longer Used
00024-5844-01 00024-5844 Sargramostim Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Dec. 1, 1996 Dec. 30, 2021 No Longer Used
00024-5844-05 00024-5844 Sargramostim Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Dec. 1, 1996 Dec. 30, 2021 No Longer Used
71837-5844-01 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
71837-5844-05 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
71837-5843-05 71837-5843 SARGRAMOSTIM Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous Sept. 1, 2023 In Use
00781-4003-32 00781-4003 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Aug. 4, 1998 In Use
47335-0936-40 47335-0936 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Dec. 15, 2014 In Use
49884-0368-26 49884-0368 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Nov. 29, 2001 March 31, 2010 No Longer Used
00703-4014-11 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov. 6, 2000 March 31, 2011 No Longer Used
00703-4014-18 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov. 6, 2000 March 31, 2011 No Longer Used
41616-0936-40 41616-0936 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Dec. 15, 2014 Aug. 31, 2015 No Longer Used
00185-7400-14 00185-7400 Leuprolide Acetate Leuprolide Acetate 1.0 mg/.2mL Hormonal Therapy GnRH Agonist Subcutaneous Jan. 6, 2011 In Use
00185-7400-85 00185-7400 Leuprolide Acetate Leuprolide Acetate 1.0 mg/.2mL Hormonal Therapy GnRH Agonist Subcutaneous Aug. 4, 1998 In Use
72664-0611-28 72664-0611 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Oct. 25, 2020 In Use
70121-2537-06 70121-2537 Leuprolide acetate Leuprolide acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov. 7, 2022 In Use
16714-0572-01 16714-0572 Leuprolide acetate Leuprolide acetate Hormonal Therapy GnRH Agonist Aug. 1, 2022 In Use
00143-9558-01 00143-9558 Levoleucovorin Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous July 7, 2016 In Use
70121-1099-01 70121-1099 Levoleucovorin Levoleucovorin 50.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intravenous Feb. 13, 2017 In Use
71288-0105-18 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 16, 2019 In Use
71288-0105-25 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 16, 2019 In Use
00591-4130-54 00591-4130 Levoleucovorin Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Feb. 6, 2017 May 31, 2019 No Longer Used
45963-0762-57 45963-0762 Levoleucovorin Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Feb. 14, 2017 July 31, 2019 In Use
71288-0104-10 71288-0104 Levoleucovorin calcium Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 22, 2019 April 30, 2024 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
70121-1572-01 70121-1572 Levoleucovorin Levoleucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 8, 2017 In Use
47335-0083-50 47335-0083 Doxorubicin Hydrochloride Lipodox 50 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Feb. 9, 2012 May 29, 2015 In Use
64764-0800-28 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
64764-0800-56 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
58181-3030-05 58181-3030 Lomustine Lomustine 10.0 mg/1 Chemotherapy Alkylating Agent Nitrosourea Oral July 29, 2014 Jan. 14, 2016 No Longer Used

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