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NDC-11 (Package) NDC-9 (Product) Generic Name (Ascending) Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
67457-0529-20 67457-0529 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 23, 2019 In Use
67457-0530-35 67457-0530 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jan. 2, 2019 In Use
71205-0908-00 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-11 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-30 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-60 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-90 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
69448-0014-63 69448-0014 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous April 5, 2022 In Use
55150-0478-01 55150-0478 LEUPROLIDE ACETATE LEUPROLIDE ACETATE Hormonal Therapy GnRH Agonist June 6, 2022 In Use
16714-0915-01 16714-0915 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
16714-0890-01 16714-0890 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
43598-0771-11 43598-0771 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
43598-0773-11 43598-0773 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
15054-0060-01 15054-0060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 Aug. 31, 2016 No Longer Used
15054-0090-01 15054-0090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 Aug. 31, 2016 No Longer Used
15054-0120-01 15054-0120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 Aug. 31, 2016 No Longer Used
15054-1060-03 15054-1060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 June 30, 2022 In Use
15054-1060-04 15054-1060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Sept. 1, 2019 In Use
15054-1090-03 15054-1090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 June 30, 2022 In Use
15054-1090-04 15054-1090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Sept. 1, 2019 In Use
15054-1120-03 15054-1120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 June 30, 2022 In Use
15054-1120-04 15054-1120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Sept. 1, 2019 In Use
69097-0870-67 69097-0870 Lanreotide acetate Lanreotide Acetate 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec. 24, 2021 In Use
69097-0880-67 69097-0880 Lanreotide acetate Lanreotide Acetate 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec. 24, 2021 In Use
69097-0890-67 69097-0890 Lanreotide acetate Lanreotide Acetate 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec. 24, 2021 In Use
76282-0709-67 76282-0709 Lanreotide acetate Lanreotide Acetate 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous June 1, 2022 Aug. 18, 2023 In Use
76282-0710-67 76282-0710 Lanreotide acetate Lanreotide Acetate 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous June 1, 2022 Aug. 18, 2023 In Use
76282-0711-67 76282-0711 Lanreotide acetate Lanreotide Acetate 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous June 1, 2022 Aug. 18, 2023 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
00173-0752-00 00173-0752 Lapatinib TYKERB 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR/HER2 Oral March 16, 2007 Nov. 30, 2017 No Longer Used
59572-0402-00 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0402-28 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0405-00 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 27, 2005 In Use
59572-0405-28 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
59572-0410-00 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 27, 2005 In Use
59572-0410-28 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
59572-0415-00 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0415-21 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0420-00 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2013 In Use
59572-0420-21 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2013 In Use
59572-0425-00 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0425-21 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
00480-1242-28 00480-1242 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
00480-1243-28 00480-1243 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
00480-1244-21 00480-1244 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
00480-1246-21 00480-1246 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
43598-0516-01 43598-0516 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0516-63 43598-0516 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0515-01 43598-0515 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use

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