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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category (Ascending) Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
00078-0109-01 00078-0109 Cyclosporine Sandimmune 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Nov. 14, 1983 In Use
00078-0109-61 00078-0109 Cyclosporine Sandimmune 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Aug. 10, 2012 In Use
00078-0240-15 00078-0240 Cyclosporine Sandimmune 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 2, 1990 In Use
00078-0240-61 00078-0240 Cyclosporine Sandimmune 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 22, 2010 In Use
00078-0241-15 00078-0241 Cyclosporine Sandimmune 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 2, 1990 In Use
00078-0241-61 00078-0241 Cyclosporine Sandimmune 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 22, 2010 In Use
00074-7269-50 00074-7269 Cyclosporine Modified Gengraf 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 25, 2010 In Use
00078-0246-15 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0246-61 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 13, 2012 In Use
00078-0248-15 00078-0248 Cyclosporine Modified NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0248-61 00078-0248 Cyclosporine Modified NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 13, 2012 In Use
55513-0005-01 55513-0005 Darbepoetin alfa Aranesp 100.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0005-04 55513-0005 Darbepoetin alfa Aranesp 100.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0027-01 55513-0027 Darbepoetin alfa Aranesp 150.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use
55513-0027-04 55513-0027 Darbepoetin alfa Aranesp 150.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 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
00054-0143-07 00054-0143 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 24, 2008 In Use
00054-0143-08 00054-0143 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 31, 2007 In Use
00054-0143-87 00054-0143 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 24, 2008 In Use
00143-9554-01 00143-9554 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous March 28, 1988 In Use
00143-9555-01 00143-9555 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sept. 14, 1987 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
00338-1305-01 00338-1305 Mesna Mesnex 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec. 30, 1988 In Use
00338-1305-03 00338-1305 Mesna Mesnex 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec. 30, 1988 In Use
00187-1221-03 00187-1221 Nabilone Cesamet 1.0 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral Nov. 1, 2009 Nov. 13, 2017 No Longer Used
00069-0107-01 00069-0107 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 10, 2011 Dec. 31, 2017 No Longer Used
00069-0109-01 00069-0109 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 10, 2011 Dec. 31, 2017 No Longer Used
00069-0186-01 00069-0186 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 10, 2011 Dec. 31, 2017 No Longer Used
55700-0484-10 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-12 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-20 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-30 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
00143-9890-01 00143-9890 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 26, 2006 In Use
00143-9890-05 00143-9890 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 26, 2006 July 15, 2014 In Use
00143-9890-10 00143-9890 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 26, 2006 In Use
00143-9891-01 00143-9891 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous July 15, 2014 In Use
00143-9891-05 00143-9891 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 10, 2009 April 10, 2013 In Use
00143-9891-25 00143-9891 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 26, 2006 In Use
00173-0569-00 00173-0569 Ondansetron Hydrochloride Zofran ODT 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 1, 1999 Sept. 30, 2017 No Longer Used
00641-6079-01 00641-6079 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 26, 2006 In Use
43063-0746-12 43063-0746 ondansetron hydrochloride Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 17, 2017 In Use
00069-1340-02 00069-1340 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous May 10, 2011 July 31, 2014 No Longer Used
00069-1340-05 00069-1340 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous May 10, 2011 May 31, 2014 No Longer Used
00069-1340-16 00069-1340 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous May 10, 2011 May 31, 2014 No Longer Used
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec. 15, 2020 In Use
00591-4385-79 00591-4385 fosaprepitant Fosaprepitant 150.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 19, 2019 In Use
00781-3497-75 00781-3497 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 2, 2020 In Use
16714-0120-01 16714-0120 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Jan. 16, 2020 In Use

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