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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
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
00069-1311-04 00069-1311 epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 1, 2020 In Use
00069-1311-10 00069-1311 epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
00069-1318-04 00069-1318 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 1, 2020 In Use
00069-1318-10 00069-1318 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 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
16714-0929-01 16714-0929 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous March 20, 2020 In Use
16729-0240-03 16729-0240 FOSAPREPITANT Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Oct. 22, 2020 In Use
00143-9384-01 00143-9384 FOSAPREPITANT DIMEGLUMINE FOSAPREPITANT DIMEGLUMINE 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 8, 2020 In Use
00187-1231-50 00187-1231 Nabilone Cesamet 1.0 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral March 9, 2020 In Use
00338-0008-01 00338-0008 Fosaprepitant Dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 In Use
00409-4215-01 00409-4215 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Oct. 19, 2017 In Use
00409-4215-05 00409-4215 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous March 18, 2019 In Use
17856-0691-01 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-02 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-04 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-05 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-06 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-07 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-08 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 10, 2021 In Use
31722-0960-60 31722-0960 dronabinol DRONABINOL 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Feb. 10, 2020 In Use
31722-0961-60 31722-0961 dronabinol DRONABINOL 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Feb. 10, 2020 In Use
31722-0962-60 31722-0962 dronabinol DRONABINOL 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Feb. 10, 2020 In Use
35356-0853-06 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 11, 2015 In Use
35356-0853-09 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 11, 2015 In Use
35356-0853-10 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 27, 2007 In Use
35356-0853-20 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 27, 2007 In Use
35356-0853-30 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 27, 2007 In Use
43598-0859-11 43598-0859 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 6, 2019 In Use
43598-0948-11 43598-0948 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous July 1, 2020 In Use
61703-0326-18 61703-0326 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Oct. 1, 2005 In Use
67457-0430-10 67457-0430 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 1, 2008 In Use
67457-0446-10 67457-0446 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 1, 2008 In Use
54868-5229-00 54868-5229 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Feb. 23, 2006 Dec. 31, 2011 No Longer Used
55513-0190-01 55513-0190 Pegfilgrastim Neulasta 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous April 1, 2002 In Use
00024-5862-01 00024-5862 Plerixafor Mozobil 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Sept. 1, 2013 In Use
00024-5150-10 00024-5150 Rasburicase Elitek Ancillary Therapy Metabolic Agent Enzyme July 12, 2002 In Use
00024-5151-75 00024-5151 Rasburicase Elitek Ancillary Therapy Metabolic Agent Enzyme June 1, 2006 In Use
57902-0860-03 57902-0860 Samarium SM 153 Lexidronam Quadramet 50.0 mCi/mL Ancillary Therapy Radiopharmaceutical Samarium Sm 153 Intravenous May 19, 1997 In Use
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
69468-0151-04 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral March 1, 2016 In Use
69468-0151-10 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral March 1, 2016 In Use

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