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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
60687-0252-40 60687-0252 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 7, 2019 In Use
60687-0252-46 60687-0252 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 7, 2019 In Use
60687-0252-67 60687-0252 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 11, 2019 May 31, 2019 In Use
60687-0252-86 60687-0252 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 7, 2019 In Use
63187-0379-03 63187-0379 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 1, 2017 In Use
63187-0379-05 63187-0379 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 2, 2017 In Use
63187-0379-10 63187-0379 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 1, 2016 In Use
63187-0379-12 63187-0379 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 4, 2018 In Use
63187-0379-15 63187-0379 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 1, 2016 In Use
63187-0379-20 63187-0379 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 1, 2016 In Use
63187-0379-30 63187-0379 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 1, 2016 In Use
63187-0266-10 63187-0266 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 3, 2014 In Use
63187-0266-15 63187-0266 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 1, 2018 In Use
63187-0266-20 63187-0266 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 1, 2017 In Use
63187-0266-30 63187-0266 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 3, 2014 In Use
42806-0359-25 42806-0359 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
50742-0183-24 50742-0183 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 30, 2020 In Use
50742-0184-25 50742-0184 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 30, 2020 In Use
60687-0428-01 60687-0428 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 26, 2019 In Use
60687-0428-65 60687-0428 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 20, 2020 In Use
68001-0437-25 68001-0437 Zoledronic acid Zoledronic acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous June 29, 2020 In Use
50742-0416-05 50742-0416 zoledronic acid Zoledronic acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Feb. 19, 2020 In Use
67457-0920-05 67457-0920 Zoledronic acid Zoledronic acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Oct. 12, 2020 In Use
76310-0017-50 76310-0017 Amifostine Ethyol 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jan. 1, 2020 In Use
59353-0220-10 59353-0220 Epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
59353-0120-10 59353-0120 Epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
67457-0889-10 67457-0889 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 In Use
69097-0830-37 69097-0830 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 In Use
71839-0104-01 71839-0104 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Oct. 15, 2019 In Use
70710-1615-01 70710-1615 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 1, 2020 In Use
70860-0782-10 70860-0782 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 30, 2020 In Use
70860-0783-10 70860-0783 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous March 15, 2021 In Use
72893-0004-01 72893-0004 Levoleucovorin KHAPZORY 175.0 mg/3.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan. 2, 2019 In Use
72893-0006-01 72893-0006 Levoleucovorin KHAPZORY 300.0 mg/6mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan. 2, 2019 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
59630-0222-07 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
59630-0222-30 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
59630-0222-90 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
60760-0313-10 60760-0313 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 2, 2020 In Use
61314-0866-01 61314-0866 pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Nov. 4, 2019 In Use
53097-0573-60 53097-0573 Dronabinol MARINOL 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 3, 2021 In Use
53097-0572-60 53097-0572 Dronabinol MARINOL 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 3, 2021 In Use
71288-0418-10 71288-0418 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 15, 2019 In Use
63323-0972-10 63323-0972 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 In Use
71731-5111-01 71731-5111 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous March 16, 2021 In Use
55150-0299-01 55150-0299 Fosaprepitant dimeglumine Fosaprepitant dimeglumine 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Jan. 12, 2021 In Use
72205-0026-01 72205-0026 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 In Use
68180-0690-01 68180-0690 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 25, 2020 In Use
69639-0105-01 69639-0105 Fosnetupitant and Palonosetron AKYNZEO 260.0 mg/20mL, 0.28 mg/20mL Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Intravenous June 15, 2020 In Use

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