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NDC-11 (Package) (Ascending) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
69315-0186-24 69315-0186 Leucovorin calcium Leucovorin calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov. 16, 2020 In Use
69315-0187-25 69315-0187 Leucovorin calcium Leucovorin calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov. 16, 2020 In Use
69339-0168-03 69339-0168 Gefitinib Gefitinib 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral June 5, 2023 In Use
69339-0171-03 69339-0171 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 24, 2022 In Use
69339-0171-05 69339-0171 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 24, 2022 In Use
69339-0172-03 69339-0172 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 24, 2022 In Use
69339-0172-05 69339-0172 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 24, 2022 In Use
69367-0190-50 69367-0190 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Feb. 2, 2023 In Use
69448-0001-05 69448-0001 Mitomycin Mutamycin 5.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous July 25, 2017 In Use
69448-0002-11 69448-0002 Mitomycin Mutamycin 20.0 mg/40mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous July 25, 2017 In Use
69448-0003-38 69448-0003 Mitomycin Mutamycin 40.0 mg/80mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous July 25, 2017 In Use
69448-0005-12 69448-0005 Carboplatin Paraplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Feb. 12, 2020 Aug. 31, 2023 In Use
69448-0005-31 69448-0005 Carboplatin Paraplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Feb. 12, 2020 Nov. 30, 2022 In Use
69448-0005-33 69448-0005 Carboplatin Paraplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Feb. 12, 2020 Nov. 30, 2022 In Use
69448-0005-34 69448-0005 Carboplatin Paraplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Feb. 12, 2020 July 31, 2023 In Use
69448-0005-38 69448-0005 Carboplatin Paraplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Aug. 17, 2020 In Use
69448-0014-63 69448-0014 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous April 5, 2022 In Use
69452-0276-20 69452-0276 Dexamethasone Dexamethasone 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 1, 2023 In Use
69452-0277-20 69452-0277 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 1, 2023 In Use
69452-0278-20 69452-0278 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 1, 2023 In Use
69452-0350-01 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 28, 2022 In Use
69452-0350-11 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 28, 2022 In Use
69452-0350-92 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 28, 2022 In Use
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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