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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status (Ascending)
61314-0312-01 61314-0312 filgrastim-sndz Zarxio 480.0 ug/.8mL, 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sept. 3, 2015 Feb. 28, 2021 No Longer Used
61314-0312-10 61314-0312 filgrastim-sndz Zarxio 480.0 ug/.8mL, 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sept. 3, 2015 Feb. 28, 2021 No Longer Used
61786-0693-02 61786-0693 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 19, 2016 Oct. 1, 2018 No Longer Used
61786-0693-03 61786-0693 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 21, 2017 Oct. 1, 2018 No Longer Used
61786-0693-15 61786-0693 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2017 Oct. 1, 2018 No Longer Used
63629-6659-01 63629-6659 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 10, 2015 Aug. 31, 2018 No Longer Used
63629-6659-02 63629-6659 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 10, 2015 Aug. 31, 2018 No Longer Used
63629-6659-03 63629-6659 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 10, 2015 Aug. 31, 2018 No Longer Used
63629-6659-04 63629-6659 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 10, 2015 Aug. 31, 2018 No Longer Used
63629-6659-05 63629-6659 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 10, 2015 Aug. 31, 2018 No Longer Used
63629-6659-06 63629-6659 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 10, 2015 Aug. 31, 2018 No Longer Used
63739-0518-10 63739-0518 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 12, 2002 Feb. 28, 2021 No Longer Used
63739-0519-10 63739-0519 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 12, 2002 Aug. 31, 2021 No Longer Used
62559-0540-15 62559-0540 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular June 3, 2016 July 31, 2018 No Longer Used
62559-0540-55 62559-0540 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular June 3, 2016 June 3, 2016 No Longer Used
62756-0581-40 62756-0581 Amifostine Amifostine 50.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous March 14, 2008 March 31, 2012 No Longer Used
62756-0581-42 62756-0581 Amifostine Amifostine 50.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous March 14, 2008 March 31, 2012 No Longer Used
62856-0601-22 62856-0601 Alitretinoin Panretin 60.0 mg/60g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical Feb. 3, 2009 Oct. 31, 2021 No Longer Used
62856-0796-01 62856-0796 Netupitant and Palonosetron Akynzeo 300.0 mg/1, 0.5 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Oral Oct. 13, 2014 May 31, 2018 No Longer Used
62856-0796-04 62856-0796 Netupitant and Palonosetron Akynzeo 300.0 mg/1, 0.5 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Oral Oct. 13, 2014 Oct. 13, 2014 No Longer Used
66220-0017-03 66220-0017 Amifostine Ethyol 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Aug. 1, 2016 Oct. 31, 2020 No Longer Used
67457-0472-10 67457-0472 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 10, 2011 Nov. 30, 2018 No Longer Used
68001-0285-22 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 1, 2016 Feb. 1, 2021 No Longer Used
68001-0285-28 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 1, 2016 Feb. 1, 2021 No Longer Used
68001-0285-29 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Oct. 25, 2016 Feb. 1, 2021 No Longer Used

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