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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
13668-0592-86 13668-0592 APREPITANT APREPITANT 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Oct. 21, 2020 In Use
13668-0593-86 13668-0593 APREPITANT APREPITANT 125.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Oct. 21, 2020 In Use
13668-0594-87 13668-0594 APREPITANT APREPITANT Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oct. 21, 2020 In Use
42254-0160-01 42254-0160 Aprepitant Emend 40.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral March 26, 2003 In Use
54868-5231-01 54868-5231 Aprepitant Emend 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral June 29, 2005 In Use
54868-5231-02 54868-5231 Aprepitant Emend 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral June 29, 2005 In Use
54868-5231-03 54868-5231 Aprepitant Emend 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral June 29, 2005 In Use
17156-0524-01 17156-0524 Strontium Chloride Sr-89 Metastron 1.0 mCi/mL Ancillary Therapy Radiopharmaceutical Strontium Sr 89 Intravenous June 18, 1993 Jan. 10, 2019 In Use
16714-0915-01 16714-0915 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
45963-0762-57 45963-0762 Levoleucovorin Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Feb. 14, 2017 July 31, 2019 In Use
67457-0600-20 67457-0600 Levoleucovorin LEVOLEUCOVORIN CALCIUM 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Oct. 21, 2015 April 30, 2019 No Longer Used
67457-0601-30 67457-0601 Levoleucovorin LEVOLEUCOVORIN CALCIUM 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Oct. 21, 2015 April 30, 2019 No Longer Used
68152-0101-00 68152-0101 Levoleucovorin Fusilev 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 15, 2008 Feb. 28, 2019 No Longer Used
68152-0102-01 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 15, 2011 Feb. 28, 2019 No Longer Used
68152-0102-02 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 15, 2011 Feb. 28, 2019 No Longer Used
68152-0112-01 68152-0112 levoleucovorin KHAPZORY 175.0 mg/3.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan. 2, 2019 In Use
68152-0114-01 68152-0114 levoleucovorin KHAPZORY 300.0 mg/6mL Ancillary Therapy Antiemetic Antidote Intravenous Jan. 2, 2019 In Use
23155-0168-31 23155-0168 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec. 13, 2012 Aug. 12, 2020 In Use
23155-0196-31 23155-0196 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Jan. 18, 2013 In Use
23155-0196-41 23155-0196 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Jan. 18, 2013 In Use
23155-0196-42 23155-0196 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Jan. 18, 2013 In Use
23155-0196-43 23155-0196 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Jan. 18, 2013 July 31, 2020 In Use
23155-0377-31 23155-0377 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Feb. 24, 2014 Oct. 11, 2019 In Use
23155-0378-31 23155-0378 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Feb. 19, 2014 Oct. 11, 2019 In Use
23155-0378-41 23155-0378 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Feb. 19, 2014 Oct. 11, 2019 In Use

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