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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
55700-0627-10 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 18, 2018 In Use
55700-0627-12 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 18, 2018 In Use
55700-0627-20 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 18, 2018 In Use
55700-0627-30 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 18, 2018 In Use
55700-0631-06 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 In Use
55700-0631-10 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 In Use
55700-0631-20 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 In Use
55700-0631-30 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 In Use
71837-5844-01 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
71837-5844-05 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
50742-0494-17 50742-0494 Levoleucovorin LEVOLEUCOVORIN 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous May 8, 2018 July 31, 2021 In Use
50742-0495-25 50742-0495 Levoleucovorin LEVOLEUCOVORIN 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous May 8, 2018 June 30, 2021 In Use
25021-0828-50 25021-0828 Leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous April 15, 2018 In Use
54288-0100-01 54288-0100 ZOLEDRONIC ACID ZOLEDRONIC ACID 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous April 2, 2018 In Use
70860-0209-10 70860-0209 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Feb. 28, 2018 In Use
70860-0209-11 70860-0209 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Feb. 28, 2018 In Use
70518-1042-00 70518-1042 Ondansetron hydrochloride Ondansetron hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 1, 2018 May 11, 2020 In Use
68083-0142-01 68083-0142 Zoledronic Acid Zoledronic Acid 4.0 mg/100mL Ancillary Therapy Bisphosphonate Intravenous July 5, 2018 In Use
47335-0962-41 47335-0962 Zoledronic Acid Zoledronic Acid Ancillary Therapy Bisphosphonate intravenous March 4, 2013 Dec. 31, 2014 No Longer Used
82009-0061-05 82009-0061 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 21, 2022 In Use
00054-0143-07 00054-0143 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 24, 2008 In Use
00054-0143-08 00054-0143 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 31, 2007 In Use
00054-0143-87 00054-0143 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 24, 2008 In Use
69639-0103-01 69639-0103 Palonosetron hydrochloride Aloxi 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 1, 2018 Nov. 1, 2022 No Longer Used
69639-0103-05 69639-0103 Palonosetron hydrochloride Aloxi 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 1, 2018 Nov. 1, 2022 No Longer Used

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