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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Ascending) Package Effective Date Package Discontinuation Date Status
55513-0098-04 55513-0098 Darbepoetin alfa Aranesp 10.0 ug/.4mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 26, 2006 In Use
55513-0209-01 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0209-10 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0209-91 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
67457-0148-00 67457-0148 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous April 3, 2012 Sept. 30, 2016 No Longer Used
67457-0148-10 67457-0148 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous April 3, 2012 Sept. 30, 2016 No Longer Used
68083-0195-01 68083-0195 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec. 5, 2016 In Use
76126-0075-01 76126-0075 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous July 19, 2014 Sept. 1, 2017 No Longer Used
70121-1572-01 70121-1572 Levoleucovorin Levoleucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 8, 2017 In Use
67457-0610-10 67457-0610 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 1, 2008 June 30, 2018 No Longer Used
55513-0530-01 55513-0530 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 19, 1997 In Use
55513-0530-10 55513-0530 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 19, 1997 In Use
55513-0546-01 55513-0546 Filgrastim Neupogen 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous April 7, 1997 In Use
55513-0546-10 55513-0546 Filgrastim Neupogen 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous April 7, 1997 In Use
55513-0924-01 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0924-10 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0924-91 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
63323-0318-01 63323-0318 GRANISETRON HYDROCHLORIDE Granisetron 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 20, 2009 In Use
63323-0734-10 63323-0734 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 19, 2002 Aug. 27, 2015 No Longer Used
67457-0390-54 67457-0390 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous March 10, 2014 In Use
00078-0846-19 00078-0846 Tisagenlecleucel Kymriah 2000000.0 1/1 Immunotherapy CAR-T CD19 Intravenous Aug. 30, 2017 In Use
63323-0172-05 63323-0172 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 15, 2009 Oct. 31, 2012 In Use
63323-0172-15 63323-0172 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 15, 2009 Jan. 31, 2014 In Use
63323-0172-45 63323-0172 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 15, 2009 Aug. 31, 2017 In Use
63323-0172-60 63323-0172 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Dec. 11, 2009 In Use

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