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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
59115-0161-99 59115-0161 Cortisone Acetate Cortisone Acetate 25.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug 26, 2013 In Use
00078-0698-02 00078-0698 RYDAPT Rydapt 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FLT3 Oral Apr 28, 2017 In Use
00555-0485-04 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jun 30, 1990 In Use
46708-0565-30 46708-0565 ERLOTINIB HYDROCHLORIDE ERLOTINIB HYDROCHLORIDE 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Jul 9, 2021 In Use
00078-0246-61 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug 13, 2012 In Use
51862-0458-01 51862-0458 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 18, 2016 In Use
65162-0240-03 65162-0240 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec 29, 2018 In Use
69097-0516-07 69097-0516 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Jan 18, 2019 In Use
44278-0025-30 44278-0025 EXEMESTANE Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Nov 22, 2013 In Use
00185-0932-87 00185-0932 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sep 23, 2014 Nov 21, 2015 No Longer Used
50881-0025-60 50881-0025 Ruxolitinib Jakafi 25.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Nov 16, 2011 In Use
72485-0217-30 72485-0217 Erlotinib hydrochloride Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Nov 6, 2019 In Use
82293-0015-10 82293-0015 Sunitinib Malate Sunitinib Malate 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FLT, PDGFR, KIT, RET, CSF Oral May 1, 2024 In Use
76282-0701-48 76282-0701 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
31722-0263-30 31722-0263 ERLOTINIB ERLOTINIB 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 24, 2024 In Use
00172-7310-00 00172-7310 Cyclosporine Modified Cyclosporine Modified 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Mar 29, 2005 Mar 31, 2017 No Longer Used
00074-6463-32 00074-6463 Cyclosporine Modified Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Aug 31, 2017 No Longer Used
73116-0225-28 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sep 25, 2018 In Use
59651-0516-30 59651-0516 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral May 20, 2022 In Use
51079-0582-01 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug 27, 1997 No Longer Used
60505-4630-03 60505-4630 Cyclosporine CycloSPORINE, Modfied 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 5, 2019 Aug 31, 2023 In Use
59651-0530-03 59651-0530 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Jun 22, 2022 In Use
59572-0425-00 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jul 7, 2006 In Use
63304-0046-22 63304-0046 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 4, 2023 In Use
00078-0698-51 00078-0698 RYDAPT Rydapt 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FLT3 Oral Apr 28, 2017 In Use

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