| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 60505-0133-00 | 60505-0133 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | May 29, 2002 | 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 | |
| 43598-0515-01 | 43598-0515 | Lenalidomide | Lenalidomide | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 59115-0161-99 | 59115-0161 | Cortisone Acetate | Cortisone Acetate | 25.0 mg/1 | Hormonal Therapy | Adrenal Glucocorticoid | Corticosteroid | Oral | Aug 26, 2013 | In Use | |
| 60687-0227-94 | 60687-0227 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 17, 2017 | In Use | |
| 31722-0262-21 | 31722-0262 | LENALIDOMIDE | LENALIDOMIDE | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | May 11, 2023 | In Use | |
| 00185-0932-30 | 00185-0932 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Jan 13, 2000 | Mar 31, 2020 | No Longer Used |
| 70771-1664-08 | 70771-1664 | Isotretinoin | Isotretinoin | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Jun 9, 2025 | In Use | |
| 51991-0005-33 | 51991-0005 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Dec 19, 2019 | Dec 31, 2022 | In Use | |
| 71779-0125-02 | 71779-0125 | duvelisib | Copiktra | 25.0 mg/1 | Chemotherapy | Enzyme Inhibitor | PI3K | Oral | Sep 25, 2018 | In Use | |
| 73555-0500-00 | 73555-0500 | Revumenib | Revuforj | 25.0 mg/1 | Chemotherapy | Enzyme Inhibitor | KMT2A | Oral | Nov 15, 2024 | In Use | |
| 73116-0125-01 | 73116-0125 | duvelisib | COPIKTRA | 25.0 mg/1 | Chemotherapy | Enzyme Inhibitor | PI3K | Oral | Sep 25, 2018 | In Use | |
| 72064-0125-30 | 72064-0125 | avapritinib | Ayvakit | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | PDGFR, KIT, CSFR1 | Oral | Jun 16, 2021 | In Use | |
| 44278-0025-30 | 44278-0025 | EXEMESTANE | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Nov 22, 2013 | In Use | ||
| 43975-0307-10 | 43975-0307 | CYCLOPHOSPHAMIDE | CYCLOPHOSPHAMIDE | 25.0 mg/1 | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Oral | Mar 20, 2018 | Feb 28, 2021 | No Longer Used |
| 00069-0298-60 | 00069-0298 | Glasdegib | Daurismo | 25.0 mg/1 | Chemotherapy | Hedgehog Pathway Inhibitor | SMO | Oral | Dec 10, 2018 | In Use | |
| 60429-0015-01 | 60429-0015 | Cortisone Acetate | Cortisone Acetate | 25.0 mg/1 | Hormonal Therapy | Adrenal Glucocorticoid | Corticosteroid | Oral | Jun 13, 1972 | Jan 2, 2017 | No Longer Used |
| 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 |
| 43598-0515-21 | 43598-0515 | Lenalidomide | Lenalidomide | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 00078-0698-19 | 00078-0698 | RYDAPT | Rydapt | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | FLT3 | Oral | Apr 28, 2017 | In Use | |
| 00054-0080-13 | 00054-0080 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Apr 1, 2011 | In Use | ||
| 60505-0133-02 | 60505-0133 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | May 29, 2002 | Dec 31, 2022 | In Use |
| 64380-0127-02 | 64380-0127 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Aug 16, 2022 | In Use | |
| 68084-0879-95 | 68084-0879 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Sep 30, 2015 | In Use | |
| 72205-0117-28 | 72205-0117 | Sunitinib Malate | Sunitinib Malate | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | VEGFR, FLT, PDGFR, KIT, RET, CSF | Oral | Jun 1, 2025 | In Use |
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