| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00555-0485-04 | 00555-0485 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jun 30, 1990 | In Use | |
| 73116-0225-28 | 73116-0225 | Duvelisib | COPIKTRA | 25.0 mg/1 | Chemotherapy | Enzyme Inhibitor | PI3K | Oral | Sep 25, 2018 | In Use | |
| 70771-1521-03 | 70771-1521 | Erlotinib | Erlotinib | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | Apr 30, 2020 | In Use | |
| 72205-0080-30 | 72205-0080 | Erlotinib Hydrochloride | Erlotinib Hydrochloride | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | May 11, 2021 | In Use | |
| 47781-0108-30 | 47781-0108 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Jul 25, 2014 | Dec 1, 2022 | No Longer Used | |
| 31722-0262-01 | 31722-0262 | LENALIDOMIDE | LENALIDOMIDE | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | May 11, 2023 | In Use | |
| 31722-0262-21 | 31722-0262 | LENALIDOMIDE | LENALIDOMIDE | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | May 11, 2023 | In Use | |
| 69315-0187-25 | 69315-0187 | Leucovorin calcium | Leucovorin calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | In Use | |
| 70710-1576-08 | 70710-1576 | Isotretinoin | Isotretinoin | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Jun 9, 2025 | In Use | |
| 46708-0618-31 | 46708-0618 | Cyclophosphamide | Cyclophosphamide | 25.0 mg/1 | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Oral | Nov 23, 2022 | 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 |
| 00832-0595-30 | 00832-0595 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Jul 27, 2017 | 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 |
| 47781-0488-77 | 47781-0488 | Lenalidomide | LENALIDOMIDE | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 3, 2022 | In Use | |
| 60219-1719-01 | 60219-1719 | Lenalidomide | LENALIDOMIDE | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Feb 12, 2025 | In Use | |
| 72603-0329-01 | 72603-0329 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Jan 1, 2025 | In Use | ||
| 54868-5218-01 | 54868-5218 | Cyclophosphamide | Cyclophosphamide | 25.0 mg/1 | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Oral | Aug 17, 1999 | In Use | |
| 42291-0902-28 | 42291-0902 | Sunitinib Malate | Sunitinib Malate | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | VEGFR, FLT, PDGFR, KIT, RET, CSF | Oral | Oct 11, 2023 | In Use | |
| 00143-1202-01 | 00143-1202 | Cortisone Acetate | Cortisone Acetate | 25.0 mg/1 | Hormonal Therapy | Adrenal Glucocorticoid | Corticosteroid | Oral | Jun 13, 1972 | In Use | |
| 31722-0263-30 | 31722-0263 | ERLOTINIB | ERLOTINIB | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | May 24, 2024 | In Use | |
| 69238-1256-03 | 69238-1256 | Isotretinoin | Isotretinoin | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Oct 10, 2025 | In Use | |
| 69097-0385-81 | 69097-0385 | Lenalidomide | Lenalidomide | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 68382-0913-84 | 68382-0913 | Erlotinib | Erlotinib | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | Apr 30, 2020 | In Use | |
| 59572-0711-01 | 59572-0711 | Luspatercept | REBLOZYL | 25.0 mg/1 | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Subcutaneous | Nov 8, 2019 | In Use | ||
| 00904-7584-10 | 00904-7584 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Mar 27, 2026 | In Use |
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