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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
65162-0240-03 65162-0240 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec 29, 2018 In Use
73555-0500-00 73555-0500 Revumenib Revuforj 25.0 mg/1 Chemotherapy Enzyme Inhibitor KMT2A Oral Nov 15, 2024 In Use
68382-0913-16 68382-0913 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Apr 30, 2020 In Use
63539-0927-01 63539-0927 Lorlatinib Lorbrena 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1 Oral Jan 3, 2023 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
54868-5261-00 54868-5261 Exemestane Aromasin 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jun 29, 2005 In Use
51862-0458-01 51862-0458 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 18, 2016 In Use
00069-0298-60 00069-0298 Glasdegib Daurismo 25.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral Dec 10, 2018 In Use
64380-0127-02 64380-0127 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug 16, 2022 In Use
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
00143-9700-01 00143-9700 Cortisone Acetate Cortisone Acetate 25.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug 22, 2013 In Use
60219-1719-02 60219-1719 Lenalidomide LENALIDOMIDE 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 12, 2025 In Use
62332-0618-31 62332-0618 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Nov 23, 2022 In Use
60687-0227-11 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 24, 2017 In Use
71921-0190-33 71921-0190 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan 15, 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
00143-1202-01 00143-1202 Cortisone Acetate Cortisone Acetate 25.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jun 13, 1972 In Use
69539-0090-30 69539-0090 Erlotinib Hydrochloride Erlotinib Hydrochloride 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 11, 2021 In Use
51079-0582-05 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug 27, 1997 Jun 30, 2023 No Longer Used
59115-0161-99 59115-0161 Cortisone Acetate Cortisone Acetate 25.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug 26, 2013 In Use
00019-9451-03 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug 22, 2011 Jul 1, 2017 No Longer Used
69945-0451-02 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct 27, 2015 Jul 1, 2018 No Longer Used
69945-0451-04 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct 27, 2015 Jul 1, 2018 No Longer Used
69945-0451-06 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct 27, 2015 Jul 1, 2018 No Longer Used
00019-9451-06 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug 22, 2011 Jul 1, 2017 No Longer Used

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