| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 64380-0127-02 | 64380-0127 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Aug 16, 2022 | In Use | |
| 42291-0843-01 | 42291-0843 | Tretinoin | Tretinoin | 10.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Sep 2, 2016 | In Use | |
| 59572-0504-21 | 59572-0504 | Pomalidomide | Pomalyst | 4.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Feb 18, 2013 | In Use | |
| 00378-1937-01 | 00378-1937 | Lenalidomide | Lenalidomide | 10.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 59572-0205-14 | 59572-0205 | Thalidomide | Thalomid | 50.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Jun 20, 2003 | In Use | |
| 00187-5525-60 | 00187-5525 | Bexarotene | Targretin | 1.0 g/100g | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Topical | Jun 28, 2000 | In Use | |
| 54868-5522-00 | 54868-5522 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Feb 10, 2006 | In Use | |
| 55154-6349-00 | 55154-6349 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Sep 1, 2010 | Oct 31, 2010 | No Longer Used |
| 72143-0253-30 | 72143-0253 | ISOTRETINOIN | ACCUTANE | 30.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Aug 1, 2022 | In Use | |
| 59651-0346-01 | 59651-0346 | Lenalidomide | Lenalidomide | 20.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 6, 2023 | In Use | |
| 00378-1942-21 | 00378-1942 | Lenalidomide | Lenalidomide | 20.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 7, 2023 | In Use | |
| 43598-0512-01 | 43598-0512 | Lenalidomide | Lenalidomide | 10.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 60505-0354-01 | 60505-0354 | Cyclosporine | Cyclosporine | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Aug 1, 2005 | Jan 31, 2012 | No Longer Used | |
| 47781-0484-28 | 47781-0484 | Lenalidomide | LENALIDOMIDE | 5.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 3, 2022 | In Use | |
| 69238-1176-03 | 69238-1176 | Isotretinoin | Isotretinoin | 40.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Oct 2, 2017 | In Use | |
| 63304-0046-01 | 63304-0046 | Lenalidomide | Lenalidomide | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 4, 2023 | In Use | |
| 70710-1578-08 | 70710-1578 | Isotretinoin | Isotretinoin | 35.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Jun 9, 2025 | In Use | |
| 00378-6613-93 | 00378-6613 | Isotretinoin | Amnesteem | 30.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Apr 10, 2025 | 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 |
| 70710-1030-07 | 70710-1030 | LENALIDOMIDE | LENALIDOMIDE | 2.5 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 7, 2023 | In Use | |
| 72694-0879-10 | 72694-0879 | Vorasidenib | VORANIGO | 10.0 mg/1 | Chemotherapy | IDH Inhibitor | IDH1, IDH2 | Oral | Aug 7, 2024 | In Use | |
| 72694-0728-40 | 72694-0728 | Vorasidenib | VORANIGO | 40.0 mg/1 | Chemotherapy | IDH Inhibitor | IDH1, IDH2 | Oral | Aug 7, 2024 | In Use | |
| 50242-0140-86 | 50242-0140 | Vismodegib | Erivedge | 150.0 mg/1 | Chemotherapy | Hedgehog Pathway Inhibitor | SMO | Oral | Apr 9, 2013 | In Use | |
| 00078-0645-15 | 00078-0645 | Sonidegib | Odomzo | 200.0 mg/1 | Chemotherapy | Hedgehog Pathway Inhibitor | SMO | Oral | Jul 24, 2015 | Dec 31, 2017 | No Longer Used |
| 00069-1531-30 | 00069-1531 | Glasdegib | Daurismo | 100.0 mg/1 | Chemotherapy | Hedgehog Pathway Inhibitor | SMO | Oral | Dec 10, 2018 | In Use |
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