| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 23155-0869-41 | 23155-0869 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Jun 23, 2023 | In Use | |
| 72694-0954-01 | 72694-0954 | Pegaspargase | Oncaspar | 750.0 [iU]/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intramuscular, Intravenous | Jan 2, 2020 | In Use | |
| 55154-7143-00 | 55154-7143 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug 12, 2008 | Sep 30, 2024 | No Longer Used |
| 67184-0607-01 | 67184-0607 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Mar 6, 2024 | In Use | |
| 14789-0600-10 | 14789-0600 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 19, 2018 | In Use | |
| 72694-0515-01 | 72694-0515 | Calaspargase Pegol | Asparlas | 750.0 U/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intravenous | Sep 27, 2019 | In Use | |
| 00006-5331-01 | 00006-5331 | Belzutifan | WELIREG | 40.0 mg/1 | Chemotherapy | Miscellaneous Agent | HIF-2 alpha | Oral | Aug 13, 2021 | In Use | |
| 69918-0720-10 | 69918-0720 | Arsenic Trioxide | ARSENIC TRIOXIDE | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 14, 2018 | In Use | |
| 82448-0100-14 | 82448-0100 | Nirogacestat | OGSIVEO | 100.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Ɣ Secretase Inhibitor | Oral | Nov 27, 2023 | In Use | |
| 50742-0525-07 | 50742-0525 | arsenic trioxide | ARSENIC TRIOXIDE | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Jan 27, 2021 | In Use | |
| 64764-0800-56 | 64764-0800 | MARIBAVIR | Livtencity | 200.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Oral | Nov 23, 2021 | In Use | |
| 81561-0413-05 | 81561-0413 | asparaginase | ERWINASE | 10000.0 [iU]/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intramuscular, Intravenous | Jun 1, 2021 | In Use | |
| 54868-4773-00 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 60429-0265-01 | 60429-0265 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 26, 2012 | Dec 31, 2024 | No Longer Used |
| 00015-3080-60 | 00015-3080 | Mitotane | Lysodren | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Adrenal Suppressant | Oral | Jun 1, 2009 | Mar 31, 2021 | No Longer Used |
| 80725-0820-60 | 80725-0820 | Hydroxyurea | DROXIA | 200.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Sep 11, 2025 | In Use | |
| 68084-0284-01 | 68084-0284 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Sep 17, 2008 | In Use | |
| 23155-0870-41 | 23155-0870 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Jun 23, 2023 | In Use | |
| 83090-0009-10 | 83090-0009 | Arsenic trioxide | ARSENIC TRIOXIDE | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 9, 2023 | In Use | |
| 49315-0007-10 | 49315-0007 | Arsenic trioxide | Arsenic trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Sep 3, 2019 | In Use | |
| 63629-8439-01 | 63629-8439 | Pilocarpine hydrchloride | Pilocarpine hydrchloride | 5.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agonist | Oral | Feb 9, 2022 | In Use | |
| 71335-2120-01 | 71335-2120 | Pilocarpine hydrchloride | Pilocarpine hydrchloride | 5.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agonist | Oral | Jun 20, 2022 | In Use | |
| 80725-0810-10 | 80725-0810 | Hydroxyurea | HYDREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Sep 11, 2025 | In Use | |
| 49315-0005-10 | 49315-0005 | Arsenic trioxide | Arsenic trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 14, 2018 | In Use | |
| 54868-4773-01 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use |
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