| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 46708-0565-90 | 46708-0565 | ERLOTINIB HYDROCHLORIDE | ERLOTINIB HYDROCHLORIDE | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | Jul 9, 2021 | In Use | |
| 59572-0711-01 | 59572-0711 | Luspatercept | REBLOZYL | 25.0 mg/1 | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Subcutaneous | Nov 8, 2019 | In Use | ||
| 57664-0022-97 | 57664-0022 | Isotretinoin | Isotretinoin | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Dec 29, 2020 | In Use | |
| 51991-0005-90 | 51991-0005 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Nov 15, 2020 | In Use | ||
| 59651-0465-28 | 59651-0465 | SUNITINIB MALATE | SUNITINIB MALATE | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | VEGFR, FLT, PDGFR, KIT, RET, CSF | Oral | Mar 14, 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 | |
| 71777-0390-01 | 71777-0390 | LAROTRECTINIB | VITRAKVI | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | TRK | Oral | Nov 26, 2018 | In Use | |
| 73555-0500-00 | 73555-0500 | Revumenib | Revuforj | 25.0 mg/1 | Chemotherapy | Enzyme Inhibitor | KMT2A | Oral | Nov 15, 2024 | In Use | |
| 69189-0382-01 | 69189-0382 | Cyclophosphamide | Cyclophosphamide | 25.0 mg/1 | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Oral | Aug 18, 2015 | May 24, 2017 | No Longer Used |
| 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 |
| 70771-1664-08 | 70771-1664 | Isotretinoin | Isotretinoin | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Jun 9, 2025 | In Use | |
| 70377-0054-11 | 70377-0054 | Lenalidomide | Lenalidomide | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 3, 2025 | In Use | |
| 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 |
| 63304-0092-86 | 63304-0092 | Sunitinib malate | Sunitinib malate | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | VEGFR, FLT, PDGFR, KIT, RET, CSF | Oral | Dec 25, 2019 | In Use | |
| 59651-0516-30 | 59651-0516 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | May 20, 2022 | In Use | ||
| 43598-0515-21 | 43598-0515 | Lenalidomide | Lenalidomide | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 71779-0125-01 | 71779-0125 | duvelisib | Copiktra | 25.0 mg/1 | Chemotherapy | Enzyme Inhibitor | PI3K | Oral | Sep 25, 2018 | 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 | |
| 70771-1521-07 | 70771-1521 | Erlotinib | Erlotinib | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | Apr 30, 2020 | In Use | |
| 63304-0095-11 | 63304-0095 | Erlotinib | Erlotinib | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | Nov 5, 2019 | 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 |
| 43598-0515-01 | 43598-0515 | Lenalidomide | Lenalidomide | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 51079-0582-01 | 51079-0582 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Aug 27, 1997 | No Longer Used | |
| 50742-0184-25 | 50742-0184 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 30, 2020 | In Use | |
| 00093-9018-65 | 00093-9018 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Jun 8, 2021 | In Use |
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