| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00591-2222-15 | 00591-2222 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Dec 1, 2008 | Dec 31, 2017 | In Use |
| 00069-0227-03 | 00069-0227 | Lorlatinib | Lorbrena | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | ALK/ROS1 | Oral | Jan 3, 2025 | In Use | |
| 68382-0913-06 | 68382-0913 | Erlotinib | Erlotinib | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | Apr 30, 2020 | In Use | |
| 60687-0227-94 | 60687-0227 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 17, 2017 | In Use | |
| 57377-0025-01 | 57377-0025 | Estradiol pellet | Estra-25 | 25.0 mg/1 | Hormonal Therapy | Estrogen | Subcutaneous | Jan 1, 2017 | 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 |
| 00832-0595-30 | 00832-0595 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Jul 27, 2017 | In Use | ||
| 42806-0359-25 | 42806-0359 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Apr 16, 2020 | In Use | |
| 63629-2056-01 | 63629-2056 | Exemestane | Exemestane | 25.0 mg/1 | Hormonal Therapy | Aromatase Inhibitor | Oral | Dec 19, 2019 | In Use | ||
| 62332-0565-90 | 62332-0565 | ERLOTINIB HYDROCHLORIDE | ERLOTINIB HYDROCHLORIDE | 25.0 mg/1 | Chemotherapy | Tyrosine Kinase Inhibitor | EGFR | Oral | Jul 9, 2021 | In Use | |
| 60505-6095-00 | 60505-6095 | Bendamustine Hydrochloride | Bendamustine Hydrochloride | 25.0 mg/1 | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Intravenous | Jun 19, 2023 | Apr 30, 2025 | No Longer Used |
| 62559-0930-01 | 62559-0930 | CYCLOPHOSPHAMIDE | CYCLOPHOSPHAMIDE | 25.0 mg/1 | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Oral | Jun 22, 2020 | Mar 31, 2023 | No Longer Used |
| 10631-0133-31 | 10631-0133 | Isotretinoin | Absorica | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Feb 17, 2015 | 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 | |
| 55154-2396-00 | 55154-2396 | cyclosporine | Gengraf | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | May 24, 2010 | Mar 31, 2016 | 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 | |
| 73116-0125-02 | 73116-0125 | duvelisib | COPIKTRA | 25.0 mg/1 | Chemotherapy | Enzyme Inhibitor | PI3K | Oral | Sep 25, 2018 | In Use | |
| 10019-0982-01 | 10019-0982 | Cyclophosphamide | Cyclophosphamide | 25.0 mg/1 | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Oral | Aug 7, 2020 | In Use | |
| 00310-4505-25 | 00310-4505 | Tremelimumab | IMJUDO | 25.0 mg/1.25mL | Immunotherapy | Checkpoint Inhibitor | CTLA-4 | Intravenous | Oct 21, 2022 | In Use | |
| 16729-0250-03 | 16729-0250 | Bendamustine hydrochloride | Bendamustine hydrochloride | 25.0 mg/5mL | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Intravenous | Dec 7, 2022 | In Use | |
| 67457-0325-12 | 67457-0325 | Bendamustine Hydrochloride | Bendamustine Hydrochloride | 25.0 mg/5mL | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Intravenous | Apr 26, 2018 | Feb 21, 2019 | In Use |
| 42799-0816-01 | 42799-0816 | Prednisolone Sodium Phosphate | Prednisolone Sodium Phosphate | 25.0 mg/5mL | Hormonal Therapy | Adrenal Glucocorticoid | Corticosteroid | Oral | May 1, 2023 | In Use | |
| 55150-0391-01 | 55150-0391 | BENDAMUSTINE HYDROCHLORIDE | BENDAMUSTINE HYDROCHLORIDE | 25.0 mg/5mL | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Intravenous | Jun 5, 2023 | In Use | |
| 71288-0102-10 | 71288-0102 | Bendamustine HCl | Bendamustine | 25.0 mg/5mL | Chemotherapy | Alkylating Agent | Purine analog | Intravenous | Jun 5, 2023 | In Use | |
| 00178-0582-01 | 00178-0582 | Prednisolone Sodium Phosphate | Prednisolone Sodium Phosphate Oral Solution | 25.0 mg/5mL | Hormonal Therapy | Adrenal Glucocorticoid | Corticosteroid | Oral | Oct 1, 2012 | In Use |
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