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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
00078-0246-61 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug 13, 2012 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
00093-9018-65 00093-9018 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 8, 2021 In Use
76282-0701-48 76282-0701 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 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
57377-0025-01 57377-0025 Estradiol pellet Estra-25 25.0 mg/1 Hormonal Therapy Estrogen Subcutaneous Jan 1, 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
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
63304-0092-27 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
00143-9700-01 00143-9700 Cortisone Acetate Cortisone Acetate 25.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug 22, 2013 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
50742-0184-25 50742-0184 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 30, 2020 In Use
00078-0698-51 00078-0698 RYDAPT Rydapt 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FLT3 Oral Apr 28, 2017 In Use
31722-0263-30 31722-0263 ERLOTINIB ERLOTINIB 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 24, 2024 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
59651-0347-21 59651-0347 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 6, 2023 In Use
70771-1521-07 70771-1521 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Apr 30, 2020 In Use
68382-0383-06 68382-0383 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct 8, 2018 In Use
00185-0932-86 00185-0932 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 21, 2015 Mar 31, 2020 No Longer Used
73116-0225-56 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sep 28, 2018 In Use
70710-1576-08 70710-1576 Isotretinoin Isotretinoin 25.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jun 9, 2025 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
70377-0054-12 70377-0054 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2025 In Use
70771-1374-03 70771-1374 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct 8, 2018 In Use
60505-0133-01 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec 31, 2022 In Use

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