| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 25021-0227-06 | 25021-0227 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Feb 15, 2023 | 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 | |
| 00781-3498-95 | 00781-3498 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 19, 2022 | In Use | |
| 50742-0438-10 | 50742-0438 | arsenic trioxide | ARSENIC TRIOXIDE | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 15, 2018 | 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 | |
| 68083-0462-10 | 68083-0462 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Oct 7, 2021 | In Use | |
| 00555-0882-02 | 00555-0882 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 19, 1998 | In Use | |
| 70069-0820-01 | 70069-0820 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jun 18, 2024 | In Use | |
| 70860-0217-10 | 70860-0217 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 30, 2020 | Oct 31, 2024 | In Use |
| 70121-1658-01 | 70121-1658 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Aug 20, 2021 | In Use | |
| 00006-5331-58 | 00006-5331 | Belzutifan | WELIREG | 40.0 mg/1 | Chemotherapy | Miscellaneous Agent | HIF-2 alpha | Oral | Jun 21, 2023 | In Use | |
| 23155-0869-41 | 23155-0869 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Jun 23, 2023 | In Use | |
| 70518-0916-01 | 70518-0916 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec 18, 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 | |
| 70121-1483-07 | 70121-1483 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Jan 25, 2021 | In Use | |
| 00781-3498-94 | 00781-3498 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 19, 2022 | In Use | |
| 83090-0010-01 | 83090-0010 | Arsenic trioxide | ARSENIC TRIOXIDE | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 9, 2023 | 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 |
| 69918-0720-10 | 69918-0720 | Arsenic Trioxide | ARSENIC TRIOXIDE | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 14, 2018 | 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 | |
| 51407-0909-01 | 51407-0909 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 22, 2024 | In Use | |
| 00078-0669-84 | 00078-0669 | Ofatumumab | Arzerra | 20.0 mg/mL | Immunotherapy | Monoclonal Antibody | CD20 | Intravenous | Feb 1, 2016 | Feb 1, 2016 | In Use |
| 00069-0249-01 | 00069-0249 | Rituximab-pvvr | Ruxience | 500.0 mg/50mL | Immunotherapy | Monoclonal Antibody | CD20 | Intravenous | Jan 23, 2020 | In Use | |
| 50242-0070-86 | 50242-0070 | Obinutuzumab | Gazyva | 1000.0 mg/40mL | Immunotherapy | Monoclonal Antibody | CD20 | Intravenous | Nov 4, 2013 | In Use | |
| 55513-0730-01 | 55513-0730 | Denosumab | XGEVA | 120.0 mg/1.7mL | Immunotherapy | Monoclonal Antibody | RANKL | Subcutaneous | Nov 18, 2010 | In Use |
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