| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 42291-0321-01 | 42291-0321 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jul 23, 2013 | In Use | |
| 54879-0027-11 | 54879-0027 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 29, 2019 | In Use | |
| 72694-0515-01 | 72694-0515 | Calaspargase Pegol | Asparlas | 750.0 U/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intravenous | Sep 27, 2019 | In Use | |
| 80725-0810-10 | 80725-0810 | Hydroxyurea | HYDREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Sep 11, 2025 | In Use | |
| 00555-0882-02 | 00555-0882 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 19, 1998 | 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 | |
| 70710-1610-06 | 70710-1610 | Arsenic trioxide | Arsenic trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Sep 3, 2019 | In Use | |
| 64764-0800-28 | 64764-0800 | MARIBAVIR | Livtencity | 200.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Oral | Nov 23, 2021 | In Use | |
| 00574-0792-01 | 00574-0792 | pilocarpine hydrchloride | pilocarpine hydrchloride | 5.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agonist | Oral | Aug 24, 2020 | Jan 31, 2026 | 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 |
| 00781-3498-94 | 00781-3498 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 19, 2022 | In Use | |
| 82448-0150-14 | 82448-0150 | Nirogacestat | OGSIVEO | 150.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Ɣ Secretase Inhibitor | Oral | Nov 27, 2023 | In Use | |
| 72205-0172-07 | 72205-0172 | ARSENIC TRIOXIDE | ARSENIC TRIOXIDE | 2.0 mg/2mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Feb 6, 2024 | In Use | |
| 54868-4773-02 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | 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 | |
| 23155-0869-41 | 23155-0869 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Jun 23, 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 |
| 00944-3810-01 | 00944-3810 | Pegaspargase | Oncaspar | 750.0 [iU]/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intramuscular, Intravenous | Feb 1, 1994 | May 16, 2020 | No Longer Used |
| 10135-0702-01 | 10135-0702 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jan 28, 2022 | In Use | |
| 51407-0909-01 | 51407-0909 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 22, 2024 | 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 | |
| 63323-0637-10 | 63323-0637 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Aug 31, 2018 | 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 |
| 00003-0830-50 | 00003-0830 | Hydroxyurea | Hydrea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jun 1, 2009 | Mar 31, 2025 | No Longer Used |
| 64764-0800-56 | 64764-0800 | MARIBAVIR | Livtencity | 200.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Oral | Nov 23, 2021 | In Use |
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