| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 72694-0515-01 | 72694-0515 | Calaspargase Pegol | Asparlas | 750.0 U/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intravenous | Sep 27, 2019 | In Use | |
| 70710-1895-06 | 70710-1895 | Arsenic trioxide | Arsenic trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Feb 28, 2023 | In Use | |
| 69918-0720-02 | 69918-0720 | Arsenic Trioxide | ARSENIC TRIOXIDE | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 14, 2018 | In Use | |
| 55150-0366-10 | 55150-0366 | ARSENIC TRIOXIDE | ARSENIC TRIOXIDE | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Oct 15, 2021 | 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 | |
| 64764-0800-56 | 64764-0800 | MARIBAVIR | Livtencity | 200.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Oral | Nov 23, 2021 | In Use | |
| 70518-0916-01 | 70518-0916 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec 18, 2019 | In Use | |
| 82448-0100-14 | 82448-0100 | Nirogacestat | OGSIVEO | 100.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Ɣ Secretase Inhibitor | Oral | Nov 27, 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 | |
| 00555-0882-02 | 00555-0882 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 19, 1998 | In Use | |
| 80725-0820-60 | 80725-0820 | Hydroxyurea | DROXIA | 200.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Sep 11, 2025 | 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 | |
| 00781-3498-94 | 00781-3498 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 19, 2022 | In Use | |
| 49315-0005-10 | 49315-0005 | Arsenic trioxide | Arsenic trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 14, 2018 | 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 | |
| 72162-1118-01 | 72162-1118 | Pilocarpine hydrchloride | Pilocarpine hydrchloride | 5.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agonist | Oral | Oct 6, 2023 | In Use | |
| 68084-0284-11 | 68084-0284 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug 13, 2008 | In Use | |
| 63629-8439-01 | 63629-8439 | Pilocarpine hydrchloride | Pilocarpine hydrchloride | 5.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agonist | Oral | Feb 9, 2022 | In Use | |
| 54868-4773-02 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 63459-0601-06 | 63459-0601 | Arsenic Trioxide | Trisenox | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Dec 22, 2017 | In Use | |
| 68382-0997-10 | 68382-0997 | Arsenic trioxide | Arsenic trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 14, 2018 | In Use | |
| 54868-4773-00 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 67184-0607-01 | 67184-0607 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Mar 6, 2024 | 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 |
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