| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 72205-0172-07 | 72205-0172 | ARSENIC TRIOXIDE | ARSENIC TRIOXIDE | 2.0 mg/2mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Feb 6, 2024 | 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 | |
| 24535-0831-01 | 24535-0831 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug 20, 2017 | In Use | |
| 00555-0882-02 | 00555-0882 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 19, 1998 | In Use | |
| 49884-0724-01 | 49884-0724 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Feb 24, 1999 | In Use | |
| 25021-0226-10 | 25021-0226 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Feb 15, 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 | |
| 81607-0006-07 | 81607-0006 | Arsenic trioxide | ARSENIC TRIOXIDE | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 31, 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 | |
| 67184-0607-01 | 67184-0607 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Mar 6, 2024 | In Use | |
| 54482-0301-01 | 54482-0301 | Pegaspargase | Oncaspar | 750.0 [iU]/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intramuscular, Intravenous | Feb 1, 1994 | Nov 30, 2016 | No Longer Used |
| 49315-0007-10 | 49315-0007 | Arsenic trioxide | Arsenic trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Sep 3, 2019 | 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 | |
| 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 |
| 68084-0284-11 | 68084-0284 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug 13, 2008 | In Use | |
| 14789-0600-10 | 14789-0600 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Nov 19, 2018 | In Use | |
| 81607-0005-11 | 81607-0005 | Arsenic trioxide | ARSENIC TRIOXIDE | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 31, 2023 | In Use | |
| 54868-4773-04 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | 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 |
| 64764-0800-56 | 64764-0800 | MARIBAVIR | Livtencity | 200.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Oral | Nov 23, 2021 | In Use | |
| 63459-0600-10 | 63459-0600 | Arsenic Trioxide | Trisenox | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Oct 15, 2000 | Aug 15, 2021 | No Longer Used |
| 00006-5331-59 | 00006-5331 | Belzutifan | WELIREG | 40.0 mg/1 | Chemotherapy | Miscellaneous Agent | HIF-2 alpha | Oral | Jun 21, 2023 | In Use | |
| 67386-0411-51 | 67386-0411 | Asparaginase (E. coli) | Elspar | Chemotherapy | Miscellaneous Agent | Enzyme | Intramuscular | Jan 10, 1978 | Jul 18, 2013 | 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 |
| 64764-0800-28 | 64764-0800 | MARIBAVIR | Livtencity | 200.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Oral | Nov 23, 2021 | In Use |
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