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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class (Ascending) Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
62584-0827-21 62584-0827 Cyclosporine Cyclosporine Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Dec. 11, 2009 Sept. 30, 2011 No Longer Used
00074-3108-32 00074-3108 Cyclosporine Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 1, 2015 In Use
00074-3109-32 00074-3109 Cyclosporine Gengraf 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 1, 2015 In Use
00078-0274-22 00078-0274 Cyclosporine NeOral 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
55154-2395-00 55154-2395 Cyclosporine Modified Gengraf 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 1, 2013 In Use
00591-2832-01 00591-2832 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 11, 2021 In Use
00245-0570-01 00245-0570 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
00245-0571-01 00245-0571 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
00245-0573-01 00245-0573 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
68308-0570-30 68308-0570 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
68308-0571-30 68308-0571 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
68308-0573-30 68308-0573 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
68308-0575-30 68308-0575 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 3, 2021 In Use
60505-0501-04 60505-0501 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 14, 2012 March 31, 2018 No Longer Used
60505-0501-05 60505-0501 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 14, 2012 March 31, 2018 No Longer Used
45802-0076-00 45802-0076 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical April 20, 2010 Aug. 1, 2013 No Longer Used
45802-0076-62 45802-0076 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical April 20, 2010 Aug. 1, 2013 No Longer Used
45802-0368-53 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical July 12, 2012 In Use
45802-0368-62 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical Nov. 9, 2010 In Use
59572-0402-00 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0402-28 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0405-00 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 27, 2005 In Use
59572-0405-28 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
59572-0410-00 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 27, 2005 In Use
59572-0410-28 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
59572-0415-00 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0415-21 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0420-00 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2013 In Use
59572-0420-21 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2013 In Use
59572-0425-00 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0425-21 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
10631-0133-31 10631-0133 Isotretinoin Absorica 25.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Feb. 17, 2015 In Use
10631-0134-31 10631-0134 Isotretinoin Absorica 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Feb. 17, 2015 In Use
59212-0601-22 59212-0601 alitretinoin PANRETIN 60.0 mg/60g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical Sept. 10, 2019 In Use
62856-0602-10 62856-0602 Bexarotene Targretin 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 1999 Dec. 1, 2014 No Longer Used
62856-0604-22 62856-0604 Bexarotene Targretin 1.0 g/100g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical June 28, 2000 April 30, 2017 No Longer Used
51862-0458-01 51862-0458 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 18, 2016 In Use
51862-0458-47 51862-0458 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 18, 2016 In Use
51862-0460-01 51862-0460 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 18, 2016 In Use
51862-0460-47 51862-0460 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 18, 2016 In Use
55154-2396-00 55154-2396 cyclosporine Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 March 31, 2016 No Longer Used
55154-3418-00 55154-3418 cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 Nov. 30, 2015 No Longer Used
60432-0140-50 60432-0140 Cyclosporine Cyclosporine 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb. 9, 2005 Feb. 5, 2012 No Longer Used
68084-0879-25 68084-0879 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sept. 30, 2015 In Use
68084-0879-95 68084-0879 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sept. 30, 2015 In Use
68084-0921-25 68084-0921 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 3, 2015 In Use
68084-0921-95 68084-0921 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb. 26, 2015 In Use
00074-0541-30 00074-0541 Cyclosporine Gengraf 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 20, 2016 April 27, 2018 No Longer Used
00185-0932-30 00185-0932 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jan. 13, 2000 March 31, 2020 No Longer Used
00185-0932-86 00185-0932 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 21, 2015 March 31, 2020 No Longer Used

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