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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class (Descending) Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
00093-9019-65 00093-9019 Cyclosporine Cyclosporine 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 8, 2021 In Use
00093-9020-65 00093-9020 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 8, 2021 In Use
00245-0575-01 00245-0575 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral June 25, 2021 In Use
60505-0133-00 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 In Use
60505-0133-01 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0133-02 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0134-00 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 In Use
60505-0134-01 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0134-02 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
00093-5740-19 00093-5740 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Dec. 31, 2022 No Longer Used
00093-5740-65 00093-5740 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Dec. 31, 2022 No Longer Used
30237-8900-06 30237-8900 Sipuleucel-T Provenge 50000000.0 1/1 Immunotherapy Immunomodulator Prostatic Acid Phosphatase Intravenous April 29, 2010 In Use
00093-5741-19 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5741-65 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5742-19 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5742-65 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00378-1935-01 00378-1935 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
00378-1935-28 00378-1935 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
00378-1942-01 00378-1942 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
00378-1942-21 00378-1942 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
31722-0257-01 31722-0257 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0257-28 31722-0257 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0258-01 31722-0258 LENALIDOMIDE LENALIDOMIDE 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0258-28 31722-0258 LENALIDOMIDE LENALIDOMIDE 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0259-01 31722-0259 LENALIDOMIDE LENALIDOMIDE 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0259-28 31722-0259 LENALIDOMIDE LENALIDOMIDE 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0260-01 31722-0260 LENALIDOMIDE LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0260-21 31722-0260 LENALIDOMIDE LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0261-01 31722-0261 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0261-21 31722-0261 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0262-01 31722-0262 LENALIDOMIDE LENALIDOMIDE 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
31722-0262-21 31722-0262 LENALIDOMIDE LENALIDOMIDE 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
00480-1241-28 00480-1241 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 8, 2023 In Use
00480-1245-21 00480-1245 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 8, 2023 In Use
42291-0072-01 42291-0072 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 14, 2023 In Use
47781-0483-01 47781-0483 Lenalidomide LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
47781-0483-28 47781-0483 Lenalidomide LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
47781-0487-01 47781-0487 Lenalidomide LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
47781-0487-77 47781-0487 Lenalidomide LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
62856-0601-22 62856-0601 Alitretinoin Panretin 60.0 mg/60g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical Feb. 3, 2009 Oct. 31, 2021 No Longer Used
00480-1242-28 00480-1242 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
00480-1243-28 00480-1243 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
00480-1244-21 00480-1244 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
00480-1246-21 00480-1246 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
68682-0002-60 68682-0002 Bexarotene Bexarotene 1.0 g/100g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical June 28, 2000 In Use
99207-0260-01 99207-0260 Imiquimod Aldara 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 27, 1997 Dec. 31, 2015 No Longer Used
99207-0260-12 99207-0260 Imiquimod Aldara 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 27, 1997 June 30, 2022 No Longer Used
59651-0342-01 59651-0342 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0342-07 59651-0342 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0342-28 59651-0342 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0343-01 59651-0343 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0343-07 59651-0343 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0343-28 59651-0343 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0344-01 59651-0344 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0344-07 59651-0344 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0344-28 59651-0344 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0345-01 59651-0345 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0345-07 59651-0345 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0345-21 59651-0345 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0346-01 59651-0346 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0346-07 59651-0346 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0346-21 59651-0346 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0347-01 59651-0347 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0347-07 59651-0347 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
59651-0347-21 59651-0347 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 6, 2023 In Use
60505-4532-02 60505-4532 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 9, 2023 In Use
60505-4536-02 60505-4536 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 9, 2023 In Use
63304-0041-01 63304-0041 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 12, 2023 In Use
63304-0041-27 63304-0041 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 12, 2023 In Use
63304-0042-01 63304-0042 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 4, 2023 In Use
63304-0042-27 63304-0042 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 4, 2023 In Use
63304-0043-01 63304-0043 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 4, 2023 In Use
63304-0043-27 63304-0043 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 4, 2023 In Use
63304-0044-01 63304-0044 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 4, 2023 In Use
63304-0044-22 63304-0044 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 4, 2023 In Use
63304-0045-01 63304-0045 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 12, 2023 In Use
63304-0045-22 63304-0045 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 12, 2023 In Use
63304-0046-01 63304-0046 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 4, 2023 In Use
63304-0046-22 63304-0046 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 4, 2023 In Use
69097-0384-81 69097-0384 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
69097-0604-73 69097-0604 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 9, 2023 In Use
70710-1030-01 70710-1030 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70710-1030-07 70710-1030 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70710-1034-01 70710-1034 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70710-1034-08 70710-1034 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70771-1676-01 70771-1676 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70771-1676-07 70771-1676 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70771-1680-01 70771-1680 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70771-1680-08 70771-1680 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
00074-7269-50 00074-7269 Cyclosporine Gengraf 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 25, 2010 In Use
00078-0109-01 00078-0109 Cyclosporine Sandimmune 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Nov. 14, 1983 In Use
00078-0109-61 00078-0109 Cyclosporine Sandimmune 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Aug. 10, 2012 In Use
00078-0240-15 00078-0240 Cyclosporine Sandimmune 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 2, 1990 In Use
00078-0240-61 00078-0240 Cyclosporine Sandimmune 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 22, 2010 In Use
00078-0241-15 00078-0241 Cyclosporine Sandimmune 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 2, 1990 In Use
00078-0241-61 00078-0241 Cyclosporine Sandimmune 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 22, 2010 In Use
00078-0246-15 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0246-61 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 13, 2012 In Use
00078-0248-15 00078-0248 cyclosporine NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0248-61 00078-0248 cyclosporine NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 13, 2012 In Use

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