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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
59572-0501-21 59572-0501 Pomalidomide Pomalyst 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0502-00 59572-0502 Pomalidomide Pomalyst 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0502-21 59572-0502 Pomalidomide Pomalyst 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0503-00 59572-0503 Pomalidomide Pomalyst 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0503-21 59572-0503 Pomalidomide Pomalyst 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0504-00 59572-0504 Pomalidomide Pomalyst 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0504-21 59572-0504 Pomalidomide Pomalyst 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
00555-0808-02 00555-0808 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral June 26, 2007 In Use
68462-0792-01 68462-0792 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 23, 2016 In Use
00078-0110-22 00078-0110 Cyclosporine Sandimmune 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 14, 1983 In Use
00172-7313-20 00172-7313 Cyclosporine Cyclosporine 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 In Use
54868-5522-00 54868-5522 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb. 10, 2006 In Use
54868-6232-00 54868-6232 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb. 10, 2011 In Use
55390-0122-10 55390-0122 Cyclosporine Cyclosporine Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Dec. 15, 1999 Feb. 29, 2012 No Longer Used
60505-0354-01 60505-0354 Cyclosporine Cyclosporine Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 1, 2005 Jan. 31, 2012 No Longer Used
62584-0827-11 62584-0827 Cyclosporine Cyclosporine Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Dec. 11, 2009 Sept. 30, 2011 No Longer Used
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
43975-0315-10 43975-0315 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 10, 2018 In Use
29336-0610-12 29336-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 24, 2010 Jan. 31, 2015 No Longer Used
29336-0610-24 29336-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical June 24, 2011 June 24, 2011 No Longer Used
00074-6463-32 00074-6463 Cyclosporine Modified Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Aug. 31, 2017 No Longer Used
00074-6479-32 00074-6479 Cyclosporine Modified Gengraf 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Sept. 16, 2017 No Longer Used
00172-7310-00 00172-7310 Cyclosporine Modified Cyclosporine Modified 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 March 31, 2017 No Longer Used
00172-7310-46 00172-7310 Cyclosporine Modified Cyclosporine Modified 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 March 31, 2017 No Longer Used
00172-7311-00 00172-7311 Cyclosporine Modified Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral April 28, 2005 Feb. 28, 2017 No Longer Used
00172-7311-46 00172-7311 Cyclosporine Modified Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral April 28, 2005 Feb. 28, 2017 No Longer Used
00172-7312-00 00172-7312 Cyclosporine Modified Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 March 31, 2017 No Longer Used
00172-7312-46 00172-7312 Cyclosporine Modified Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 29, 2005 March 31, 2017 No Longer Used
00832-0285-00 00832-0285 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral July 25, 2018 In Use
69238-1250-01 69238-1250 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 4, 2018 In Use
00115-1476-23 00115-1476 Imiquimod Imiquimod 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 28, 2011 June 1, 2017 No Longer Used
00115-1476-59 00115-1476 Imiquimod Imiquimod 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 28, 2011 June 1, 2017 No Longer Used
68084-0075-11 68084-0075 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral July 18, 2013 In Use
68084-0075-21 68084-0075 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral July 18, 2013 In Use
00054-0399-25 00054-0399 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 11, 2020 In Use
72189-0084-24 72189-0084 IMIQUIMOD IMIQUIMOD 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical March 23, 2020 In Use
00591-2433-15 00591-2433 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 29, 2021 In Use
00591-2434-15 00591-2434 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 29, 2021 In Use
00591-2451-15 00591-2451 Isotretinoin Isotretinoin 25.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 29, 2021 In Use
00591-2501-15 00591-2501 Isotretinoin Isotretinoin 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 29, 2021 In Use
00591-2435-15 00591-2435 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 29, 2021 In Use
00591-2436-15 00591-2436 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 29, 2021 In Use
10631-0002-31 10631-0002 isotretinoin Absorica LD 8.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 20, 2019 In Use
10631-0003-31 10631-0003 isotretinoin Absorica LD 16.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 20, 2019 In Use
10631-0004-31 10631-0004 isotretinoin Absorica LD 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 20, 2019 In Use
10631-0005-31 10631-0005 isotretinoin Absorica LD 24.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 20, 2019 In Use

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