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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
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
00185-0932-87 00185-0932 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sept. 23, 2014 Nov. 21, 2015 No Longer Used
00185-0933-30 00185-0933 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jan. 13, 2000 Feb. 28, 2020 No Longer Used
00185-0933-86 00185-0933 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 21, 2015 Feb. 28, 2020 No Longer Used
00185-0933-87 00185-0933 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sept. 23, 2014 Nov. 21, 2015 No Longer Used
00591-2222-15 00591-2222 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Dec. 1, 2008 Dec. 31, 2017 In Use
00591-2223-15 00591-2223 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Dec. 1, 2008 Feb. 28, 2018 In Use
00591-2224-55 00591-2224 Cyclosporine Cyclosporine 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Dec. 1, 2008 July 31, 2016 In Use
55154-6349-00 55154-6349 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sept. 1, 2010 Oct. 31, 2010 No Longer Used
69189-0464-01 69189-0464 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 8, 2016 May 24, 2017 No Longer Used
42292-0007-01 42292-0007 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 15, 2016 Jan. 31, 2020 No Longer Used
42292-0007-10 42292-0007 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 15, 2016 Jan. 31, 2020 No Longer Used
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
69238-2088-06 69238-2088 Bexarotene Bexarotene 10.0 mg/g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical May 4, 2022 In Use
10370-0268-01 10370-0268 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 24, 2012 In Use
42291-0843-01 42291-0843 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 2, 2016 In Use
43598-0516-01 43598-0516 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0516-63 43598-0516 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0515-01 43598-0515 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0515-21 43598-0515 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0514-01 43598-0514 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0514-21 43598-0514 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0513-01 43598-0513 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0513-21 43598-0513 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0512-01 43598-0512 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0512-63 43598-0512 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0511-01 43598-0511 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
43598-0511-63 43598-0511 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
47781-0484-01 47781-0484 Lenalidomide LENALIDOMIDE 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 3, 2022 In Use
47781-0484-28 47781-0484 Lenalidomide LENALIDOMIDE 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 3, 2022 In Use
47781-0485-01 47781-0485 Lenalidomide LENALIDOMIDE 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 3, 2022 In Use
47781-0485-28 47781-0485 Lenalidomide LENALIDOMIDE 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 3, 2022 In Use
47781-0486-01 47781-0486 Lenalidomide LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 3, 2022 In Use
47781-0486-77 47781-0486 Lenalidomide LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 3, 2022 In Use
47781-0488-01 47781-0488 Lenalidomide LENALIDOMIDE 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 3, 2022 In Use
47781-0488-77 47781-0488 Lenalidomide LENALIDOMIDE 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 3, 2022 In Use
64380-0127-02 64380-0127 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 16, 2022 In Use

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