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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength (Ascending) SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
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
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
69097-0516-07 69097-0516 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Jan. 18, 2019 In Use
70771-1374-03 70771-1374 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct. 8, 2018 In Use
68382-0383-06 68382-0383 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct. 8, 2018 In Use
59572-0711-01 59572-0711 Luspatercept REBLOZYL 25.0 mg/1 Ancillary Therapy Erythropoiesis-Stimulating Agent Subcutaneous Nov. 8, 2019 In Use
65162-0240-03 65162-0240 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec. 29, 2018 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
60687-0227-11 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 24, 2017 In Use
60687-0227-94 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 24, 2017 In Use
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
63629-2056-01 63629-2056 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec. 19, 2019 In Use
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
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
69097-0316-02 69097-0316 exemestane EXEMESTANE 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral April 27, 2018 In Use
00069-0227-01 00069-0227 Lorlatinib Lorbrena 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1 Oral Nov. 19, 2018 In Use
00069-0298-60 00069-0298 Glasdegib Daurismo 25.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral Dec. 10, 2018 In Use
71777-0390-01 71777-0390 LAROTRECTINIB VITRAKVI 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRK Oral Nov. 26, 2018 In Use
73116-0125-01 73116-0125 duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0125-02 73116-0125 duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
60429-0015-01 60429-0015 Cortisone Acetate Cortisone Acetate 25.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 13, 1972 Jan. 2, 2017 No Longer Used
00378-6679-28 00378-6679 sunitinib malate Sunitinib Malate 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FLT, PDGFR, KIT, RET, CSF Oral Jan. 4, 2022 In Use
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
00054-0382-25 00054-0382 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Sept. 16, 2013 In Use
00054-4129-25 00054-4129 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 17, 1999 July 11, 2016 No Longer Used
54868-5218-00 54868-5218 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 17, 1999 In Use
54868-5218-01 54868-5218 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 17, 1999 In Use
50242-0062-01 50242-0062 Erlotinib Hydrochloride Tarceva 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2005 In Use
54868-5290-00 54868-5290 Erlotinib Hydrochloride Tarceva 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral July 1, 2005 In Use
00009-7663-04 00009-7663 Exemestane Aromasin 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct. 21, 1999 In Use
00054-0080-13 00054-0080 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral April 1, 2011 In Use
00832-0595-30 00832-0595 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral July 27, 2017 In Use
54868-5261-00 54868-5261 Exemestane Aromasin 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 29, 2005 In Use
59762-2858-01 59762-2858 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral April 1, 2011 In Use
50881-0025-60 50881-0025 Ruxolitinib Jakafi 25.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Nov. 16, 2011 In Use
00069-0770-38 00069-0770 Sunitinib Malate Sutent 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FLT, PDGFR, KIT, RET, CSF Oral Jan. 26, 2006 In Use
00074-3108-32 00074-3108 Cyclosporine Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 1, 2015 In Use
00054-4499-11 00054-4499 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
00555-0485-04 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
00555-0485-27 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
10019-0982-01 10019-0982 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 7, 2020 In Use
42292-0051-05 42292-0051 Erlotinib hydrochloride Erlotinib Hydrochloride 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 28, 2019 Jan. 31, 2021 No Longer Used
59923-0725-30 59923-0725 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 1, 2020 In Use
68382-0913-06 68382-0913 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use

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