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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
00006-5331-58 00006-5331 Belzutifan WELIREG 40.0 mg/1 Chemotherapy Miscellaneous Agent HIF-2 alpha Oral June 21, 2023 In Use
00006-5331-59 00006-5331 Belzutifan WELIREG 40.0 mg/1 Chemotherapy Miscellaneous Agent HIF-2 alpha Oral June 21, 2023 In Use
54879-0027-11 54879-0027 Arsenic Trioxide Arsenic Trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous May 29, 2019 In Use
70860-0217-10 70860-0217 Arsenic Trioxide Arsenic Trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 30, 2020 Oct. 31, 2024 In Use
72205-0171-07 72205-0171 ARSENIC TRIOXIDE ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Feb. 6, 2024 In Use
72205-0172-07 72205-0172 ARSENIC TRIOXIDE ARSENIC TRIOXIDE 2.0 mg/2mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Feb. 6, 2024 In Use
83090-0009-01 83090-0009 Arsenic trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 9, 2023 In Use
83090-0009-10 83090-0009 Arsenic trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 9, 2023 In Use
83090-0010-01 83090-0010 Arsenic trioxide ARSENIC TRIOXIDE 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 9, 2023 In Use
83090-0010-10 83090-0010 Arsenic trioxide ARSENIC TRIOXIDE 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 9, 2023 In Use
82448-0050-18 82448-0050 Nirogacestat OGSIVEO 50.0 mg/1 Ancillary Therapy Miscellaneous Agent Ɣ Secretase Inhibitor Oral Nov. 27, 2023 In Use
70121-1658-01 70121-1658 Arsenic Trioxide Arsenic Trioxide 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Aug. 20, 2021 In Use
55150-0366-10 55150-0366 ARSENIC TRIOXIDE ARSENIC TRIOXIDE 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Oct. 15, 2021 In Use
68083-0462-10 68083-0462 Arsenic Trioxide Arsenic Trioxide 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Oct. 7, 2021 In Use
64764-0800-28 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
64764-0800-56 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
42291-0321-01 42291-0321 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral July 23, 2013 In Use
50742-0525-07 50742-0525 arsenic trioxide ARSENIC TRIOXIDE 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Jan. 27, 2021 In Use
63323-0637-10 63323-0637 Arsenic Trioxide Arsenic Trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Aug. 31, 2018 In Use
63459-0600-10 63459-0600 Arsenic Trioxide Trisenox 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Oct. 15, 2000 Aug. 15, 2021 No Longer Used
57902-0249-05 57902-0249 Asparaginase Erwinaze 10000.0 [iU]/mL Chemotherapy Miscellaneous Agent Enzyme Intramuscular, Intravenous Nov. 18, 2011 July 23, 2021 No Longer Used
72694-0515-01 72694-0515 Calaspargase Pegol Asparlas 750.0 U/mL Chemotherapy Miscellaneous Agent Enzyme Intravenous Sept. 27, 2019 In Use
00015-3080-60 00015-3080 Mitotane Lysodren 500.0 mg/1 Chemotherapy Miscellaneous Agent Adrenal Suppressant Oral June 1, 2009 March 31, 2021 No Longer Used
00944-3810-01 00944-3810 Pegaspargase Oncaspar 750.0 [iU]/mL Chemotherapy Miscellaneous Agent Enzyme Intramuscular, Intravenous Feb. 1, 1994 May 16, 2020 No Longer Used
24535-0831-01 24535-0831 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Aug. 20, 2017 In Use

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