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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
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
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
68727-0900-03 68727-0900 asparaginase erwinia chrysanthemi (recombinant)-rywn Rylaze 20.0 mg/mL Chemotherapy Miscellaneous Agent Enzyme Intramuscular June 30, 2021 In Use
49315-0005-10 49315-0005 Arsenic trioxide Arsenic trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 14, 2018 In Use
50742-0438-10 50742-0438 arsenic trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 15, 2018 In Use
68382-0997-10 68382-0997 Arsenic trioxide Arsenic trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 14, 2018 In Use
63629-8439-01 63629-8439 Pilocarpine hydrchloride Pilocarpine hydrchloride 5.0 mg/1 Ancillary Therapy Miscellaneous Agent Cholinergic Agonist Oral Feb. 9, 2022 In Use
63459-0601-06 63459-0601 Arsenic Trioxide Trisenox 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Dec. 22, 2017 In Use
00574-0792-01 00574-0792 pilocarpine hydrchloride pilocarpine hydrchloride 5.0 mg/1 Ancillary Therapy Miscellaneous Agent Cholinergic Agonist Oral Aug. 24, 2020 In Use
14789-0600-10 14789-0600 Arsenic Trioxide Arsenic Trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 19, 2018 In Use
00555-0882-02 00555-0882 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Oct. 19, 1998 In Use
49884-0724-01 49884-0724 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Feb. 24, 1999 In Use
54868-4773-00 54868-4773 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral April 11, 2003 In Use

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