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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
71258-0015-22 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous Jul 30, 2018 In Use
69945-0452-75 69945-0452 sodium iodide i 131 SODIUM IODIDE I 131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct 27, 2015 Jul 1, 2018 No Longer Used
69945-0452-10 69945-0452 sodium iodide i 131 SODIUM IODIDE I 131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct 27, 2015 Jul 1, 2018 No Longer Used
69945-0452-11 69945-0452 sodium iodide i 131 SODIUM IODIDE I 131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct 27, 2015 Jul 1, 2018 No Longer Used
55513-0488-96 55513-0488 Sotorasib LUMAKRAS 120.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral May 28, 2021 In Use
55513-0504-50 55513-0504 Sotorasib LUMAKRAS 320.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral Feb 2, 2023 In Use
55513-0512-60 55513-0512 Sotorasib LUMAKRAS 240.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral Jun 27, 2024 In Use
55513-0488-24 55513-0488 Sotorasib LUMAKRAS 120.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral May 28, 2021 In Use
80739-0812-12 80739-0812 Adagrasib KRAZATI 200.0 mg/1 Immunotherapy RAS Inhibitor KRAS G12C Oral Dec 12, 2022 In Use
80739-0812-18 80739-0812 Adagrasib KRAZATI 200.0 mg/1 Immunotherapy RAS Inhibitor KRAS G12C Oral Dec 12, 2022 In Use
55513-0488-02 55513-0488 Sotorasib LUMAKRAS 120.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral May 28, 2021 In Use
00024-5840-01 00024-5840 ziv-Aflibercept Zaltrap 100.0 mg/4mL Chemotherapy Recombinant Fusion Protein VEGF-IgG1 Intravenous Aug 3, 2012 In Use
00024-5840-03 00024-5840 ziv-Aflibercept Zaltrap 100.0 mg/4mL Chemotherapy Recombinant Fusion Protein VEGF-IgG1 Intravenous Aug 3, 2012 Nov 27, 2019 In Use
00024-5841-01 00024-5841 ziv-Aflibercept Zaltrap 200.0 mg/8mL, 200.0 mg/8mL Chemotherapy Recombinant Fusion Protein VEGF-IgG1 Intravenous Aug 3, 2012 In Use
75929-0174-03 75929-0174 Belumosudil Rezurock 200.0 mg/1 Chemotherapy Rho Kinase Inhibitor ROCK 1, ROCK2 Oral Jul 16, 2021 In Use
79802-0200-30 79802-0200 belumosudil Rezurock 200.0 mg/1 Chemotherapy Rho Kinase Inhibitor ROCK 1, ROCK2 Oral Jul 16, 2021 In Use
68084-0935-11 68084-0935 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 4, 2016 Jul 31, 2018 No Longer Used
75907-0059-10 75907-0059 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug 22, 2024 In Use
63739-0269-42 63739-0269 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 8, 2019 Dec 31, 2020 In Use
54868-3004-02 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Apr 26, 1994 In Use
66993-0661-30 66993-0661 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug 28, 2015 Jul 31, 2022 No Longer Used
43598-0505-01 43598-0505 Raloxifene hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Oct 12, 2016 In Use
51862-0682-01 51862-0682 TAMOXIFEN CITRATE SOLTAMOX 20.0 mg/10mL Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jun 18, 2021 In Use
51862-0642-60 51862-0642 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug 27, 2021 In Use
51862-0642-10 51862-0642 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug 27, 2021 In Use

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