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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
55150-0311-00 55150-0311 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 1250.0 mg/5mL Hormonal Therapy Progestin Intramuscular May 9, 2019 Oct 9, 2019 In Use
00310-7720-10 00310-7720 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Oct 8, 2019 Mar 31, 2023 No Longer Used
58160-0830-43 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Jul 25, 2011 Nov 29, 2016 No Longer Used
52125-0712-08 52125-0712 Triamcinolone Acetonide Kenalog-40 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular Apr 15, 2014 Apr 15, 2015 No Longer Used
00006-4119-02 00006-4119 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec 10, 2014 May 22, 2019 In Use
00591-5019-02 00591-5019 Fulvestrant Fulvestrant 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Aug 22, 2019 Jun 30, 2024 No Longer Used
00480-9259-08 00480-9259 Octreotide Acetate Octreotide Acetate 3.33 mg/ml Hormonal Therapy Somatostatin Analog Intramuscular Oct 1, 2024 In Use
68727-0900-03 68727-0900 asparaginase erwinia chrysanthemi (recombinant)-rywn Rylaze 20.0 mg/mL Chemotherapy Miscellaneous Agent Enzyme Intramuscular Jun 30, 2021 In Use
42023-0136-01 42023-0136 Estradiol Valerate Estradiol Valerate 40.0 mg/mL Hormonal Therapy Estrogen Intramuscular Jun 1, 2012 Mar 31, 2017 No Longer Used
00006-4045-01 00006-4045 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Jun 8, 2006 In Use
55150-0311-05 55150-0311 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 1250.0 mg/5mL Hormonal Therapy Progestin Intramuscular May 9, 2019 In Use
71731-6121-01 71731-6121 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Apr 1, 2021 In Use
00006-4121-02 00006-4121 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec 10, 2014 In Use
00480-9257-08 00480-9257 Octreotide Acetate Octreotide Acetate 1.667 mg/ml Hormonal Therapy Somatostatin Analog Intramuscular Mar 20, 2025 In Use
00517-0420-01 00517-0420 ESTRADIOL VALERATE ESTRADIOL VALERATE 20.0 mg/mL Hormonal Therapy Estrogen Intramuscular Mar 1, 2020 In Use
00517-0440-01 00517-0440 ESTRADIOL VALERATE ESTRADIOL VALERATE 40.0 mg/mL Hormonal Therapy Estrogen Intramuscular Mar 1, 2020 In Use
00310-0720-10 00310-0720 Fulvestrant Faslodex 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Nov 1, 2010 In Use
00781-3492-12 00781-3492 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Mar 26, 2020 Aug 31, 2024 No Longer Used
00006-4119-01 00006-4119 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec 10, 2014 In Use
62559-0540-55 62559-0540 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular Jun 3, 2016 Jun 3, 2016 No Longer Used
52544-0153-02 52544-0153 Triptorelin Pamoate Trelstar 3.75 mg/2mL Hormonal Therapy GnRH Agonist Intramuscular Jun 15, 2000 Oct 31, 2018 No Longer Used
70121-1463-02 70121-1463 Fulvestrant Fulvestrant 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Mar 4, 2019 In Use
58160-0830-05 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Mar 20, 2012 Nov 29, 2016 No Longer Used
00574-0870-05 00574-0870 Estradiol Valerate Estradiol Valerate 20.0 mg/mL Hormonal Therapy Estrogen Intramuscular Mar 31, 2010 In Use
58160-0830-46 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Oct 16, 2009 Sep 3, 2013 No Longer Used

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