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NDC-11 (Package) NDC-9 (Product) (Ascending) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
71205-0908-11 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-30 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-60 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-90 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71209-0082-01 71209-0082 Raloxifene hydrochloride Raloxifene hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 30, 2017 In Use
71209-0082-05 71209-0082 Raloxifene hydrochloride Raloxifene hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 30, 2017 In Use
71209-0082-11 71209-0082 Raloxifene hydrochloride Raloxifene hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 13, 2021 In Use
71209-0082-13 71209-0082 Raloxifene hydrochloride Raloxifene hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 30, 2017 In Use
71258-0015-02 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous July 30, 2018 In Use
71258-0015-22 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous July 30, 2018 In Use
71287-0119-02 71287-0119 Axicabtagene ciloleucel Yescarta 2000000.0 1/68mL Immunotherapy CAR-T CD19 Intravenous Oct. 18, 2017 In Use
71287-0219-02 71287-0219 brexucabtagene autoleucel TECARTUS 2000000.0 1/68mL Immunotherapy CAR-T CD19 Intravenous July 24, 2020 In Use
71287-0220-02 71287-0220 brexucabtagene autoleucel TECARTUS 1000000.0 1/68mL Immunotherapy CAR-T CD19 Intravenous Oct. 1, 2021 In Use
71288-0100-05 71288-0100 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 19, 2017 In Use
71288-0100-15 71288-0100 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 19, 2017 In Use
71288-0100-45 71288-0100 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 19, 2017 In Use
71288-0100-51 71288-0100 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 19, 2017 In Use
71288-0101-10 71288-0101 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Oct. 1, 2017 In Use
71288-0101-20 71288-0101 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Oct. 1, 2017 In Use
71288-0104-10 71288-0104 Levoleucovorin calcium Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 22, 2019 In Use
71288-0105-18 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 16, 2019 In Use
71288-0105-25 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 16, 2019 In Use
71288-0106-10 71288-0106 Bleomycin Sulfate Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Aug. 31, 2018 In Use
71288-0107-20 71288-0107 Bleomycin Sulfate Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Aug. 31, 2018 In Use

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