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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class (Ascending) Administration Route Package Effective Date Package Discontinuation Date Status
70700-0273-22 70700-0273 ESTRADIOL VALERATE Estradiol valerate 10.0 mg/mL Hormonal Therapy Estrogen Intramuscular May 1, 2023 In Use
70700-0274-22 70700-0274 ESTRADIOL VALERATE Estradiol valerate 20.0 mg/mL Hormonal Therapy Estrogen Intramuscular May 1, 2023 In Use
70700-0275-22 70700-0275 ESTRADIOL VALERATE Estradiol valerate 40.0 mg/mL Hormonal Therapy Estrogen Intramuscular May 1, 2023 In Use
72189-0415-30 72189-0415 ANASTROZOLE ANASTROZOLE 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 30, 2023 In Use
00069-1311-04 00069-1311 epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 1, 2020 In Use
00069-1311-10 00069-1311 epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
00002-4184-02 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 Jan. 1, 2023 In Use
00002-4184-07 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 Nov. 30, 2019 In Use
00002-4184-30 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 In Use
00046-1100-51 00046-1100 Estrogens, Conjugated Premarin 0.3 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 April 30, 2020 In Use
00046-1100-52 00046-1100 Estrogens, Conjugated Premarin 0.3 mg/1 Hormonal Therapy Estrogen Oral Nov. 11, 2019 In Use
00046-1100-81 00046-1100 Estrogens, Conjugated Premarin 0.3 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 In Use
00046-1100-91 00046-1100 Estrogens, Conjugated Premarin 0.3 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 In Use
00046-1102-51 00046-1102 Estrogens, Conjugated Premarin 0.625 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 May 22, 2020 In Use
00046-1102-52 00046-1102 Estrogens, Conjugated Premarin 0.625 mg/1 Hormonal Therapy Estrogen Oral Feb. 10, 2020 In Use
00046-1102-81 00046-1102 Estrogens, Conjugated Premarin 0.625 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 In Use
00046-1102-91 00046-1102 Estrogens, Conjugated Premarin 0.625 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 In Use
00046-1104-51 00046-1104 Estrogens, Conjugated Premarin 1.25 mg/1 Hormonal Therapy Estrogen Oral Sept. 1, 2004 April 30, 2013 In Use
00046-1104-81 00046-1104 Estrogens, Conjugated Premarin 1.25 mg/1 Hormonal Therapy Estrogen Oral Sept. 1, 2004 In Use
00046-1104-91 00046-1104 Estrogens, Conjugated Premarin 1.25 mg/1 Hormonal Therapy Estrogen Oral Sept. 1, 2004 In Use
00069-1305-10 00069-1305 epoetin alfa-epbx RETACRIT 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1307-10 00069-1307 epoetin alfa-epbx RETACRIT 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1308-10 00069-1308 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1309-04 00069-1309 epoetin alfa-epbx RETACRIT 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1309-10 00069-1309 epoetin alfa-epbx RETACRIT 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1306-10 00069-1306 epoetin alfa-epbx RETACRIT 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1318-04 00069-1318 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 1, 2020 In Use
00069-1318-10 00069-1318 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
00078-0180-01 00078-0180 Octreotide Acetate Sandostatin 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0180-61 00078-0180 Octreotide Acetate Sandostatin 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use
00078-0181-01 00078-0181 Octreotide Acetate Sandostatin 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0181-61 00078-0181 Octreotide Acetate Sandostatin 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use
00078-0182-01 00078-0182 Octreotide Acetate Sandostatin 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0182-61 00078-0182 Octreotide Acetate Sandostatin 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use
00310-0720-10 00310-0720 Fulvestrant Faslodex 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Nov. 1, 2010 In Use
00310-0720-25 00310-0720 Fulvestrant Faslodex 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Nov. 1, 2010 Sept. 21, 2010 In Use
00310-0720-50 00310-0720 Fulvestrant Faslodex 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular May 20, 2002 Oct. 31, 2015 In Use
00641-6174-01 00641-6174 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 4, 2005 In Use
00641-6174-10 00641-6174 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 4, 2005 In Use
25021-0455-05 25021-0455 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 Feb. 29, 2020 In Use
57884-2021-01 57884-2021 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral May 16, 2013 In Use
60429-0910-30 60429-0910 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Sept. 28, 2016 Feb. 28, 2023 No Longer Used
62935-0303-30 62935-0303 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Feb. 26, 2003 In Use
67457-0311-05 67457-0311 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Sept. 9, 2019 In Use
67157-0111-05 67157-0111 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular In Use
67157-0111-25 67157-0111 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular Dec. 2, 2016 Dec. 2, 2016 In Use
00310-4715-11 00310-4715 IV Solution Stabilizer for Lumoxiti IV Solution Stabilizer for Lumoxiti 6.5 mg/mL Ancillary Therapy Excipient Intravenous Oct. 24, 2018 In Use
70518-2484-00 70518-2484 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec. 13, 2019 In Use
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
55150-0311-01 55150-0311 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 1250.0 mg/5mL Hormonal Therapy Progestin Intramuscular May 9, 2019 In Use

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