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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
11994-0016-01 11994-0016 samarium Sm 153 lexidronam Quadramet 50.0 mCi/mL Ancillary Therapy Radiopharmaceutical Samarium Sm 153 Intravenous May 19, 1997 In Use
69488-0010-61 69488-0010 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous March 23, 2022 In Use
65174-0880-00 65174-0880 Sodium Iodide I 131 HICON 1000.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral April 7, 2003 In Use
65174-0880-25 65174-0880 Sodium Iodide I 131 HICON 1000.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral April 7, 2003 In Use
65174-0880-50 65174-0880 Sodium Iodide I 131 HICON 1000.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral April 7, 2003 In Use
50419-0208-01 50419-0208 Radium Ra 223 dichloride Xofigo 30.0 uCi/mL Chemotherapy Radiopharmaceutical Radium 223 Intravenous May 20, 2013 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
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
79802-0200-30 79802-0200 belumosudil Rezurock 200.0 mg/1 Chemotherapy Rho Kinase Inhibitor ROCK 1, ROCK2 Oral July 16, 2021 In Use
75929-0174-03 75929-0174 Belumosudil Rezurock 200.0 mg/1 Chemotherapy Rho Kinase Inhibitor ROCK 1, ROCK2 Oral July 16, 2021 In Use
54868-4170-00 54868-4170 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 11, 2000 In Use
54868-4170-01 54868-4170 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 11, 2000 In Use
65162-0057-03 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 20, 2016 In Use
65162-0057-09 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 20, 2016 In Use
65162-0057-10 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 20, 2016 In Use
65162-0057-11 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 20, 2016 In Use
65162-0057-33 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 20, 2016 In Use
65162-0057-50 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 20, 2016 In Use
00310-0600-30 00310-0600 Tamoxifen Citrate Nolvadex Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 1, 1995 March 31, 2008 No Longer Used
00310-0604-60 00310-0604 Tamoxifen Citrate Nolvadex Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Sept. 1, 1990 March 31, 2008 No Longer Used
00555-0446-05 00555-0446 Tamoxifen Citrate Tamoxifen Citrate Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Feb. 20, 2003 April 30, 2011 No Longer Used
00555-0446-09 00555-0446 Tamoxifen Citrate Tamoxifen Citrate Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Feb. 20, 2003 April 30, 2011 No Longer Used

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