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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name (Ascending) Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
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
59353-0002-10 59353-0002 Epoetin alfa-epbx RETACRIT 2000.0 [iU]/mL, 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
59353-0003-10 59353-0003 Epoetin alfa-epbx RETACRIT 3000.0 [iU]/mL, 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
59353-0004-10 59353-0004 Epoetin alfa-epbx RETACRIT 4000.0 [iU]/mL, 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
59353-0010-10 59353-0010 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL, 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
59353-0120-10 59353-0120 Epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL, 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
59353-0220-10 59353-0220 Epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL, 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
00002-2980-26 00002-2980 Selpercatinib RETEVMO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
00002-2980-60 00002-2980 Selpercatinib RETEVMO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
00002-3977-60 00002-3977 Selpercatinib RETEVMO 40.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
71332-0005-01 71332-0005 Olutasidenib REZLIDHIA 150.0 mg/1 Chemotherapy Enzyme Inhibitor IDH1 Oral Dec. 1, 2022 In Use
73491-0627-01 73491-0627 Efbemalenograstim alfa-vuxw RYZNEUTA 20.0 mg/mL Immunotherapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 23, 2023 In Use
00591-2367-01 00591-2367 Raloxifene Hydrochloride Raloxifene 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 18, 2015 In Use
00591-2367-10 00591-2367 Raloxifene Hydrochloride Raloxifene 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 18, 2015 In Use
00591-2367-30 00591-2367 Raloxifene Hydrochloride Raloxifene 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 18, 2015 In Use
69189-2367-01 69189-2367 Raloxifene Hydrochloride Raloxifene 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 9, 2016 May 24, 2017 No Longer Used
65862-0709-01 65862-0709 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 28, 2015 In Use
65862-0709-03 65862-0709 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 28, 2015 In Use
65862-0709-10 65862-0709 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 28, 2015 In Use
65862-0709-22 65862-0709 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 28, 2015 In Use
65862-0709-30 65862-0709 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 28, 2015 In Use
65862-0709-99 65862-0709 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 28, 2015 In Use
00093-7290-01 00093-7290 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 28, 2014 In Use
00093-7290-10 00093-7290 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 28, 2014 April 30, 2018 In Use

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