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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength (Descending) SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
50242-0260-86 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 In Use
55513-0004-01 55513-0004 Darbepoetin alfa Aranesp 60.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0004-04 55513-0004 Darbepoetin alfa Aranesp 60.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
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
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
00006-4119-03 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
00006-4121-01 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
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
55513-0023-01 55513-0023 Darbepoetin alfa Aranesp 60.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use
55513-0023-04 55513-0023 Darbepoetin alfa Aranesp 60.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 14, 2006 In Use
55513-0710-01 55513-0710 Denosumab Prolia 60.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous June 5, 2010 In Use
55513-0710-21 55513-0710 Denosumab Prolia 60.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous March 5, 2024 In Use
59212-0601-22 59212-0601 alitretinoin PANRETIN 60.0 mg/60g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical Sept. 10, 2019 In Use
62856-0601-22 62856-0601 Alitretinoin Panretin 60.0 mg/60g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical Feb. 3, 2009 Oct. 31, 2021 No Longer Used
76075-0101-01 76075-0101 Carfilzomib Kyprolis 60.0 mg/30mL Chemotherapy Proteasome Inhibitor 20S Intravenous July 20, 2012 In Use
14789-0013-10 14789-0013 Busulfan Busulfan 60.0 mg/10mL Chemotherapy Alkylating Agent Alkylsulfonate Intravenous Sept. 15, 2023 July 21, 2024 No Longer Used
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
00002-4165-02 00002-4165 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 6, 1998 Dec. 31, 2017 No Longer Used

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