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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
69488-0010-61 69488-0010 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous Mar 23, 2022 In Use
00078-1217-61 00078-1217 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous Jan 15, 2026 In Use
00007-3260-31 00007-3260 Tositumomab Bexxar Immunotherapy Radioimmunotherapy CD20 Jul 15, 2009 Nov 28, 2014 No Longer Used
00003-7125-11 00003-7125 nivolumab and relatlimab-rmbw OPDUALAG 12.0 mg/mL, 4.0 mg/mL Immunotherapy Checkpoint Inhibitor, Monoclonal Antibody PD-1, LAG3 Intravenous Mar 18, 2022 In Use
50242-0245-86 50242-0245 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 In Use
00006-3026-04 00006-3026 Pembrolizumab Keytruda 25.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Aug 1, 2019 In Use
63850-0131-01 63850-0131 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
51991-0342-01 51991-0342 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2025 In Use
63850-0133-02 63850-0133 Pomalidomide Pomalidomide 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
63304-0044-01 63304-0044 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 4, 2023 In Use
00115-1476-59 00115-1476 Imiquimod Imiquimod 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb 28, 2011 Jun 1, 2017 No Longer Used
00069-0238-01 00069-0238 Rituximab-pvvr Ruxience 100.0 mg/10mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan 23, 2020 In Use
57894-0503-01 57894-0503 Daratumumab and hyaluronidase-fihj (human recombinant) Darzalex Faspro 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL Immunotherapy Monoclonal Antibody CD38 Subcutaneous May 1, 2020 In Use
00085-1287-02 00085-1287 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Mar 29, 2011 Jan 13, 2016 No Longer Used
87262-0160-02 87262-0160 Afamitresgene autoleucel TECELRA 10000000000.0 1/1 Immunotherapy T Cell Receptor (TCR) MAGE-A4 Intravenous Jan 19, 2026 In Use
51991-0344-01 51991-0344 Pomalidomide Pomalidomide 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2025 In Use
51991-0346-01 51991-0346 Pomalidomide Pomalidomide 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2025 In Use
60219-1717-01 60219-1717 Lenalidomide LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 12, 2025 In Use
63850-0132-01 63850-0132 Pomalidomide Pomalidomide 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
63850-0133-01 63850-0133 Pomalidomide Pomalidomide 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
63850-0134-01 63850-0134 Pomalidomide Pomalidomide 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
63850-0134-02 63850-0134 Pomalidomide Pomalidomide 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
00085-1388-01 00085-1388 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Mar 29, 2011 Jan 13, 2016 No Longer Used
50242-0061-01 50242-0061 Bevacizumab Avastin 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Feb 26, 2004 In Use
63850-0131-02 63850-0131 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use

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