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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
59572-0410-00 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec 27, 2005 In Use
65219-0672-01 65219-0672 Denosumab BOMYNTRA 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 2025 In Use
60505-4534-02 60505-4534 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 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
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
00378-1942-21 00378-1942 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 7, 2023 In Use
00093-6126-64 00093-6126 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Dec 19, 2013 Apr 30, 2015 No Longer Used
73043-0040-28 73043-0040 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jan 31, 2026 In Use
00085-1312-01 00085-1312 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Mar 29, 2011 Jan 13, 2016 No Longer Used
00085-1388-01 00085-1388 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Mar 29, 2011 Jan 13, 2016 No Longer Used
60505-4537-02 60505-4537 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
43598-0515-01 43598-0515 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
82705-0010-01 82705-0010 Epcoritamab-bysp EPKINLY 48.0 mg/.8mL Immunotherapy Monoclonal Antibody CD20, CD3 Subcutaneous May 19, 2023 In Use
00378-1936-01 00378-1936 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
63304-0042-27 63304-0042 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 4, 2023 In Use
57894-0502-05 57894-0502 Daratumumab Darzalex 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Nov 16, 2015 Oct 31, 2026 In Use
59651-0196-01 59651-0196 Pomalidomide Pomalidomide 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Oct 30, 2020 In Use
31722-0262-21 31722-0262 LENALIDOMIDE LENALIDOMIDE 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
00069-0308-01 00069-0308 trastuzumab-qyyp Trazimera 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous Mar 10, 2021 In Use
00004-0352-98 00004-0352 Peginterferon alfa-2a Pegasys Immunotherapy Cytokine Interferon Oct 16, 2002 Jul 31, 2015 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
59572-0220-16 59572-0220 Thalidomide Thalomid 200.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jun 20, 2003 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

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