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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
00078-1217-61 00078-1217 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous Jan 15, 2026 In Use
69488-0010-61 69488-0010 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous Mar 23, 2022 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
60505-4500-02 60505-4500 Pomalidomide Pomalidomide 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 11, 2026 In Use
60505-4498-02 60505-4498 Pomalidomide Pomalidomide 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 11, 2026 In Use
47781-0485-28 47781-0485 Lenalidomide LENALIDOMIDE 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 3, 2022 In Use
16729-0694-09 16729-0694 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 17, 2026 In Use
31722-0770-32 31722-0770 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2026 In Use
16729-0696-06 16729-0696 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 26, 2026 In Use
00007-3261-01 00007-3261 Tositumomab, Iodine I-131 Bexxar Dosimetric Immunotherapy Radioimmunotherapy CD20 Jul 15, 2009 Feb 13, 2014 No Longer Used
31722-0772-21 31722-0772 Pomalidomide Pomalidomide 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2026 In Use
51144-0003-01 51144-0003 Tisotumab vedotin TIVDAK 40.0 mg/4mL Immunotherapy Drug Antibody Conjugate Tissue factor Intravenous Sep 20, 2021 In Use
60505-4534-01 60505-4534 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 Mar 8, 2023 In Use
31722-0773-21 31722-0773 Pomalidomide Pomalidomide 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2026 In Use
00480-4022-21 00480-4022 Pomalidomide Pomalidomide 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 2, 2026 In Use
16729-0692-09 16729-0692 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Apr 8, 2026 In Use
16729-0693-09 16729-0693 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 26, 2026 In Use
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
50242-0108-86 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous Jun 23, 2017 In Use
31722-0770-01 31722-0770 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2026 In Use
16729-0697-06 16729-0697 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Apr 8, 2026 In Use
31722-0771-01 31722-0771 Pomalidomide Pomalidomide 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2026 In Use
00480-4035-21 00480-4035 Pomalidomide Pomalidomide 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 2, 2026 In Use
31722-0772-01 31722-0772 Pomalidomide Pomalidomide 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2026 In Use
16729-0695-06 16729-0695 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 2, 2026 In Use

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