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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
59651-0347-21 59651-0347 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 6, 2023 In Use
60219-1717-02 60219-1717 Lenalidomide LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 12, 2025 In Use
59572-0205-94 59572-0205 Thalidomide Thalomid 50.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jun 20, 2003 In Use
59572-0220-16 59572-0220 Thalidomide Thalomid 200.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jun 20, 2003 In Use
70710-1033-01 70710-1033 LENALIDOMIDE LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 12, 2022 In Use
73380-4700-01 73380-4700 MOXETUMOMAB PASUDOTOX LUMOXITI 1.0 mg/mL Immunotherapy Drug Antibody Conjugate CD22 Intravenous May 15, 2020 In Use
59572-0215-93 59572-0215 Thalidomide Thalomid 150.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 20, 2007 In Use
59651-0197-21 59651-0197 Pomalidomide Pomalidomide 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Oct 30, 2020 In Use
70377-0054-12 70377-0054 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2025 In Use
59572-0515-03 59572-0515 idecabtagene vicleucel Abecma 300000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous Mar 26, 2021 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
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
00007-3261-01 00007-3261 Tositumomab, Iodine I-131 Bexxar Dosimetric Immunotherapy Radioimmunotherapy CD20 Jul 15, 2009 Feb 13, 2014 No Longer Used
00074-1055-01 00074-1055 Telisotuzumab Vedotin EMRELIS 100.0 mg/mL Immunotherapy Drug Antibody Conjugate c-MET Intravenous May 14, 2025 In Use
00078-0690-61 00078-0690 Ofatumumab Arzerra 20.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous Feb 1, 2016 Mar 31, 2026 In Use
57894-0514-01 57894-0514 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) RYBREVANT FASPRO 2240.0 mg/14mL, 28000.0 mg/14mL Immunotherapy Bispecific Antibody EGFR, MET Subcutaneous Dec 17, 2025 In Use
99207-0260-01 99207-0260 Imiquimod Aldara 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb 27, 1997 Dec 31, 2015 No Longer Used
31722-0259-28 31722-0259 LENALIDOMIDE LENALIDOMIDE 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
59572-0220-96 59572-0220 Thalidomide Thalomid 200.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jun 20, 2003 In Use
59651-0194-21 59651-0194 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Oct 30, 2020 In Use
72579-0121-01 72579-0121 Tislelizumab, Tislelizumab-jsgr TEVIMBRA 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Mar 14, 2024 In Use
00378-1936-01 00378-1936 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
60505-4533-02 60505-4533 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use

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