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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
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
63850-0134-02 63850-0134 Pomalidomide Pomalidomide 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
68727-0950-02 68727-0950 Zanidatamab-hrii ZIIHERA 50.0 mg/mL Immunotherapy Bispecific Antibody HER2 Intravenous Nov 20, 2024 In Use
63304-0044-01 63304-0044 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 4, 2023 In Use
60219-1717-01 60219-1717 Lenalidomide LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 12, 2025 In Use
51991-0342-01 51991-0342 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 28, 2025 In Use
63850-0133-01 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
50242-0125-01 50242-0125 Glofitamab Columvi 2.5 mg/2.5mL Immunotherapy Monoclonal Antibody CD20, CD3 Intravenous Jun 15, 2023 In Use
50242-0201-01 50242-0201 Mosunetuzumab Lunsumio Velo 45.0 mg/mL Immunotherapy Bispecific Antibody CD20, CD3 Subcutaneous Dec 19, 2025 In Use
55513-0077-01 55513-0077 Tarlatamab-dlle IMDELLTRA (AMG757) 10.0 mg/14ml Immunotherapy T Cell Receptor (TCR) DLL3, CD3 Intravenous Jun 12, 2024 In Use
69448-0015-05 69448-0015 Trastuzumab-strf HERCESSI 150.0 mg/7.4mL, 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jan 1, 2025 In Use
55513-0730-21 55513-0730 Denosumab XGEVA 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Apr 15, 2025 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
47781-0483-28 47781-0483 Lenalidomide LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 6, 2023 In Use
63850-0131-02 63850-0131 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
63850-0132-01 63850-0132 Pomalidomide Pomalidomide 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
63850-0133-02 63850-0133 Pomalidomide Pomalidomide 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
55513-0730-01 55513-0730 Denosumab XGEVA 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Nov 18, 2010 In Use
55513-0141-01 55513-0141 trastuzumab-anns Kanjinti 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous Oct 28, 2019 In Use
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
63850-0131-01 63850-0131 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use

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