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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
42238-0111-01 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 Jan 17, 2018 No Longer Used
42238-0111-12 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 Jan 17, 2018 No Longer Used
44087-3535-01 44087-3535 Avelumab Bavencio 20.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Mar 23, 2017 In Use
45802-0076-00 45802-0076 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Apr 20, 2010 Aug 1, 2013 No Longer Used
45802-0368-53 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical Jul 12, 2012 In Use
45802-0368-62 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical Nov 9, 2010 In Use
50242-0070-86 50242-0070 Obinutuzumab Gazyva 1000.0 mg/40mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov 4, 2013 In Use
50242-0087-01 50242-0087 ADO-Trastuzumab Emtansine Kadcyla 20.0 mg/mL, 20.0 mg/mL Immunotherapy Drug Antibody Conjugate HER2 Intravenous Feb 22, 2013 In Use
50242-0103-01 50242-0103 polatuzumab vedotin POLIVY 30.0 mg/1.88mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous Sep 18, 2020 In Use
50242-0105-01 50242-0105 polatuzumab vedotin POLIVY 140.0 mg/7.52mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous Jun 10, 2019 In Use
00480-1243-28 00480-1243 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2022 In Use
50242-0245-01 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 Jun 29, 2020 In Use
00003-2327-11 00003-2327 Ipilimumab Yervoy 5.0 mg/mL Immunotherapy Checkpoint Inhibitor CTLA-4 Intravenous Mar 25, 2011 In Use
50242-0260-01 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 Jun 29, 2020 In Use
00002-7678-01 00002-7678 Ramucirumab Cyramza 10.0 mg/mL Immunotherapy Monoclonal Antibody VEGF Intravenous Apr 21, 2014 In Use
50242-0917-01 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous May 18, 2016 In Use
50242-0051-21 50242-0051 Rituximab Rituxan 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov 26, 1997 In Use
57894-0505-20 57894-0505 Daratumumab Darzalex IV 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Oct 15, 2021 In Use
00004-0365-09 00004-0365 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 In Use
59572-0504-00 59572-0504 Pomalidomide Pomalyst 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 18, 2013 In Use
00310-4700-01 00310-4700 moxetumomab pasudotox LUMOXITI 1.0 mg/mL Immunotherapy Drug Antibody Conjugate CD22 Intravenous Oct 24, 2018 Sep 30, 2024 No Longer Used
60505-4532-02 60505-4532 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 9, 2023 In Use
61755-0008-01 61755-0008 cemiplimab-rwlc LIBTAYO 50.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Sep 28, 2018 In Use
43598-0515-01 43598-0515 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
00085-1388-02 00085-1388 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Mar 29, 2011 Jan 13, 2016 No Longer Used

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