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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
00008-0100-01 00008-0100 Inotuzumab Ozogamicin Besponsa 0.25 mg/mL Immunotherapy Drug Antibody Conjugate CD22 Intravenous Aug 18, 2017 In Use
00002-7190-01 00002-7190 Olaratumab Lartruvo 10.0 mg/mL Immunotherapy Monoclonal Antibody PDGFR Intravenous Feb 14, 2017 Nov 27, 2020 No Longer Used
00006-3026-04 00006-3026 Pembrolizumab Keytruda 25.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Aug 1, 2019 In Use
00002-7716-01 00002-7716 Necitumumab Portrazza 16.0 mg/mL Immunotherapy Monoclonal Antibody EGFR Intravenous Nov 24, 2015 In Use
00052-0602-02 00052-0602 BACILLUS CALMETTE-GUERIN TICE BCG 50.0 mg/50mL Immunotherapy Biological Response Modifier Live Vaccine Intravesical Aug 24, 1990 In Use
00002-7678-01 00002-7678 Ramucirumab Cyramza 10.0 mg/mL Immunotherapy Monoclonal Antibody VEGF Intravenous Apr 21, 2014 In Use
00003-2328-22 00003-2328 Ipilimumab Yervoy 5.0 mg/mL Immunotherapy Checkpoint Inhibitor CTLA-4 Intravenous Mar 25, 2011 In Use
00003-4522-11 00003-4522 Elotuzumab Empliciti 400.0 mg/1 Immunotherapy Monoclonal Antibody SLAMF7 Intravenous Nov 30, 2015 In Use
00004-0360-30 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 Jan 31, 2019 No Longer Used
00007-3262-01 00007-3262 Tositumomab, Iodine I-131 Bexxar Therapeutic Immunotherapy Radioimmunotherapy CD20 Jul 15, 2009 Feb 20, 2014 No Longer Used
00008-4510-01 00008-4510 Gemtuzumab ozogamicin Mylotarg 5.0 mg/5mL Immunotherapy Drug Antibody Conjugate CD33 Intravenous Sep 7, 2017 In Use
00002-8926-01 00002-8926 Olaratumab Lartruvo 10.0 mg/mL Immunotherapy Monoclonal Antibody PDGFR Intravenous Oct 19, 2016 Nov 27, 2020 No Longer Used
00004-0365-09 00004-0365 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 In Use
00003-3756-14 00003-3756 nivolumab OPDIVO 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Aug 30, 2021 In Use
00002-7669-01 00002-7669 Ramucirumab Cyramza 10.0 mg/mL Immunotherapy Monoclonal Antibody VEGF Intravenous Apr 21, 2014 In Use
00085-4347-01 00085-4347 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Aug 30, 2014 Oct 18, 2020 In Use
00003-2291-11 00003-2291 Elotuzumab Empliciti 300.0 mg/1 Immunotherapy Monoclonal Antibody SLAMF7 Intravenous Nov 30, 2015 In Use
00003-3772-11 00003-3772 Nivolumab Opdivo 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Dec 22, 2014 In Use
00003-3774-12 00003-3774 Nivolumab Opdivo 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Dec 22, 2014 In Use
70121-1754-01 70121-1754 Bevacizumab-maly ALYMSYS 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGF Intravenous Apr 15, 2022 In Use
00004-0360-09 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 Feb 8, 2018 No Longer Used
00007-3260-36 00007-3260 Tositumomab Bexxar Immunotherapy Radioimmunotherapy CD20 Jul 15, 2009 Nov 28, 2014 No Longer Used
00007-3261-01 00007-3261 Tositumomab, Iodine I-131 Bexxar Dosimetric Immunotherapy Radioimmunotherapy CD20 Jul 15, 2009 Feb 13, 2014 No Longer Used
00006-3029-02 00006-3029 Pembrolizumab Keytruda 50.0 mg/2mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Sep 4, 2014 Dec 21, 2015 In Use

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