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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
57894-0450-01 57894-0450 Teclistamab TECVAYLI 90.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct 25, 2022 In Use
59572-0503-21 59572-0503 Pomalidomide Pomalyst 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 18, 2013 In Use
00074-1055-01 00074-1055 Telisotuzumab Vedotin EMRELIS 100.0 mg/mL Immunotherapy Drug Antibody Conjugate c-MET Intravenous May 14, 2025 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
00004-0350-39 00004-0350 Peginterferon alfa-2a Pegasys 180.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Oct 16, 2002 Sep 1, 2009 No Longer Used
65219-0670-01 65219-0670 Denosumab BOMYNTRA 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 2025 In Use
55513-0132-01 55513-0132 trastuzumab-anns Kanjinti 420.0 mg/20mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jun 11, 2019 In Use
55513-0141-21 55513-0141 trastuzumab-anns Kanjinti 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jul 1, 2025 In Use
00074-1044-01 00074-1044 Telisotuzumab Vedotin EMRELIS 20.0 mg/mL Immunotherapy Drug Antibody Conjugate c-MET Intravenous May 14, 2025 In Use
73535-0208-01 73535-0208 Tafasitamab-cxix MONJUVI 200.0 mg/5mL Immunotherapy Monoclonal Antibody CD19 Intravenous Aug 5, 2020 Nov 30, 2025 In Use
49281-0880-03 49281-0880 BACILLUS CALMETTE-GUERIN SUBSTRAIN CONNAUGHT LIVE ANTIGEN THERACYS 81.0 mg/3mL Immunotherapy Biological Response Modifier Live Vaccine Intravesical Jul 22, 2011 May 8, 2017 No Longer Used
61755-0056-01 61755-0056 Linvoseltamab-gcpt LYNOZYFIC 200.0 mg/10mL Immunotherapy Bispecific Antibody BCMA, CD3 Intravenous Jul 2, 2025 In Use
00004-0350-09 00004-0350 Peginterferon alfa-2a Pegasys 180.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Oct 16, 2002 Jun 30, 2025 No Longer Used
55513-0132-21 55513-0132 trastuzumab-anns Kanjinti 420.0 mg/20mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jul 1, 2025 In Use
00085-1388-01 00085-1388 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Mar 29, 2011 Jan 13, 2016 No Longer Used
59572-0402-28 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0405-28 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2009 In Use
00115-1476-59 00115-1476 Imiquimod Imiquimod 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb 28, 2011 Jun 1, 2017 No Longer Used
55513-0141-01 55513-0141 trastuzumab-anns Kanjinti 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous Oct 28, 2019 In Use
83444-0301-10 83444-0301 Cosibelimab UNLOXCYT 300.0 mg/5mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Jun 30, 2025 In Use
55513-0206-01 55513-0206 Bevacizumab-awwb MVASI 100.0 mg/4mL, 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Jun 1, 2018 In Use
61755-0054-01 61755-0054 Linvoseltamab-gcpt LYNOZYFIC 5.0 mg/2.5mL Immunotherapy Bispecific Antibody BCMA, CD3 Intravenous Jul 2, 2025 In Use
00480-1246-21 00480-1246 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2022 In Use
00069-0238-01 00069-0238 Rituximab-pvvr Ruxience 100.0 mg/10mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan 23, 2020 In Use

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