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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
00078-1217-61 00078-1217 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous Jan 15, 2026 In Use
69488-0010-61 69488-0010 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous Mar 23, 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
63850-0131-02 63850-0131 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Nov 1, 2025 In Use
65219-0672-01 65219-0672 Denosumab BOMYNTRA 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 2025 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
63304-0042-27 63304-0042 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 4, 2023 In Use
00004-0352-98 00004-0352 Peginterferon alfa-2a Pegasys Immunotherapy Cytokine Interferon Oct 16, 2002 Jul 31, 2015 No Longer Used
64116-0011-12 64116-0011 Interferon gamma-1b Actimmune Immunotherapy Cytokine Interferon Feb 25, 1999 Mar 31, 2015 No Longer Used
59572-0220-16 59572-0220 Thalidomide Thalomid 200.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jun 20, 2003 In Use
00093-6126-64 00093-6126 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Dec 19, 2013 Apr 30, 2015 No Longer Used
73043-0040-28 73043-0040 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jan 31, 2026 In Use
60505-4535-02 60505-4535 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
59651-0194-01 59651-0194 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Oct 30, 2020 In Use
60505-4534-02 60505-4534 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
00069-0308-01 00069-0308 trastuzumab-qyyp Trazimera 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous Mar 10, 2021 In Use
00378-1936-01 00378-1936 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
63304-0041-27 63304-0041 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 12, 2023 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
59572-0210-15 59572-0210 Thalidomide Thalomid 100.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jun 20, 2003 In Use
59572-0215-13 59572-0215 Thalidomide Thalomid 150.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 20, 2007 In Use
60505-4537-02 60505-4537 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
60505-4536-02 60505-4536 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 9, 2023 In Use
63304-0043-27 63304-0043 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 4, 2023 In Use

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