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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
69097-0604-73 69097-0604 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 9, 2023 In Use
00173-0808-01 00173-0808 Ofatumumab Arzerra Immunotherapy Monoclonal Antibody CD20 Oct 26, 2009 Mar 31, 2012 No Longer Used
00173-0821-02 00173-0821 Ofatumumab Arzerra 20.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jul 22, 2011 Aug 31, 2017 No Longer Used
00173-0821-33 00173-0821 Ofatumumab Arzerra 20.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jul 22, 2011 Aug 31, 2017 No Longer Used
00310-4500-12 00310-4500 Durvalumab Imfinzi 120.0 mg/2.4mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous May 1, 2017 In Use
00310-4611-50 00310-4611 Durvalumab Imfinzi 500.0 mg/10mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous May 1, 2017 In Use
70771-1676-01 70771-1676 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 7, 2023 In Use
00480-1244-21 00480-1244 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2022 In Use
00007-3261-01 00007-3261 Tositumomab, Iodine I-131 Bexxar Dosimetric Immunotherapy Radioimmunotherapy CD20 Jul 15, 2009 Feb 13, 2014 No Longer Used
59651-0346-21 59651-0346 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 6, 2023 In Use
42747-0761-01 42747-0761 mogamulizumab-kpkc POTELIGEO 4.0 mg/mL Immunotherapy Monoclonal Antibody CCR4 Intravenous Aug 8, 2018 In Use
44087-3535-01 44087-3535 Avelumab Bavencio 20.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Mar 23, 2017 In Use
00085-4347-01 00085-4347 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Aug 30, 2014 Oct 18, 2020 In Use
45802-0368-53 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical Jul 12, 2012 In Use
76282-0697-48 76282-0697 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 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
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
50242-0134-68 50242-0134 Trastuzumab Herceptin Immunotherapy Monoclonal Antibody HER2 Sep 25, 1998 Apr 30, 2019 No Longer Used
50242-0145-01 50242-0145 Pertuzumab Perjeta 30.0 mg/mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jun 8, 2012 In Use
50242-0245-86 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 May 3, 2021 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
71287-0219-02 71287-0219 brexucabtagene autoleucel TECARTUS 2000000.0 1/68mL Immunotherapy CAR-T CD19 Intravenous Jul 24, 2020 In Use

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