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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
00074-0282-02 00074-0282 Pivekimab sunirine-pvzy DECNUPAZ 2.0 mg/mL Immunotherapy Drug Antibody Conjugate CD123 Intravenous May 27, 2026 In Use
60505-4537-01 60505-4537 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 Mar 8, 2023 In Use
55513-0160-01 55513-0160 Blinatumomab Blincyto Immunotherapy Monoclonal Antibody CD3 (T cells) and CD19 (B cells) Intravenous Dec 18, 2014 In Use
85006-1754-01 85006-1754 Bevacizumab-maly ALYMSYS 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGF Intravenous Mar 30, 2026 In Use
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
00006-5033-02 00006-5033 Trastuzumab Ontruzant 150.0 mg/1 Immunotherapy Monoclonal Antibody HER2 Intravenous Apr 15, 2020 Sep 30, 2023 No Longer Used
57894-0450-01 57894-0450 Teclistamab-cqyv TECVAYLI 90.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct 25, 2022 In Use
70377-0054-12 70377-0054 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2025 In Use
00003-2327-11 00003-2327 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
83654-0105-01 83654-0105 Penpulimab Penpulimab 100.0 mg/10mL Immunotherapy Monoclonal Antibody PD-1 Intravenous Apr 23, 2025 In Use
51144-0030-01 51144-0030 ENFORTUMAB VEDOTIN PADCEV 30.0 mg/3mL Immunotherapy Drug Antibody Conjugate Nectin-4 Intravenous Dec 18, 2019 In Use
50242-0917-86 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Aug 11, 2016 In Use
59651-0194-01 59651-0194 Pomalidomide Pomalidomide 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Oct 30, 2020 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
00085-4347-01 00085-4347 Peginterferon alfa-2b Sylatron Immunotherapy Cytokine Interferon Aug 30, 2014 Oct 18, 2020 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
00480-1245-21 00480-1245 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 8, 2023 In Use
60219-1718-02 60219-1718 Lenalidomide LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb 12, 2025 In Use
83077-0100-02 83077-0100 Zenocutuzumab BIZENGRI 20.0 mg/mL Immunotherapy Monoclonal Antibody HER2, HER3 Intravenous Dec 4, 2024 In Use
83257-0009-11 83257-0009 Bevacizumab-nwgd JOBEVNE 25.0 mg/mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Apr 10, 2025 In Use
00085-0539-01 00085-0539 Interferon alfa-2b Intron A Immunotherapy Cytokine Interferon Jun 4, 1986 Jul 31, 2016 No Longer Used

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