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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
00009-0064-04 00009-0064 Medroxyprogesterone Acetate Provera 2.5 mg/1 Hormonal Therapy Progestin Oral June 3, 1959 April 30, 2020 In Use
00009-0064-06 00009-0064 Medroxyprogesterone Acetate Provera 2.5 mg/1 Hormonal Therapy Progestin Oral June 3, 1959 April 23, 2007 In Use
00009-0286-03 00009-0286 Medroxyprogesterone Acetate Provera 5.0 mg/1 Hormonal Therapy Progestin Oral June 3, 1959 June 30, 2019 In Use
00009-0626-01 00009-0626 Medroxyprogesterone Acetate Depo-Provera 400.0 mg/mL Hormonal Therapy Progestin Intramuscular Nov. 1, 1960 In Use
00078-0652-06 00078-0652 Panobinostat Farydak 20.0 mg/1 Chemotherapy Enzyme Inhibitor HDAC Oral Feb. 23, 2015 Dec. 31, 2022 In Use
68152-0103-03 68152-0103 Ibritumomab Tiuxetan Zevalin Immunotherapy Radioimmunotherapy CD20 Feb. 19, 2002 Oct. 26, 2020 In Use
65483-0116-07 65483-0116 Aldesleukin Proleukin 1.1 mg/mL Immunotherapy Cytokine Interleukin-2 Intravenous May 5, 1992 In Use
60505-0501-04 60505-0501 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 14, 2012 March 31, 2018 No Longer Used
60505-0501-05 60505-0501 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 14, 2012 March 31, 2018 No Longer Used
57894-0421-01 57894-0421 Siltuximab Sylvant 400.0 mg/1 Immunotherapy Monoclonal Antibody Interleukin-6 Antagonists Intravenous April 1, 2014 Jan. 31, 2021 No Longer Used
57894-0420-01 57894-0420 Siltuximab Sylvant 100.0 mg/1 Immunotherapy Monoclonal Antibody Interleukin-6 Antagonists Intravenous April 23, 2014 Jan. 31, 2021 No Longer Used
50242-0333-01 50242-0333 Trastuzumab Herceptin Immunotherapy Monoclonal Antibody HER2 Feb. 10, 2017 Feb. 10, 2017 No Longer Used
50242-0134-68 50242-0134 Trastuzumab Herceptin Immunotherapy Monoclonal Antibody HER2 Sept. 25, 1998 April 30, 2019 No Longer Used
42238-0111-01 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec. 1, 2013 Jan. 17, 2018 No Longer Used
42238-0111-12 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec. 1, 2013 Jan. 17, 2018 No Longer Used
00310-4700-01 00310-4700 moxetumomab pasudotox LUMOXITI 1.0 mg/mL Immunotherapy Drug Antibody Conjugate CD22 Intravenous Oct. 24, 2018 In Use
30237-8900-06 30237-8900 Sipuleucel-T Provenge 50000000.0 1/1 Immunotherapy Immunomodulator Prostatic Acid Phosphatase Intravenous April 29, 2010 In Use
45802-0076-00 45802-0076 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical April 20, 2010 Aug. 1, 2013 No Longer Used
45802-0076-62 45802-0076 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical April 20, 2010 Aug. 1, 2013 No Longer Used
45802-0368-53 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical July 12, 2012 In Use
45802-0368-62 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical Nov. 9, 2010 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 July 22, 2011 May 8, 2017 No Longer Used
50242-0070-01 50242-0070 Obinutuzumab Gazyva 1000.0 mg/40mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 1, 2013 In Use
50242-0070-86 50242-0070 Obinutuzumab Gazyva 1000.0 mg/40mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 4, 2013 In Use
51144-0020-01 51144-0020 ENFORTUMAB VEDOTIN PADCEV 20.0 mg/2mL Immunotherapy Drug Antibody Conjugate Nectin-4 Intravenous Dec. 18, 2019 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
55513-0955-01 55513-0955 Panitumumab Vectibix 200.0 mg/10mL Immunotherapy Monoclonal Antibody EGFR Intravenous Oct. 10, 2006 Feb. 28, 2010 No Longer Used
59572-0205-14 59572-0205 Thalidomide Thalomid 50.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 20, 2003 In Use
59572-0205-17 59572-0205 Thalidomide Thalomid 50.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 1, 2010 In Use
59572-0205-94 59572-0205 Thalidomide Thalomid 50.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 20, 2003 In Use
59572-0205-97 59572-0205 Thalidomide Thalomid 50.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jan. 26, 2011 In Use
59572-0210-15 59572-0210 Thalidomide Thalomid 100.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 20, 2003 In Use
59572-0210-95 59572-0210 Thalidomide Thalomid 100.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 20, 2003 In Use
59572-0215-13 59572-0215 Thalidomide Thalomid 150.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 20, 2007 In Use
59572-0215-93 59572-0215 Thalidomide Thalomid 150.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 20, 2007 In Use
59572-0220-16 59572-0220 Thalidomide Thalomid 200.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 20, 2003 In Use
59572-0220-96 59572-0220 Thalidomide Thalomid 200.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 20, 2003 In Use
59572-0402-00 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0402-28 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0405-00 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 27, 2005 In Use
59572-0405-28 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
59572-0410-00 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 27, 2005 In Use
59572-0410-28 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
59572-0415-00 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0415-21 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0420-00 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2013 In Use
59572-0420-21 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2013 In Use
59572-0425-00 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0425-21 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
62856-0603-01 62856-0603 Denileukin diftitox Ontak 150.0 ug/mL Immunotherapy Cytokine Interleukin-2 Intravenous Nov. 1, 2013 Nov. 1, 2013 No Longer Used

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