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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category (Ascending) Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
50242-0132-01 50242-0132 Trastuzumab Herceptin 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous Feb. 10, 2017 In Use
50242-0132-10 50242-0132 Trastuzumab Herceptin 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous June 3, 2019 In Use
50242-0917-01 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous May 18, 2016 In Use
50242-0917-86 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Aug. 11, 2016 In Use
63459-0303-43 63459-0303 TRASTUZUMAB HERZUMA 150.0 mg/20mL Immunotherapy Monoclonal Antibody HER2 Intravenous March 16, 2020 In Use
67457-0847-44 67457-0847 Trastuzumab OGIVRI 420.0 mg/ 20 mL Immunotherapy Monoclonal Antibody HER2 Intravenous Nov. 29, 2019 In Use
67457-0991-15 67457-0991 Trastuzumab OGIVRI 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous Nov. 29, 2019 In Use
55513-0141-01 55513-0141 trastuzumab-anns Kanjinti 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous Oct. 28, 2019 In Use
55513-0224-01 55513-0224 rituximab-arrx Riabni 100.0 mg/10mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan. 6, 2021 In Use
55513-0326-01 55513-0326 rituximab-arrx Riabni 500.0 mg/50mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan. 6, 2021 In Use
65597-0406-01 65597-0406 fam-trastuzumab deruxtecan-nxki Enhertu 100.0 mg/5mL Immunotherapy Drug Antibody Conjugate Topoisomerase I Inhibitor Intravenous Dec. 20, 2019 In Use
00173-0898-03 00173-0898 dostarlimab Jemperli 50.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous April 22, 2021 In Use
00002-7190-01 00002-7190 Olaratumab Lartruvo 10.0 mg/mL Immunotherapy Monoclonal Antibody PDGFR Intravenous Feb. 14, 2017 Nov. 27, 2020 No Longer Used
57894-0501-01 57894-0501 Amivantamab Rybrevant 350.0 mg/1 Immunotherapy Monoclonal Antibody EGFR, MET Intravenous May 21, 2021 In Use
00024-0654-01 00024-0654 Isatuximab Sarclisa 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous March 2, 2020 In Use
00024-0656-01 00024-0656 Isatuximab Sarclisa 500.0 mg/25mL Immunotherapy Monoclonal Antibody CD38 Intravenous March 2, 2020 In Use
78206-0148-01 78206-0148 Trastuzumab Ontruzant Immunotherapy Monoclonal Antibody HER2 Intravenous June 1, 2021 In Use
00002-8926-01 00002-8926 Olaratumab Lartruvo 10.0 mg/mL Immunotherapy Monoclonal Antibody PDGFR Intravenous Oct. 19, 2016 Nov. 27, 2020 No Longer Used
00003-2327-11 00003-2327 Ipilimumab Yervoy 5.0 mg/mL Immunotherapy Checkpoint Inhibitor CTLA-4 Intravenous March 25, 2011 In Use
00003-2328-22 00003-2328 Ipilimumab Yervoy 5.0 mg/mL Immunotherapy Checkpoint Inhibitor CTLA-4 Intravenous March 25, 2011 In Use
00006-3029-02 00006-3029 Pembrolizumab Keytruda 50.0 mg/2mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Sept. 4, 2014 Dec. 21, 2015 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
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

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