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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
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
63459-0103-10 63459-0103 Rituximab-abbs Truxima 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous May 4, 2020 In Use
63459-0104-50 63459-0104 Rituximab-abbs Truxima 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous May 4, 2020 In Use
63459-0305-47 63459-0305 TRASTUZUMAB HERZUMA Immunotherapy Monoclonal Antibody HER2 March 16, 2020 In Use
79952-0110-01 79952-0110 loncastuximab tesirine ZYNLONTA 10.0 mg/2mL Immunotherapy Drug Antibody Conjugate CD19 Intravenous April 30, 2021 In Use
73042-0201-01 73042-0201 Naxitamab DANYELZA 40.0 mg/10mL Immunotherapy Monoclonal Antibody GD2 Intravenous Nov. 25, 2020 In Use
74527-0022-02 74527-0022 margetuximab-cmkb MARGENZA 25.0 mg/mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jan. 15, 2021 In Use
74527-0022-03 74527-0022 margetuximab-cmkb MARGENZA 25.0 mg/mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jan. 15, 2021 In Use
00069-0238-01 00069-0238 Rituximab-pvvr Ruxience 100.0 mg/10mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan. 23, 2020 In Use
00069-0249-01 00069-0249 Rituximab-pvvr Ruxience 500.0 mg/50mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan. 23, 2020 In Use
00069-0315-01 00069-0315 Bevacizumab-bvzr Zirabev 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Jan. 13, 2020 In Use
00069-0342-01 00069-0342 Bevacizumab-bvzr Zirabev 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Jan. 13, 2020 In Use
73153-0900-01 73153-0900 Lisocabtagene maraleucel BREYANZI Immunotherapy CAR-T CD19 Feb. 5, 2021 In Use
00069-0308-01 00069-0308 trastuzumab-qyyp Trazimera 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous March 10, 2021 In Use
72189-0084-24 72189-0084 IMIQUIMOD IMIQUIMOD 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical March 23, 2020 In Use
50242-0051-10 50242-0051 Rituximab Rituxan 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous June 3, 2019 In Use
50242-0051-21 50242-0051 Rituximab Rituxan 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 26, 1997 In Use
50242-0103-01 50242-0103 polatuzumab vedotin POLIVY 30.0 mg/1.88mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous Sept. 18, 2020 In Use
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
00006-3026-02 00006-3026 Pembrolizumab Keytruda 25.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Jan. 15, 2015 In Use
00006-3026-04 00006-3026 Pembrolizumab Keytruda 25.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Aug. 1, 2019 In Use
00173-0896-01 00173-0896 Belantamab Blenrep 50.0 mg/mL Immunotherapy Drug Antibody Conjugate BCMA Intravenous Aug. 5, 2020 In Use
50242-0105-01 50242-0105 polatuzumab vedotin POLIVY 140.0 mg/7.52mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous June 10, 2019 In Use
55135-0132-01 55135-0132 SACITUZUMAB GOVITECAN TRODELVY 180.0 mg/1 Immunotherapy Drug Antibody Conjugate Trop-2 Intravenous April 23, 2020 In Use
59572-0775-01 59572-0775 Luspatercept Reblozyl 75.0 mg/1 Immunotherapy Erythropoiesis-Stimulating Agent Subcutaneous Nov. 8, 2019 In Use
73535-0208-01 73535-0208 Tafasitamab-cxix MONJUVI 200.0 mg/5mL Immunotherapy Monoclonal Antibody CD19 Intravenous Aug. 5, 2020 In Use

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