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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category (Descending) Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
69488-0010-61 69488-0010 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous March 23, 2022 In Use
00003-3756-14 00003-3756 nivolumab OPDIVO 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Aug. 30, 2021 In Use
57894-0505-05 57894-0505 Daratumumab Darzalex IV 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Oct. 15, 2021 In Use
57894-0505-20 57894-0505 Daratumumab Darzalex IV 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Oct. 15, 2021 In Use
71287-0220-02 71287-0220 brexucabtagene autoleucel TECARTUS 1000000.0 1/68mL Immunotherapy CAR-T CD19 Intravenous Oct. 1, 2021 In Use
44087-3535-01 44087-3535 Avelumab Bavencio 20.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous March 23, 2017 In Use
72187-0401-01 72187-0401 Tagraxofusp Elzonris 1000.0 ug/mL Immunotherapy Fusion Protein IL3/ CD123 Intravenous Jan. 18, 2019 In Use
73380-4700-01 73380-4700 MOXETUMOMAB PASUDOTOX LUMOXITI 1.0 mg/mL Immunotherapy Drug Antibody Conjugate CD22 Intravenous May 15, 2020 In Use
50242-0245-01 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 June 29, 2020 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 June 29, 2020 In Use
50242-0260-86 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 May 3, 2021 In Use
51144-0003-01 51144-0003 Tisotumab vedotin TIVDAK 40.0 mg/4mL Immunotherapy Drug Antibody Conjugate Tissue factor Intravenous Sept. 20, 2021 In Use
00008-4510-01 00008-4510 Gemtuzumab ozogamicin Mylotarg 5.0 mg/5mL Immunotherapy Drug Antibody Conjugate CD33 Intravenous Sept. 7, 2017 In Use
80446-0401-01 80446-0401 TEBENTAFUSP KIMMTRAK 100.0 ug/.5mL Immunotherapy T Cell Receptor (TCR) HLA-A*02:01 Intravenous Jan. 26, 2022 In Use
50242-0108-01 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 In Use
50242-0108-86 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 23, 2017 In Use
00078-0846-19 00078-0846 Tisagenlecleucel Kymriah 2000000.0 1/1 Immunotherapy CAR-T CD19 Intravenous Aug. 30, 2017 In Use
50242-0077-01 50242-0077 Trastuzumab and Hyaluronidase-oysk Herceptin Hylecta 10000.0 U/5mL, 10000.0 U/5mL, 600.0 mg/5mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Feb. 28, 2019 In Use
50242-0109-01 50242-0109 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 In Use
57894-0111-01 57894-0111 ciltacabtagene autoleucel CARVYKTI 100000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous Feb. 28, 2022 In Use
57894-0111-02 57894-0111 ciltacabtagene autoleucel CARVYKTI 100000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous Feb. 28, 2022 In Use
73536-0500-01 73536-0500 ROPEGINTERFERON ALFA-2B BESREMi 500.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 12, 2021 In Use
00480-1242-28 00480-1242 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use
00480-1243-28 00480-1243 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2022 In Use

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