| HCPCS | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Drug Class | Minor Drug Class | Oral (Y/N) | FDA Approval Year | FDA Discontinuation Year | CMS Effective Date | CMS Discontinuation Date | Status |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C9058 | Pegfilgrastim-bmez | Ziextenzo | 0.5mg | Ancillary Therapy | immunomodulatorne | Granulocyte Colony Stimulating Factor | No | 2019 | Mar 31, 2020 | Jul 1, 2020 | No Longer Used | |
| J9309 | Polatuzumab Vedotin | Polivy | 1mg | Immunotherapy | Drug Antibody Conjugate | CD79b | No | 2019 | Jan 1, 2020 | In Use | ||
| J9044 | Bortezomib | Bortezomib | 0.1mg | Chemotherapy | Proteasome Inhibitor | 26S | No | 2019 | Nov 3, 2019 | Dec 21, 2022 | In Use | |
| Q5116 | Trastuzumab-qyyp | Trazimera | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2020 | Oct 1, 2019 | In Use | ||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| J9113 | Cemiplimab-rwlc | Libtayo | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9204 | Mogamulizumab-kpkc | Poteligeo | 1mg | Immunotherapy | Monoclonal Antibody | CCR4 | No | 2018 | Oct 1, 2019 | In Use | ||
| Q5117 | Trastuzumab-anns | Kanjinti | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Oct 1, 2019 | In Use | ||
| J9313 | Moxetumomab-pasudotox-tdfk | Lumoxiti | 0.01mg | Immunotherapy | Drug Antibody Conjugate | CD22 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9269 | Tagraxofusp-erzs | Elzonris | 10mcg | Immunotherapy | Recombinant Fusion Protein | IL3/CD123 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9118 | Calaspargase pegol-mknl | Asparlas | 10 units | Chemotherapy | Miscellaneous Agent | Enzyme | No | 2018 | Oct 1, 2019 | In Use | ||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| Q5118 | Bevacizumab-bvzr | Zirabev | 10mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2019 | Oct 1, 2019 | In Use | ||
| J9356 | Trastuzumab and Hyaluronidase-oysk | Herceptin hylecta | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Jul 1, 2019 | In Use | ||
| J9036 | Bendamustine HCL | Belrapzo | 1mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | No | 2018 | Jul 1, 2019 | In Use | ||
| J9030 | Bacillus calmette-guerin | BCG Vaccine, Tice BCG | 1mg | Immunotherapy | Biological Response Modifier | Live Vaccine | No | 1990 | Jul 1, 2019 | In Use | ||
| Q5115 | Rituximab-abbs | Truxima | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2018 | Jul 1, 2019 | In Use | ||
| Q5114 | Trastuzumab-dkst | Ogivri | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2017 | Jul 1, 2019 | In Use | ||
| Q5113 | Trastuzumab-pkrb | Herzuma | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2018 | Jul 1, 2019 | In Use | ||
| Q5112 | Trastuzumab-dttb | Ontruzant | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2021 | Jul 1, 2019 | In Use | ||
| J9173 | Durvalumab | Imfinzi | 10mg | Immunotherapy | Checkpoint Inhibitor | PD-L1 | No | 2017 | Jan 1, 2019 | In Use | ||
| Q5111 | Pegfilgrastim-cbqv | Udenyca | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2019 | Jan 1, 2019 | In Use | ||
| J9311 | Rituximab and Hyaluronidase | Rituxan Hycela | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2017 | Jan 1, 2019 | In Use | ||
| Q2041 | Axicabtagene Ciloleucel | Yescarta | Up to 200 million | Immunotherapy | CAR-T | CD19 | No | 2017 | Jan 1, 2019 | In Use | ||
| Q5107 | Bevacizumab-awwb | Mvasi | 10mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2018 | Jan 1, 2019 | In Use |
The use of NA indicates that the HCPCS code was Not Available. NA may mean that a) the HCPCS code has
not yet been created (new drug), b) the drug is given as an oral drug or alternative route (only in
specific instances are HCPCS assigned to these medications), or c) the HCPCS could not be found or is
truly not available.
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