| 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 | |
| J9313 | Moxetumomab-pasudotox-tdfk | Lumoxiti | 0.01mg | Immunotherapy | Drug Antibody Conjugate | CD22 | No | 2018 | Oct 1, 2019 | 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 | ||
| 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 | ||
| J9204 | Mogamulizumab-kpkc | Poteligeo | 1mg | Immunotherapy | Monoclonal Antibody | CCR4 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9113 | Cemiplimab-rwlc | Libtayo | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | 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 | ||
| Q5117 | Trastuzumab-anns | Kanjinti | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Oct 1, 2019 | In Use | ||
| J9118 | Calaspargase pegol-mknl | Asparlas | 10 units | Chemotherapy | Miscellaneous Agent | Enzyme | No | 2018 | Oct 1, 2019 | In Use | ||
| J9036 | Bendamustine HCL | Belrapzo | 1mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | No | 2018 | Jul 1, 2019 | In Use | ||
| Q5113 | Trastuzumab-pkrb | Herzuma | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2018 | Jul 1, 2019 | In Use | ||
| J9356 | Trastuzumab and Hyaluronidase-oysk | Herceptin hylecta | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Jul 1, 2019 | In Use | ||
| Q5115 | Rituximab-abbs | Truxima | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2018 | Jul 1, 2019 | In Use | ||
| Q5112 | Trastuzumab-dttb | Ontruzant | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2021 | Jul 1, 2019 | In Use | ||
| Q5114 | Trastuzumab-dkst | Ogivri | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2017 | 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 | ||
| Q2041 | Axicabtagene Ciloleucel | Yescarta | Up to 200 million | Immunotherapy | CAR-T | CD19 | No | 2017 | Jan 1, 2019 | In Use | ||
| J9173 | Durvalumab | Imfinzi | 10mg | Immunotherapy | Checkpoint Inhibitor | PD-L1 | No | 2017 | Jan 1, 2019 | In Use | ||
| Q5107 | Bevacizumab-awwb | Mvasi | 10mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2018 | 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 |
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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