| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A9534 | Tositumomab | Bexxar, Iodine i-131 Tositumomab, therapeutic | per MC | Immunotherapy, Radiopharmaceutical | Radioimmunotherapy | CD20 | No | 2003 | 2014 | Jul 1, 2003 | In Use | |
| J1094 | Dexamethasone Acetate | Dalalone DP, Decadron-LA | 1 mg | Hormonal Therapy | Adrenal Glucocorticoid | Corticosteroid | No | 1978 | 2014 | Jan 1, 2003 | In Use | |
| J3240 | Thyrotropin alfa | Thyrogen | 0.9 mg /1.1 ml vial | Hormonal Therapy | Thyroid Stimulating Hormone | No | 1998 | Jan 1, 2003 | In Use | |||
| J3315 | Triptorelin Pamoate | Trelstar, Trelstar Mixject | 3.75 mg | Hormonal Therapy | GnRH Agonist | No | 2000 | Jan 1, 2003 | In Use | |||
| J3487 | Zoledronic acid | Zometa (4 mg/5 ml) | 1 mg | Ancillary Therapy | Bisphosphonate | No | 2001 | Jan 1, 2003 | Dec 31, 2013 | No Longer Used | ||
| J1051 | Medroxyprogesterone Acetate | Depo-Provera, Depo-SubQ Provera 104, Provera | 50 mg | Hormonal Therapy | Progestin | No | 1959 | Jan 1, 2003 | Dec 31, 2012 | No Longer Used | ||
| J3590 | Immunotherapy - non specific | Unclassified biologics | NA | Immunotherapy | No | Jan 1, 2003 | In Use | |||||
| J9010 | Alemtuzumab | Campath | 10 mg | Immunotherapy | Monoclonal Antibody | CD52 | No | 2001 | 2012 | Jan 1, 2003 | Dec 31, 2015 | No Longer Used |
| C9118 | Ibritumomab tiuxetan | Zevalin | Per MCI | Immunotherapy | Radioimmunotherapy | CD20 | No | 2002 | Oct 1, 2002 | Dec 31, 2002 | No Longer Used | |
| C9117 | Ibritumomab tiuxetan | Zevalin | Per MCI | Immunotherapy | Radioimmunotherapy | CD20 | No | 2002 | Oct 1, 2002 | Dec 31, 2002 | No Longer Used | |
| S0108 | Mercaptopurine | Mercaptopurine | 50 mg | Chemotherapy | Antimetabolite | Purine Analog | Yes | 1953 | Apr 1, 2002 | In Use | ||
| S2107 | Immunotherapy - non specific | Adoptive immunotherapy (ie development of specific anti-tumor reactivity) | NA | Immunotherapy | No | Apr 1, 2002 | In Use | |||||
| S0177 | Levamisole | Ergamisol | 50 mg | Immunotherapy | Antiinfective Agent | antihelminitic | Yes | 1990 | 2000 | Jan 1, 2002 | In Use | |
| S0176 | Hydroxyurea | Hydrea | 500 mg | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Yes | 1967 | Jan 1, 2002 | In Use | ||
| S0181 | Ondansetron | Zofran, Zofran ODT, Zuplenz | 4 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1991 | Jan 1, 2002 | Dec 31, 2011 | No Longer Used | |
| S0182 | Procarbazine | Matulane | 50 mg | Chemotherapy | Alkylating Agent | Benzamide | Yes | 1969 | Jan 1, 2002 | In Use | ||
| S0088 | Imatinib mesylate | Gleevec | 100 mg | Chemotherapy | Tyrosine Kinase Inhibitor | BCR-ABL | Yes | 2001 | Jan 1, 2002 | In Use | ||
| J9300 | Gemtuzumab ozogamicin | Mylotarg | 5 mg | Immunotherapy | Drug Antibody Conjugate | CD33 | No | 2000 | Jan 1, 2002 | In Use | ||
| S9338 | Immunotherapy - non specific | Home infusion therapy, immunotherapy | NA | Immunotherapy | No | Jan 1, 2002 | In Use | |||||
| S0087 | Alemtuzumab | Campath | 30 mg | Immunotherapy | Monoclonal Antibody | CD52 | No | 2001 | 2012 | Jan 1, 2002 | Dec 31, 2002 | No Longer Used |
| S0174 | Dolasetron Mesylate | Anzemet | 50 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1997 | Jan 1, 2002 | In Use | ||
| J9017 | Arsenic Trioxide | Trisenox | 1 mg | Chemotherapy | Miscellaneous Agent | PML/RARa | No | 2000 | Jan 1, 2002 | In Use | ||
| S0187 | Tamoxifen Citrate | Nolvadex, Nolvadex-D, Soltamox | 10 mg | Hormonal Therapy | Selective Estrogen Receptor Modulator (SERM) | Yes | 1977 | Jan 1, 2002 | In Use | |||
| S0178 | Lomustine | Ceenu, Gleostine | 10 mg | Chemotherapy | Alkylating Agent | Nitrosourea | Yes | 1976 | Jan 1, 2002 | In Use | ||
| S0172 | Chlorambucil | Leukeran | 2 mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Yes | 1957 | Jan 1, 2002 | 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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