| 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 | |
| J9010 | Alemtuzumab | Campath | 10 mg | Immunotherapy | Monoclonal Antibody | CD52 | No | 2001 | 2012 | Jan 1, 2003 | Dec 31, 2015 | No Longer Used |
| J3590 | Immunotherapy - non specific | Unclassified biologics | NA | Immunotherapy | No | Jan 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 | |||
| 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 | ||
| J3315 | Triptorelin Pamoate | Trelstar, Trelstar Mixject | 3.75 mg | Hormonal Therapy | GnRH Agonist | No | 2000 | Jan 1, 2003 | In Use | |||
| 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 | |||||
| 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 | |
| S0088 | Imatinib mesylate | Gleevec | 100 mg | Chemotherapy | Tyrosine Kinase Inhibitor | BCR-ABL | Yes | 2001 | Jan 1, 2002 | In Use | ||
| S0178 | Lomustine | Ceenu, Gleostine | 10 mg | Chemotherapy | Alkylating Agent | Nitrosourea | Yes | 1976 | Jan 1, 2002 | In Use | ||
| J9300 | Gemtuzumab ozogamicin | Mylotarg | 5 mg | Immunotherapy | Drug Antibody Conjugate | CD33 | No | 2000 | Jan 1, 2002 | In Use | ||
| S0177 | Levamisole | Ergamisol | 50 mg | Immunotherapy | Antiinfective Agent | antihelminitic | Yes | 1990 | 2000 | Jan 1, 2002 | In Use | |
| J9017 | Arsenic Trioxide | Trisenox | 1 mg | Chemotherapy | Miscellaneous Agent | PML/RARa | No | 2000 | Jan 1, 2002 | In Use | ||
| S0172 | Chlorambucil | Leukeran | 2 mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Yes | 1957 | Jan 1, 2002 | In Use | ||
| S0174 | Dolasetron Mesylate | Anzemet | 50 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1997 | Jan 1, 2002 | In Use | ||
| S0170 | Anastrozole | Arimidex | 1mg | Hormonal Therapy | Aromatase Inhibitor | Yes | 1995 | Jan 1, 2002 | In Use | |||
| S0182 | Procarbazine | Matulane | 50 mg | Chemotherapy | Alkylating Agent | Benzamide | Yes | 1969 | 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 |
| S0187 | Tamoxifen Citrate | Nolvadex, Nolvadex-D, Soltamox | 10 mg | Hormonal Therapy | Selective Estrogen Receptor Modulator (SERM) | Yes | 1977 | Jan 1, 2002 | In Use | |||
| S0091 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1993 | 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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