| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C9433 | Thiotepa | Tepadina | 15 mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard /Ethylenimine | No | 1959 | Jan 1, 2004 | Dec 31, 2005 | No Longer Used | |
| NA | Ponatinib | Iclusig | 15 mg | Chemotherapy | Tyrosine Kinase Inhibitor | BCR-ABL | Yes | 2012 | In Use | |||
| NA | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 15 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | In Use | ||
| NA | Ruxolitinib | Jakafi | 15 mg | Chemotherapy | Enzyme Inhibitor | JAK 1/2 | Yes | 2011 | In Use | |||
| NA | Panobinostat | Farydak | 15 mg | Chemotherapy | Enzyme Inhibitor | HDAC | Yes | 2015 | In Use | |||
| NA | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 15 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | In Use | ||
| Vimseltinib | Romvimza | 14mg, 20mg, 30mg | Chemotherapy | Tyrosine Kinase Inhibitor | CSF1R | Yes | 2025 | In Use | ||||
| NA | Ibrutinib | Imbruvica | 140 mg | Chemotherapy | Tyrosine Kinase Inhibitor | Bruton's Tyrosine Kinase (Btk) /BCR | Yes | 2014 | In Use | |||
| NA | Estramustine Phosphate Sodium | Emcyt | 140 mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | Yes | 1981 | In Use | |||
| NA | Dasatinib | Sprycel | 140 mg | Chemotherapy | Tyrosine Kinase Inhibitor | BCR-ABL | Yes | 2006 | In Use | |||
| NA | Palbociclib | Ibrance | 125 mg | Chemotherapy | Cyclin Dependent Kinase Inhibitor | CDK 4/6 | Yes | 2015 | In Use | |||
| NA | Flutamide | Euflex, Eulexin | 125 mg | Hormonal Therapy | Androgen Receptor Inhibitor | Yes | 1989 | In Use | ||||
| J2930 | Methylprednisolone Sodium Succinate | A-Methapred, SOLU-medrol | 125 mg | Hormonal Therapy | Adrenal Glucocorticoid | Corticosteroid | No | 1959 | Jan 1, 1997 | Apr 17, 2024 | No Longer Used | |
| NA | Aprepitant | Emend | 125 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2003 | In Use | |||
| NA | Relugolix | Orgovyx | 120mg | Hormonal Therapy | Androgen Receptor Inhibitor | GnRH Receptor Antagonist | Yes | 2020 | In Use | |||
| NA | Sunitinib malate | Sutent | 12.5 mg | Chemotherapy | Tyrosine Kinase Inhibitor | VEGFR, FLT, PDGFR,KIT, RET, CSF | Yes | 2006 | In Use | |||
| NA | Chlorotrianisene | Anisene | 12 mg | Hormonal Therapy | Estrogen | Yes | 1992 | 1997 | In Use | |||
| Vorasidenib | Voranigo | 10mg,40mg | Chemotherapy | IDH Inhibitor | IDH1, IDH2 | Yes | 2024 | In Use | ||||
| NA | Selumetinib | Koselugo | 10mg, 25mg | Chemotherapy | MEK Inhibitor | MEK 1/2 | Yes | 2020 | In Use | |||
| Q5119 | Rituximab-pvvr | Ruxience | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2019 | Jul 1, 2020 | In Use | ||
| Q5123 | Rituximab-arrx | Riabni | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2021 | Jul 23, 2021 | In Use | ||
| C9260 | Ofatumumab | Arzerra | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2009 | Apr 1, 2010 | Dec 31, 2010 | No Longer Used | |
| C9087 | Cyclophosphamide (Auromedics) | Cyclophosphamide | 10mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | No | 2021 | Jan 26, 2022 | Mar 25, 2022 | No Longer Used | |
| Q5115 | Rituximab-abbs | Truxima | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2018 | Jul 1, 2019 | In Use | ||
| J9292 | Pemetrexed dipotassium | Pemetrexed Dipotassium | 10mg | Chemotherapy | Antimetabolite | Folic Acid Analog | No | 2025 | Jan 1, 2025 | 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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