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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
S0091 Granisetron Hydrochloride Granisol [DSC], Sancuso, Sustol, Kytril 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1993 Jan 1, 2002 In Use
J2405 Ondansetron Zofran, Zofran ODT, Zuplenz 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist No 1991 Jan 1, 1993 In Use
J0641 Levoleucovorin Fusilev, Levoleucovorin 0.5 mg Ancillary Therapy Chemoprotective Antidote No 2008 Oct 1, 2019 In Use
Q5122 Pegfilgrastim-apgf Nyvepria 0.5mg Ancillary Therapy Immunostimulant Granulocyte Colony Stimulating Factor No 2020 Jan 1, 2021 In Use
J2277 Motixafortide Motixafortide 0.25mg Ancillary Therapy Immunostimulant Stem cell mobilizer No 2023 Apr 17, 2024 In Use
NA Uridine Triacetate Xuriden 2 g Ancillary Therapy Chemoprotective Antidote Yes 2015 In Use
C9448 Netupitant/Palonosetron Akynzeo 300mg/0.5 mg Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Yes 2014 Apr 1, 2015 Jun 30, 2015 No Longer Used
NA oxymetholone Anadrol-50 50 mg Ancillary Therapy Anabolic Steroid Androgen Yes 1972 In Use
NA Cyclosporine Sandimmune 25mg, 50mg, 100mg Ancillary Therapy Immunomodulator Calcineurin Inhibitor Yes 1983 In Use
NA Pilocarpine Hydrochloride Pilocarpine 5mg, 10mg Ancillary Therapy Miscellaneous Agent Cholinergic Agent Yes 2020 In Use
J1434 Fosaprepitant Focinvez 1mg Ancillary Therapy Antiemetic Substance P/Neurokinin 1 No 2023 Apr 17, 2024 In Use
J2820 Sargramostim Leukine 50 mcg Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor No 1991 Jan 1, 1998 In Use
J8670 Rolapitant Varubi 1 mg Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Yes 2015 Jan 1, 2017 In Use
NA Aprepitant Emend 125 mg Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Yes 2003 In Use
J1190 Dexrazoxane Zinecard 250 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1995 Jan 1, 2007 In Use
C9096 Filgrastim Releuko 1mcg Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor No 2022 Mar 25, 2022 Sep 27, 2022 No Longer Used
J0642 Levoleucovorin Khapzory 0.5mg Ancillary Therapy Chemoprotective Antidote No 2018 Oct 1, 2019 In Use
Q0166 Granisetron Hydrochloride Granisol [DSC], Sancuso, Sustol, Kytril 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1993 Jan 1, 2009 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 10 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan 1, 1997 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
Q0162 Ondansetron with active chemotherapy treatment adminstration Zofran, Zofran ODT, Zuplenz 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1991 Jan 1, 2012 In Use
J9209 Mesna Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan 200 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1988 Jan 1, 1990 In Use
S0119 Ondansetron Zofran, Zofran ODT, Zuplenz 4 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1991 Jan 1, 2012 In Use
Q0168 Dronabinol Marinol 5 mg Ancillary Therapy Antiemetic CB1/CB2 Yes 1985 Apr 1, 1998 In Use
Q0179 Ondansetron Zofran, Zofran ODT, Zuplenz 8 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1991 Apr 1, 1998 Dec 31, 2011 No Longer Used
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.