| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J1190 | Dexrazoxane | Zinecard | 250 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 2007 | In Use | ||
| J1441 | Filgrastim | Neupogen, Zarxio | 480 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 2014 | Dec 31, 2013 | No Longer Used | |
| S0091 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1993 | Jan 1, 2002 | In Use | ||
| J2562 | Plerixafor | Mozobil | 1 mg | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | No | 2008 | Jan 1, 2010 | In Use | ||
| J8655 | Netupitant/Palonosetron | Akynzeo | 300mg/0.5 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Anatagonist, Substance P/Neurokinin 1 | Yes | 2014 | Jan 1, 2016 | 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 | ||
| J2425 | Palifermin | Kepivance | 50 mcg | Ancillary Therapy | Epithelial Growth Factor | Keratinocyte Growth Factor/rHuKGF | No | 2004 | Jan 1, 2006 | In Use | ||
| S0119 | Ondansetron | Zofran, Zofran ODT, Zuplenz | 4 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1991 | Jan 1, 2012 | In Use | ||
| NA | Aprepitant | Emend | 80 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2003 | 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 | ||
| C9293 | Glucarpidase | Voraxaze | 10 units | Ancillary Therapy | Chemoprotective | Antidote | No | 2012 | Jan 1, 2012 | 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 | ||
| 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 | |
| J1627 | Granisetron Hydrochloride Extended Release | Granisol [DSC], Sancuso, Sustol, Kytril | 0.1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 2016 | Jan 1, 2018 | In Use | ||
| NA | Gardasil | Human papillomavirus vaccine | Ancillary Therapy | Protective Agent | HPV Vaccine | No | 2006 | 2016 | In Use | |||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| J1453 | Fosaprepitant | Emend | 150 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2008 | Jan 1, 2009 | In Use | ||
| NA | Naldemedine | Symproic | 0.2mg | Ancillary Therapy | Opioid Antagonist | Yes | 2018 | In Use | ||||
| J1626 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 100 mcg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 1993 | Jan 1, 2009 | In Use | ||
| NA | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 25 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | In Use | ||
| S0174 | Dolasetron Mesylate | Anzemet | 50 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1997 | Jan 1, 2002 | In Use | ||
| Q9978 | Netupitant/palonostron | Akynzeo | 300mg/0.5 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 | Yes | 2014 | Jul 1, 2015 | Dec 31, 2015 | No Longer Used | |
| J1446 | Tbo-filgrastim | Granix | 5 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | Dec 31, 2015 | No Longer Used | |
| J1447 | Tbo-filgrastim | Granix | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | In Use | ||
| NA | Mesna | Mesnex | 400 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Yes | 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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