| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| J3489 | Zoledronic acid | Zometa (4 mg/5 ml) | 1 mg | Ancillary Therapy | Bisphosphonate | No | 2001 | Jan 1, 2014 | In Use | |||
| NA | oxymetholone | Anadrol-50 | 50 mg | Ancillary Therapy | Anabolic Steroid | Androgen | Yes | 1972 | In Use | |||
| Q5111 | Pegfilgrastim-cbqv | Udenyca | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2019 | Jan 1, 2019 | In Use | ||
| J0885 | Epoetin Alfa | Epogen, Procrit | 1000 units | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 1989 | Jan 1, 2006 | In Use | |||
| J1442 | Filgrastim | Neupogen, Zarxio | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 2016 | In Use | ||
| NA | Gardasil-9 | Human papillomavirus vaccine | Ancillary Therapy | Protective Agent | HPV Vaccine | No | 2016 | In Use | ||||
| C9252 | Plerixafor | Mozobil | 1 mg | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | No | 2008 | Jul 1, 2009 | Dec 31, 2009 | No Longer Used | |
| NA | Uridine Triacetate | Xuriden | 2 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
| J1440 | Filgrastim | Neupogen, Zarxio | 300 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 2014 | Dec 31, 2013 | No Longer Used | |
| J2468 | Palonosetron hydrochloride (avyxa) | Palonosetron hydrochloride (avyxa) | 25 MCG | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 2016 | Jun 10, 2024 | In Use | ||
| J2820 | Sargramostim | Leukine | 50 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 1998 | In Use | ||
| J1456 | Fosaprepitant (Teva) | Fosaprepitant (Teva) | 1mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2019 | Dec 21, 2022 | In Use | ||
| J0896 | Luspatercept | Reblozyl | 0.25mg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2019 | Jul 1, 2020 | In Use | |||
| NA | Uridine Triacetate | Vistogard | 10 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
| J0640 | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 50 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 1952 | Jan 1, 1997 | In Use | ||
| J1260 | Dolasetron Mesylate | Anzemet | 10 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 1997 | Jan 1, 2000 | In Use | ||
| J9209 | Mesna | Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan | 200 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1988 | Jan 1, 1990 | In Use | ||
| J2505 | Pegfilgrastim | Neulasta:Neulasta Onpro | 6 mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2002 | Jan 1, 2004 | Jan 26, 2022 | No Longer Used | |
| Q2051 | Zoledronic acid | Zometa (4 mg/5 ml) | 1 mg | Ancillary Therapy | Bisphosphonate | No | 2001 | Jul 1, 2013 | Jan 1, 2014 | No Longer Used | ||
| J8670 | Rolapitant | Varubi | 1 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2015 | Jan 1, 2017 | In Use | ||
| Q0168 | Dronabinol | Marinol | 5 mg | Ancillary Therapy | Antiemetic | CB1/CB2 | Yes | 1985 | Apr 1, 1998 | 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 | ||
| 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 | ||
| C9173 | Filgrastim-txid (nypozi) | Nypozi | 1 mcg | Ancillary Therapy | Immunostimulant | Colony-Stimulating Factor | No | 2024 | Dec 17, 2024 | Jul 9, 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.
Home