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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
C9293 | Glucarpidase | Voraxaze | 10 units | Ancillary Therapy | Chemoprotective | Antidote | No | 2012 | Jan 1, 2012 | In Use | ||
NA | Cyclosporine | Gengraf | 25mg, 50mg, 100mg | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Yes | 2010 | In Use | |||
NA | Aprepitant | Emend | 80 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2003 | In Use | |||
Q5130 | Pegfilgrastim-pbbk | Fylnetra | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | No | 2022 | Mar 17, 2023 | In Use | ||
NA | Cyclosporine | Sandimmune | 25mg, 50mg, 100mg | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Yes | 1983 | In Use | |||
NA | Metoclopramide | Reglan | 5mg, 10mg | Ancillary Therapy | Antiemetic | Dopamine-2 Receptor Antagonist | Yes | 1991 | In Use | |||
Maribavir | Livtencity | 200mg | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Yes | 2021 | In Use | ||||
J2820 | Sargramostim | Leukine | 50 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 1998 | In Use | ||
NA | oxymetholone | Anadrol-50 | 50 mg | Ancillary Therapy | Anabolic Steroid | Androgen | Yes | 1972 | In Use | |||
J1447 | Tbo-filgrastim | Granix | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | In Use | ||
NA | Uridine Triacetate | Vistogard | 10 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
J0896 | Luspatercept | Reblozyl | 0.25mg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2019 | Jul 1, 2020 | In Use | |||
J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | 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 | ||
NA | Uridine Triacetate | Xuriden | 2 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
Q5122 | Pegfilgrastim-apgf | Nyvepria | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony Stimulating Factor | No | 2020 | Jan 1, 2021 | 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 | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 15 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | 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 | ||
NA | Anagrelide | Agrylin | 1mg | Ancillary Therapy | Platelet-Reducing Agent | PDE-3 Inhibitor | Yes | 1997 | 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 | Cervarix | Human papillomavirus vaccine | 20 mcg vaccine | Ancillary Therapy | Protective Agent | HPV Vaccine | No | 2009 | 2016 | In Use | ||
NA | Anagrelide | Agrylin | 0.5mg | Ancillary Therapy | Platelet-Reducing Agent | PDE-3 Inhibitor | Yes | 1997 | In Use | |||
J0207 | Amifostine | Ethyol | 500 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 1998 | 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.