| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J2425 | Palifermin | Kepivance | 50 mcg | Ancillary Therapy | Epithelial Growth Factor | Keratinocyte Growth Factor/rHuKGF | No | 2004 | Jan 1, 2006 | In Use | ||
| Q5130 | Pegfilgrastim-pbbk | Fylnetra | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | No | 2022 | Mar 17, 2023 | 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 | |
| J0207 | Amifostine | Ethyol | 500 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 1998 | In Use | ||
| S0119 | Ondansetron | Zofran, Zofran ODT, Zuplenz | 4 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1991 | Jan 1, 2012 | In Use | ||
| NA | Cyclosporine | NeOral | 25mg, 100mg | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Yes | 1995 | In Use | |||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | 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 | |
| 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 | |
| J2562 | Plerixafor | Mozobil | 1 mg | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | No | 2008 | Jan 1, 2010 | In Use | ||
| J1447 | Tbo-filgrastim | Granix | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | In Use | ||
| J9209 | Mesna | Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan | 200 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1988 | Jan 1, 1990 | In Use | ||
| NA | oxymetholone | Anadrol-50 | 50 mg | Ancillary Therapy | Anabolic Steroid | Androgen | Yes | 1972 | 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 | ||
| J2277 | Motixafortide | Motixafortide | 0.25mg | Ancillary Therapy | Immunostimulant | Stem cell mobilizer | No | 2023 | Apr 17, 2024 | In Use | ||
| Q5101 | Filgrastim | Neupogen, Zarxio | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jul 1, 2015 | In Use | ||
| C9252 | Plerixafor | Mozobil | 1 mg | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | No | 2008 | Jul 1, 2009 | Dec 31, 2009 | No Longer Used | |
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| NA | Uridine Triacetate | Xuriden | 2 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
| C9293 | Glucarpidase | Voraxaze | 10 units | Ancillary Therapy | Chemoprotective | Antidote | No | 2012 | Jan 1, 2012 | In Use | ||
| Q0167 | Dronabinol | Marinol | 2.5 mg | Ancillary Therapy | Antiemetic | CB1/CB2 | Yes | 1985 | Apr 1, 1998 | 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 |
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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