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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
NA Ribociclib and letrozole Kisqali Femara Co-pack 200 mg/ 2.5 mg Chemotherapy, Hormonal Therapy Cyclin dependent kinase inhibitor/ aromatase inhibitor CDK 4/6 Yes 2017 In Use
Q5120 Pegfilgratim-bmez Ziextenzo 0.5mg Ancillary Therapy Immunostimulant Granulocyte Colony Stimulating Factor No 2019 Jul 1, 2020 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 Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 15 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan 1, 1997 In Use
J1190 Dexrazoxane Zinecard 250 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1995 Jan 1, 2007 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
J0640 Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 50 mg Ancillary Therapy Chemoprotective Antidote No 1952 Jan 1, 1997 In Use
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
S0091 Granisetron Hydrochloride Granisol [DSC], Sancuso, Sustol, Kytril 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1993 Jan 1, 2002 In Use
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
Q0166 Granisetron Hydrochloride Granisol [DSC], Sancuso, Sustol, Kytril 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1993 Jan 1, 2009 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
C9293 Glucarpidase Voraxaze 10 units Ancillary Therapy Chemoprotective Antidote No 2012 Jan 1, 2012 In Use
J2506 Pegfilgratim (ex Biosimilars) Neulasta 0.5mg Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor No 2002 Jan 26, 2022 In Use
Q5130 Pegfilgrastim-pbbk Fylnetra 0.5mg Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor No 2022 Mar 17, 2023 In Use
Q5111 Pegfilgrastim-cbqv Udenyca 0.5mg Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor No 2019 Jan 1, 2019 In Use
NA Gardasil-9 Human papillomavirus vaccine Ancillary Therapy Protective Agent HPV Vaccine No 2016 In Use
NA Pilocarpine Hydrochloride Pilocarpine 5mg, 10mg Ancillary Therapy Miscellaneous Agent Cholinergic Agent Yes 2020 In Use
J0881 Darbepoetin alfa Aranesp 1 mcg Ancillary Therapy Erythropoiesis-Stimulating Agent No 2001 Jan 1, 2006 In Use
C9252 Plerixafor Mozobil 1 mg Ancillary Therapy Immunostimulant Stem Cell Mobilizer No 2008 Jul 1, 2009 Dec 31, 2009 No Longer Used
J2562 Plerixafor Mozobil 1 mg Ancillary Therapy Immunostimulant Stem Cell Mobilizer No 2008 Jan 1, 2010 In Use
NA Cyclosporine Sandimmune 25mg, 50mg, 100mg Ancillary Therapy Immunomodulator Calcineurin Inhibitor Yes 1983 In Use
C9058 Pegfilgrastim-bmez Ziextenzo 0.5mg Ancillary Therapy immunomodulatorne Granulocyte Colony Stimulating Factor No 2019 Mar 31, 2020 Jul 1, 2020 No Longer Used
Q5122 Pegfilgrastim-apgf Nyvepria 0.5mg Ancillary Therapy Immunostimulant Granulocyte Colony Stimulating Factor No 2020 Jan 1, 2021 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.