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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 Cyclosporine Gengraf 25mg, 50mg, 100mg Ancillary Therapy Immunomodulator Calcineurin Inhibitor Yes 2010 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
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
S0174 Dolasetron Mesylate Anzemet 50 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1997 Jan 1, 2002 In Use
NA Cyclosporine Sandimmune 25mg, 50mg, 100mg Ancillary Therapy Immunomodulator Calcineurin Inhibitor Yes 1983 In Use
J3489 Zoledronic acid Zometa (4 mg/5 ml) 1 mg Ancillary Therapy Bisphosphonate No 2001 Jan 1, 2014 In Use
J0881 Darbepoetin alfa Aranesp 1 mcg Ancillary Therapy Erythropoiesis-Stimulating Agent No 2001 Jan 1, 2006 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 Dutasteride Avodart 0.5mg Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Yes 2002 In Use
J1447 Tbo-filgrastim Granix 1 mcg Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor No 2015 Jan 1, 2016 In Use
C9096 Filgrastim Releuko 1mcg Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor No 2022 Mar 25, 2022 Sep 27, 2022 No Longer Used
C9252 Plerixafor Mozobil 1 mg Ancillary Therapy Immunostimulant Stem Cell Mobilizer No 2008 Jul 1, 2009 Dec 31, 2009 No Longer Used
Q0180 Dolasetron Mesylate Anzemet 100 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1997 Apr 1, 1998 In Use
J2277 Motixafortide Motixafortide 0.25mg Ancillary Therapy Immunostimulant Stem cell mobilizer No 2023 Apr 17, 2024 In Use
NA Gardasil-9 Human papillomavirus vaccine Ancillary Therapy Protective Agent HPV Vaccine No 2016 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
C9145 Aprepitant Aponvie 1mg Ancillary Therapy Antiemetic Substance P/Neurokinin 1 No 2023 Mar 17, 2023 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
NA Aprepitant Emend 125 mg Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Yes 2003 In Use
NA Uridine Triacetate Xuriden 2 g Ancillary Therapy Chemoprotective Antidote Yes 2015 In Use
J2405 Ondansetron Zofran, Zofran ODT, Zuplenz 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist No 1991 Jan 1, 1993 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.