| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Q5101 | Filgrastim | Neupogen, Zarxio | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jul 1, 2015 | In Use | ||
| J1190 | Dexrazoxane | Zinecard | 250 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 2007 | 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 | ||
| J1446 | Tbo-filgrastim | Granix | 5 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | Dec 31, 2015 | No Longer Used | |
| J8670 | Rolapitant | Varubi | 1 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2015 | Jan 1, 2017 | In Use | ||
| J2783 | Rasburicase | Elitek, Fasturtec | 0.5 mg | Ancillary Therapy | Metabolic Agent | Enzyme | No | 2002 | Jan 1, 2004 | In Use | ||
| NA | Cyclosporine | Sandimmune | 25mg, 50mg, 100mg | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Yes | 1983 | In Use | |||
| J0896 | Luspatercept | Reblozyl | 0.25mg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2019 | Jul 1, 2020 | In Use | |||
| S0181 | Ondansetron | Zofran, Zofran ODT, Zuplenz | 4 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1991 | Jan 1, 2002 | Dec 31, 2011 | No Longer Used | |
| J2469 | Palonosetron | Aloxi | 25 mcg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 2003 | Jan 1, 2005 | In Use | ||
| NA | oxymetholone | Anadrol-50 | 50 mg | Ancillary Therapy | Anabolic Steroid | Androgen | Yes | 1972 | In Use | |||
| NA | Uridine Triacetate | Vistogard | 10 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
| Maribavir | Livtencity | 200mg | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Yes | 2021 | 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 | ||
| Q0166 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1993 | Jan 1, 2009 | In Use | ||
| Q5130 | Pegfilgrastim-pbbk | Fylnetra | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | No | 2022 | Mar 17, 2023 | In Use | ||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| Q5120 | Pegfilgratim-bmez | Ziextenzo | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony Stimulating Factor | No | 2019 | Jul 1, 2020 | In Use | ||
| Q5127 | Pegflilgrastim-fpgk | Stimufend | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | No | 2022 | Mar 17, 2023 | 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 | Finasteride | Proscar | 5mg | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Yes | 1992 | In Use | |||
| NA | Metoclopramide | Reglan | 5mg, 10mg | Ancillary Therapy | Antiemetic | Dopamine-2 Receptor Antagonist | Yes | 1991 | 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 | |
| J2820 | Sargramostim | Leukine | 50 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 1998 | 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 |
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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