| 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 | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 10 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | 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 | ||
| NA | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 25 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | In Use | ||
| NA | Cyclosporine | Gengraf | 25mg, 50mg, 100mg | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Yes | 2010 | In Use | |||
| Q5111 | Pegfilgrastim-cbqv | Udenyca | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2019 | Jan 1, 2019 | In Use | ||
| J2820 | Sargramostim | Leukine | 50 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | 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 | ||
| J2425 | Palifermin | Kepivance | 50 mcg | Ancillary Therapy | Epithelial Growth Factor | Keratinocyte Growth Factor/rHuKGF | No | 2004 | Jan 1, 2006 | In Use | ||
| J3489 | Zoledronic acid | Zometa (4 mg/5 ml) | 1 mg | Ancillary Therapy | Bisphosphonate | No | 2001 | Jan 1, 2014 | In Use | |||
| J1447 | Tbo-filgrastim | Granix | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | In Use | ||
| J0881 | Darbepoetin alfa | Aranesp | 1 mcg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2001 | Jan 1, 2006 | In Use | |||
| S0174 | Dolasetron Mesylate | Anzemet | 50 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1997 | Jan 1, 2002 | 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 | ||
| 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 | ||
| C9096 | Filgrastim | Releuko | 1mcg | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | No | 2022 | Mar 25, 2022 | Sep 27, 2022 | No Longer Used | |
| NA | Dutasteride | Avodart | 0.5mg | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Yes | 2002 | In Use | |||
| C9252 | Plerixafor | Mozobil | 1 mg | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | No | 2008 | Jul 1, 2009 | Dec 31, 2009 | No Longer Used | |
| C9293 | Glucarpidase | Voraxaze | 10 units | Ancillary Therapy | Chemoprotective | Antidote | No | 2012 | Jan 1, 2012 | In Use | ||
| NA | Gardasil-9 | Human papillomavirus vaccine | Ancillary Therapy | Protective Agent | HPV Vaccine | No | 2016 | In Use | ||||
| Q5148 | Filgrastim-txid (nypozi) | Nypozi | 1 microgram | Ancillary Therapy | Immunostimulant | Colony-Stimulating Factor | No | 2024 | Mar 26, 2025 | In Use | ||
| Q0180 | Dolasetron Mesylate | Anzemet | 100 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1997 | Apr 1, 1998 | 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 | ||
| 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.
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