| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J1626 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 100 mcg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 1993 | Jan 1, 2009 | In Use | ||
| NA | Mesna | Mesnex | 400 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Yes | 2002 | 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 | ||
| J2506 | Pegfilgratim (ex Biosimilars) | Neulasta | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2002 | Jan 26, 2022 | In Use | ||
| NA | Pilocarpine Hydrochloride | Pilocarpine | 5mg, 10mg | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agent | Yes | 2020 | In Use | |||
| J2783 | Rasburicase | Elitek, Fasturtec | 0.5 mg | Ancillary Therapy | Metabolic Agent | Enzyme | No | 2002 | Jan 1, 2004 | In Use | ||
| NA | Finasteride | Proscar | 5mg | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Yes | 1992 | 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 | ||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| Q5111 | Pegfilgrastim-cbqv | Udenyca | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2019 | Jan 1, 2019 | 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 | 25 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | In Use | ||
| NA | Uridine Triacetate | Xuriden | 2 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
| J1436 | Etidronate Disodium | Didronel | 300 mg | Ancillary Therapy | Bisphosphonate | No | 1977 | Jan 1, 1990 | In Use | |||
| J2277 | Motixafortide | Motixafortide | 0.25mg | Ancillary Therapy | Immunostimulant | Stem cell mobilizer | No | 2023 | Apr 17, 2024 | In Use | ||
| J8670 | Rolapitant | Varubi | 1 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2015 | Jan 1, 2017 | 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 | ||
| J8655 | Netupitant/Palonosetron | Akynzeo | 300mg/0.5 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Anatagonist, Substance P/Neurokinin 1 | Yes | 2014 | Jan 1, 2016 | In Use | ||
| J8650 | Nabilone | Cesamet | 1 mg | Ancillary Therapy | Antiemetic | Cannabinoid | Yes | 1985 | Jan 1, 2007 | In Use | ||
| J8502 | Aprepitant | Aponvie | 1mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2023 | Mar 18, 2026 | In Use | ||
| J2425 | Palifermin | Kepivance | 50 mcg | Ancillary Therapy | Epithelial Growth Factor | Keratinocyte Growth Factor/rHuKGF | No | 2004 | Jan 1, 2006 | In Use | ||
| NA | Uridine Triacetate | Vistogard | 10 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
| N/A | Calcium folinate | Lederle Leucovorin | 5mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2025 | 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 | |
| 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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