| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | 25 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | In Use | ||
| NA | Mesna | Mesnex | 400 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Yes | 2002 | 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 | ||
| 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 | |
| J1447 | Tbo-filgrastim | Granix | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | In Use | ||
| S0119 | Ondansetron | Zofran, Zofran ODT, Zuplenz | 4 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1991 | Jan 1, 2012 | In Use | ||
| Q0168 | Dronabinol | Marinol | 5 mg | Ancillary Therapy | Antiemetic | CB1/CB2 | Yes | 1985 | Apr 1, 1998 | In Use | ||
| J1440 | Filgrastim | Neupogen, Zarxio | 300 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 2014 | Dec 31, 2013 | No Longer Used | |
| Maribavir | Livtencity | 200mg | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Yes | 2021 | In Use | ||||
| C9210 | Palonosetron | Aloxi | 25 mcg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 2003 | Jan 1, 2004 | Dec 31, 2004 | No Longer Used | |
| NA | Cyclosporine | Gengraf | 25mg, 50mg, 100mg | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Yes | 2010 | In Use | |||
| J1260 | Dolasetron Mesylate | Anzemet | 10 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 1997 | Jan 1, 2000 | In Use | ||
| Q5111 | Pegfilgrastim-cbqv | Udenyca | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2019 | Jan 1, 2019 | In Use | ||
| J2468 | Palonosetron hydrochloride (avyxa) | Palonosetron hydrochloride (avyxa) | 25 MCG | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 2016 | Jun 10, 2024 | 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 | ||
| J2277 | Motixafortide | Motixafortide | 0.25mg | Ancillary Therapy | Immunostimulant | Stem cell mobilizer | No | 2023 | Apr 17, 2024 | In Use | ||
| J1434 | Fosaprepitant | Focinvez | 1mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2023 | Apr 17, 2024 | In Use | ||
| J2562 | Plerixafor | Mozobil | 1 mg | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | No | 2008 | Jan 1, 2010 | In Use | ||
| Q9978 | Netupitant/palonostron | Akynzeo | 300mg/0.5 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 | Yes | 2014 | Jul 1, 2015 | Dec 31, 2015 | No Longer Used | |
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| J2430 | Pamidronate disodium | Aredia | 30mg | Ancillary Therapy | Bisphosphonate | No | 1987 | In Use | ||||
| J1190 | Dexrazoxane | Zinecard | 250 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 2007 | 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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