| 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 | ||
| J2430 | Pamidronate disodium | Aredia | 30mg | Ancillary Therapy | Bisphosphonate | No | 1987 | In Use | ||||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | 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 | ||
| Maribavir | Livtencity | 200mg | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Yes | 2021 | 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 | |
| J3487 | Zoledronic acid | Zometa (4 mg/5 ml) | 1 mg | Ancillary Therapy | Bisphosphonate | No | 2001 | Jan 1, 2003 | Dec 31, 2013 | No Longer Used | ||
| J1626 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 100 mcg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 1993 | Jan 1, 2009 | In Use | ||
| NA | oxymetholone | Anadrol-50 | 50 mg | Ancillary Therapy | Anabolic Steroid | Androgen | Yes | 1972 | In Use | |||
| J2783 | Rasburicase | Elitek, Fasturtec | 0.5 mg | Ancillary Therapy | Metabolic Agent | Enzyme | No | 2002 | Jan 1, 2004 | In Use | ||
| S0174 | Dolasetron Mesylate | Anzemet | 50 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1997 | Jan 1, 2002 | In Use | ||
| NA | Uridine Triacetate | Vistogard | 10 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | In Use | |||
| Q5111 | Pegfilgrastim-cbqv | Udenyca | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2019 | Jan 1, 2019 | In Use | ||
| 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 | ||
| J2505 | Pegfilgrastim | Neulasta:Neulasta Onpro | 6 mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2002 | Jan 1, 2004 | Jan 26, 2022 | No Longer Used | |
| Q0166 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1993 | Jan 1, 2009 | 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 | ||
| 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 | |
| NA | Gardasil-9 | Human papillomavirus vaccine | Ancillary Therapy | Protective Agent | HPV Vaccine | No | 2016 | 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 | ||
| 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 |
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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