| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C9252 | Plerixafor | Mozobil | 1 mg | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | No | 2008 | Jul 1, 2009 | Dec 31, 2009 | No Longer Used | |
| J1456 | Fosaprepitant (Teva) | Fosaprepitant (Teva) | 1mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2019 | Dec 21, 2022 | In Use | ||
| J0207 | Amifostine | Ethyol | 500 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 1998 | In Use | ||
| Q5101 | Filgrastim | Neupogen, Zarxio | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jul 1, 2015 | In Use | ||
| J2425 | Palifermin | Kepivance | 50 mcg | Ancillary Therapy | Epithelial Growth Factor | Keratinocyte Growth Factor/rHuKGF | No | 2004 | Jan 1, 2006 | In Use | ||
| NA | Pilocarpine Hydrochloride | Pilocarpine | 5mg, 10mg | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agent | Yes | 2020 | In Use | |||
| Q5122 | Pegfilgrastim-apgf | Nyvepria | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony Stimulating Factor | No | 2020 | Jan 1, 2021 | In Use | ||
| Q2051 | Zoledronic acid | Zometa (4 mg/5 ml) | 1 mg | Ancillary Therapy | Bisphosphonate | No | 2001 | Jul 1, 2013 | Jan 1, 2014 | No Longer Used | ||
| Q0179 | Ondansetron | Zofran, Zofran ODT, Zuplenz | 8 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1991 | Apr 1, 1998 | Dec 31, 2011 | 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 | ||
| J0881 | Darbepoetin alfa | Aranesp | 1 mcg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2001 | Jan 1, 2006 | 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 | |
| NA | Gardasil-9 | Human papillomavirus vaccine | Ancillary Therapy | Protective Agent | HPV Vaccine | No | 2016 | 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 | Uridine Triacetate | Vistogard | 10 g | Ancillary Therapy | Chemoprotective | Antidote | Yes | 2015 | 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 | ||
| 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 | |
| J2430 | Pamidronate disodium | Aredia | 30mg | Ancillary Therapy | Bisphosphonate | No | 1987 | 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 | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 10 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | 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 | ||
| Q5125 | Filgrastim | Releuko | 1mcg | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | No | 2022 | Sep 27, 2022 | In Use | ||
| J2820 | Sargramostim | Leukine | 50 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 1998 | 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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