| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| S0091 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1993 | Jan 1, 2002 | In Use | ||
| NA | Mesna | Mesnex | 400 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Yes | 2002 | In Use | |||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| NA | Aprepitant | Emend | 80 mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Yes | 2003 | 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 | ||
| J2783 | Rasburicase | Elitek, Fasturtec | 0.5 mg | Ancillary Therapy | Metabolic Agent | Enzyme | No | 2002 | Jan 1, 2004 | In Use | ||
| Q5111 | Pegfilgrastim-cbqv | Udenyca | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2019 | Jan 1, 2019 | In Use | ||
| J1447 | Tbo-filgrastim | Granix | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | In Use | ||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| J2506 | Pegfilgratim (ex Biosimilars) | Neulasta | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2002 | Jan 26, 2022 | In Use | ||
| J2562 | Plerixafor | Mozobil | 1 mg | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | No | 2008 | Jan 1, 2010 | In Use | ||
| C9210 | Palonosetron | Aloxi | 25 mcg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 2003 | Jan 1, 2004 | Dec 31, 2004 | No Longer Used | |
| J1190 | Dexrazoxane | Zinecard | 250 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 2007 | 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 | |
| J1626 | Granisetron Hydrochloride | Granisol [DSC], Sancuso, Sustol, Kytril | 100 mcg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 1993 | Jan 1, 2009 | 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 | ||
| Nirogacestat | Ogsiveo | 50mg, 100mg, 150mg | Ancillary Therapy | Miscellaneous Agent | Ɣ Secretase Inhibitor | Yes | 2023 | In Use | ||||
| Q5101 | Filgrastim | Neupogen, Zarxio | 1 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jul 1, 2015 | 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 | |||
| NA | Dutasteride | Avodart | 0.5mg | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Yes | 2002 | In Use | |||
| J8502 | Aprepitant | Aponvie | 1mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2023 | Mar 18, 2026 | In Use | ||
| J1436 | Etidronate Disodium | Didronel | 300 mg | Ancillary Therapy | Bisphosphonate | No | 1977 | Jan 1, 1990 | In Use | |||
| C9448 | Netupitant/Palonosetron | Akynzeo | 300mg/0.5 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 | Yes | 2014 | Apr 1, 2015 | Jun 30, 2015 | 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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