| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Q5114 | Trastuzumab-dkst | Ogivri | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2017 | Jul 1, 2019 | In Use | ||
| J9030 | Bacillus calmette-guerin | BCG Vaccine, Tice BCG | 1mg | Immunotherapy | Biological Response Modifier | Live Vaccine | No | 1990 | Jul 1, 2019 | In Use | ||
| Q5115 | Rituximab-abbs | Truxima | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2018 | Jul 1, 2019 | In Use | ||
| J9036 | Bendamustine HCL | Belrapzo | 1mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | No | 2018 | Jul 1, 2019 | In Use | ||
| J9356 | Trastuzumab and Hyaluronidase-oysk | Herceptin hylecta | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Jul 1, 2019 | In Use | ||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| Q5117 | Trastuzumab-anns | Kanjinti | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Oct 1, 2019 | In Use | ||
| Q5118 | Bevacizumab-bvzr | Zirabev | 10mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2019 | Oct 1, 2019 | In Use | ||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| J9313 | Moxetumomab-pasudotox-tdfk | Lumoxiti | 0.01mg | Immunotherapy | Drug Antibody Conjugate | CD22 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9113 | Cemiplimab-rwlc | Libtayo | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9204 | Mogamulizumab-kpkc | Poteligeo | 1mg | Immunotherapy | Monoclonal Antibody | CCR4 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9269 | Tagraxofusp-erzs | Elzonris | 10mcg | Immunotherapy | Recombinant Fusion Protein | IL3/CD123 | No | 2018 | Oct 1, 2019 | In Use | ||
| Q5116 | Trastuzumab-qyyp | Trazimera | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2020 | Oct 1, 2019 | In Use | ||
| J9118 | Calaspargase pegol-mknl | Asparlas | 10 units | Chemotherapy | Miscellaneous Agent | Enzyme | No | 2018 | Oct 1, 2019 | In Use | ||
| J9044 | Bortezomib | Bortezomib | 0.1mg | Chemotherapy | Proteasome Inhibitor | 26S | No | 2019 | Nov 3, 2019 | Dec 21, 2022 | In Use | |
| J9309 | Polatuzumab Vedotin | Polivy | 1mg | Immunotherapy | Drug Antibody Conjugate | CD79b | No | 2019 | Jan 1, 2020 | 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 | |
| J9246 | Melphalan | Evomela | 1mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | No | 2016 | Jul 1, 2020 | In Use | ||
| J9177 | Enfortumab vedotin-ejfv | Padcev | 0.25mg | Immunotherapy | Drug Antibody Conjugate | Nectin-4 | No | 2019 | Jul 1, 2020 | In Use | ||
| Q5120 | Pegfilgratim-bmez | Ziextenzo | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony Stimulating Factor | No | 2019 | Jul 1, 2020 | In Use | ||
| J9358 | Fam-trastuzumab deruxtecan-nxki | Enhertu | 1mg | Immunotherapy | Drug Antibody Conjugate | HER2, topoisomerase, tetrapeptide | No | 2019 | Jul 1, 2020 | In Use | ||
| J9198 | Gemcitabine HCl | Infugem | 100mg | Chemotherapy | Antimetabolite | Pyrimidine Analog | No | 2018 | Jul 1, 2020 | In Use | ||
| Q5119 | Rituximab-pvvr | Ruxience | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2019 | Jul 1, 2020 | In Use | ||
| J0896 | Luspatercept | Reblozyl | 0.25mg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2019 | Jul 1, 2020 | 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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