| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J9311 | Rituximab and Hyaluronidase | Rituxan Hycela | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2017 | Jan 1, 2019 | In Use | ||
| Q5113 | Trastuzumab-pkrb | Herzuma | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2018 | Jul 1, 2019 | In Use | ||
| Q5114 | Trastuzumab-dkst | Ogivri | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2017 | 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 | ||
| 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 | ||
| Q5112 | Trastuzumab-dttb | Ontruzant | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2021 | Jul 1, 2019 | In Use | ||
| Q5117 | Trastuzumab-anns | Kanjinti | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Oct 1, 2019 | In Use | ||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| J9113 | Cemiplimab-rwlc | Libtayo | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | 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 | ||
| Q5118 | Bevacizumab-bvzr | Zirabev | 10mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2019 | Oct 1, 2019 | In Use | ||
| J9118 | Calaspargase pegol-mknl | Asparlas | 10 units | Chemotherapy | Miscellaneous Agent | Enzyme | No | 2018 | Oct 1, 2019 | In Use | ||
| J9204 | Mogamulizumab-kpkc | Poteligeo | 1mg | Immunotherapy | Monoclonal Antibody | CCR4 | 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 | ||
| Q5116 | Trastuzumab-qyyp | Trazimera | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2020 | Oct 1, 2019 | In Use | ||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | 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 | |
| J9198 | Gemcitabine HCl | Infugem | 100mg | Chemotherapy | Antimetabolite | Pyrimidine Analog | No | 2018 | 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 |
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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