| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J9225 | Histrelin Acetate | Vantas | 50 mg | Hormonal Therapy | GnRH Agonist | No | 2004 | Jan 1, 2008 | In Use | |||
| J0881 | Darbepoetin alfa | Aranesp | 1 mcg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2001 | Jan 1, 2006 | In Use | |||
| J1051 | Medroxyprogesterone Acetate | Depo-Provera, Depo-SubQ Provera 104, Provera | 50 mg | Hormonal Therapy | Progestin | No | 1959 | Jan 1, 2003 | Dec 31, 2012 | No Longer Used | ||
| J1675 | Histrelin Acetate | Supprelin LA, Vantas | 10 mcg | Hormonal Therapy | GnRH Agonist | No | 2004 | Jan 1, 2006 | In Use | |||
| J3130 | Testosterone Enanthate | Testosterone Enanthate | 200 mg | Hormonal Therapy | Androgen | No | 1953 | Jan 1, 1982 | Jan 1, 2015 | No Longer Used | ||
| NA | Anastrozole | Arimidex | 0.5 mg | Hormonal Therapy | Aromatase Inhibitor | Yes | 1995 | In Use | ||||
| NA | Diethylstilbestrol | DES, Stilbestrol | unspecified | Hormonal Therapy | Estrogen | No | 1905 | 2000 | In Use | |||
| J8999 | Chemotherapy - non specific | Prescription drug, oral, chemotherapeutic NOS | NA | Chemotherapy | Yes | In Use | ||||||
| J3315 | Triptorelin Pamoate | Trelstar, Trelstar Mixject | 3.75 mg | Hormonal Therapy | GnRH Agonist | No | 2000 | Jan 1, 2003 | In Use | |||
| J3489 | Zoledronic acid | Zometa (4 mg/5 ml) | 1 mg | Ancillary Therapy | Bisphosphonate | No | 2001 | Jan 1, 2014 | In Use | |||
| J2354 | octreotide | sandostatin | 25 mcg | Hormonal Therapy | Somatostatin Analog | No | 1998 | Jan 1, 2004 | In Use | |||
| J3120 | Testosterone Enanthate | Testosterone Enanthate | 100 mg | Hormonal Therapy | Androgen | No | 1953 | Jan 1, 1982 | Jan 1, 2015 | No Longer Used | ||
| Q2051 | Zoledronic acid | Zometa (4 mg/5 ml) | 1 mg | Ancillary Therapy | Bisphosphonate | No | 2001 | Jul 1, 2013 | Jan 1, 2014 | No Longer Used | ||
| NA | Methyltestosterone | Android, Methitest, Testred | 10 mg | Hormonal Therapy | Androgen | Yes | 1982 | In Use | ||||
| J1726 | Hydroxyprogesterone Caproate | Makena | 10 mg | Hormonal Therapy | Progestin | No | 2011 | Jan 1, 2018 | 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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