| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Maribavir | Livtencity | 200mg | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Yes | 2021 | In Use | ||||
| Q5120 | Pegfilgratim-bmez | Ziextenzo | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony Stimulating Factor | No | 2019 | Jul 1, 2020 | In Use | ||
| NA | Gardasil | Human papillomavirus vaccine | Ancillary Therapy | Protective Agent | HPV Vaccine | No | 2006 | 2016 | In Use | |||
| C9293 | Glucarpidase | Voraxaze | 10 units | Ancillary Therapy | Chemoprotective | Antidote | No | 2012 | Jan 1, 2012 | In Use | ||
| J1446 | Tbo-filgrastim | Granix | 5 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 2015 | Jan 1, 2016 | Dec 31, 2015 | No Longer Used | |
| NA | oxymetholone | Anadrol-50 | 50 mg | Ancillary Therapy | Anabolic Steroid | Androgen | Yes | 1972 | In Use | |||
| J2783 | Rasburicase | Elitek, Fasturtec | 0.5 mg | Ancillary Therapy | Metabolic Agent | Enzyme | No | 2002 | Jan 1, 2004 | In Use | ||
| C9428 | Mesna | Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan | 200 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1988 | Jan 1, 2004 | Dec 31, 2005 | No Longer Used | |
| J1456 | Fosaprepitant (Teva) | Fosaprepitant (Teva) | 1mg | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | No | 2019 | Dec 21, 2022 | In Use | ||
| J9209 | Mesna | Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan | 200 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1988 | Jan 1, 1990 | 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 | ||
| S0119 | Ondansetron | Zofran, Zofran ODT, Zuplenz | 4 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1991 | Jan 1, 2012 | In Use | ||
| 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 | |
| NA | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 25 mg | Ancillary Therapy | Chemoprotective | Antidote | Yes | 1952 | Jan 1, 1997 | 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 | ||
| C9310 | Leucovorin calcium ( avyxa) | Vykoura | 1mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2026 | Jun 17, 2026 | 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 | ||
| NA | Finasteride | Proscar | 5mg | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Yes | 1992 | In Use | |||
| J2405 | Ondansetron | Zofran, Zofran ODT, Zuplenz | 1 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 1991 | Jan 1, 1993 | In Use | ||
| S0174 | Dolasetron Mesylate | Anzemet | 50 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Yes | 1997 | Jan 1, 2002 | In Use | ||
| J1260 | Dolasetron Mesylate | Anzemet | 10 mg | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | No | 1997 | Jan 1, 2000 | 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 | |
| J2430 | Pamidronate disodium | Aredia | 30mg | Ancillary Therapy | Bisphosphonate | No | 1987 | In Use | ||||
| J1441 | Filgrastim | Neupogen, Zarxio | 480 mcg | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | No | 1991 | Jan 1, 2014 | Dec 31, 2013 | No Longer Used | |
| NA | Ribociclib and letrozole | Kisqali Femara Co-pack | 200 mg/ 2.5 mg | Chemotherapy, Hormonal Therapy | Cyclin dependent kinase inhibitor/ aromatase inhibitor | CDK 4/6 | Yes | 2017 | 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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