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HCPCS Generic Name Brand Name Strength SEER*Rx Category Major Drug Class Minor Drug Class (Ascending) Oral (Y/N) FDA Approval Year FDA Discontinuation Year CMS Effective Date CMS Discontinuation Date Status
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 10 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan. 1, 1997 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 15 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan. 1, 1997 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
J0640 Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 50 mg Ancillary Therapy Chemoprotective Antidote No 1952 Jan. 1, 1997 In Use
J0641 Levoleucovorin Fusilev, Levoleucovorin 0.5 mg Ancillary Therapy Chemoprotective Antidote No 2008 Oct. 1, 2019 In Use
NA Uridine Triacetate Xuriden 2 g Ancillary Therapy Chemoprotective Antidote Yes 2015 In Use
NA Uridine Triacetate Vistogard 10 g Ancillary Therapy Chemoprotective Antidote Yes 2015 In Use
J0642 Levoleucovorin Khapzory 0.5mg Ancillary Therapy Chemoprotective Antidote No 2018 Oct. 1, 2019 In Use
S0176 Hydroxyurea Hydrea 500 mg Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Yes 1967 Jan. 1, 2002 In Use
NA venetoclax Venclexta 10 mg Chemotherapy Enzyme Inhibitor BCL-2 Yes 2016 In Use

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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.