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HCPCS Generic Name Brand Name (Ascending) 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
NA Ruxolitinib Jakafi 15 mg Chemotherapy Enzyme Inhibitor JAK 1/2 Yes 2011 In Use
NA Ruxolitinib Jakafi 20 mg Chemotherapy Enzyme Inhibitor JAK 1/2 Yes 2011 In Use
NA Ruxolitinib Jakafi 25 mg Chemotherapy Enzyme Inhibitor JAK 1/2 Yes 2011 In Use
J9281 Mitomycin Pyelocalyceal Instillation Jelmyto 1mg Chemotherapy Antitumor Antibiotic Alkylating Agent/Mitomycin No 2020 Jan. 1, 2021 In Use
C9064 Mitomycin pyelocalyceal instillation Jelmyto 1mg Chemotherapy Antitumor Antibiotic Alkylating Agent/Mitomycin No 2020 Oct. 1, 2020 Jan. 1, 2021 No Longer Used
NA Dostarlimab Jemperli 50mg Immunotherapy Checkpoint Inhibitor PD-1 Yes 2021 In Use
C9082 Dostarlimab-gxly Jemperli 100mg Immunotherapy Checkpoint Inhibitor PD-1 No 2021 Sept. 27, 2021 Jan. 26, 2022 No Longer Used
J9272 Dostarlimab-gxly Jemperli 10mg Immunotherapy Checkpoint Inhibitor PD-1 No 2021 Jan. 26, 2022 In Use
C9276 Cabazitaxel Jevtana 1 mg Chemotherapy Antimitotic Agent Taxane No 2010 Jan. 1, 2011 Dec. 31, 2011 No Longer Used
J9043 Cabazitaxel Jevtana 1 mg Chemotherapy Antimitotic Agent Taxane No 2010 Jan. 1, 2012 In Use
J9354 Ado-Trastuzumab Emtansine Kadcyla 1mg Immunotherapy Drug Antibody Conjugate HER2 No 2013 Jan. 1, 2014 In Use
C9131 Ado-Trastuzumab Emtansine Kadcyla 1mg Immunotherapy Drug Antibody Conjugate HER2 No 2013 July 1, 2013 Dec. 31, 2013 No Longer Used
Q5117 Trastuzumab-anns Kanjinti 10mg Immunotherapy Monoclonal Antibody HER2 No 2019 Oct. 1, 2019 In Use
J7684 Triamcinolone Kenalog Aristocort 1 mg Hormonal Therapy Adrenal Glucocorticoid Corticosteroid No 1960 Jan. 1, 2000 In Use
J3300 Triamcinolone Kenalog, Aristocort 1 mg Hormonal Therapy Adrenal Glucocorticoid Corticosteroid No 1960 Jan. 1, 2009 In Use
J3301 Triamcinolone Kenalog, Aristocort 10 mg Hormonal Therapy Adrenal Glucocorticoid Corticosteroid No 1960 Jan. 1, 1991 In Use
J2425 Palifermin Kepivance 50 mcg Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF No 2004 Jan. 1, 2006 In Use
C9027 Pembrolizumab Keytruda 1 mg Immunotherapy Checkpoint Inhibitor PD-1 No 2014 Jan. 1, 2015 Dec. 31, 2015 No Longer Used
J9271 Pembrolizumab Keytruda 1 mg Immunotherapy Checkpoint Inhibitor PD-1 No 2014 Jan. 1, 2016 In Use
J0642 Levoleucovorin Khapzory 0.5mg Ancillary Therapy Chemoprotective Antidote No 2018 Oct. 1, 2019 In Use
J9274 Tebentafusp-tebn Kimmtrak 1mcg Immunotherapy T Cell Receptor (TCR) HLA-A*02:01 No 2022 Sept. 27, 2022 In Use
C9095 Tebentafusp-tebn Kimmtrak 1mcg Immunotherapy T Cell Receptor (TCR) HLA-A*02:01 No 2022 March 25, 2022 Sept. 27, 2022 No Longer Used
NA Ribociclib Kisqali 200 mg Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Yes 2017 In Use
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
S0190 Mifepristone Korlym, Mifeprex 200 mg Hormonal Therapy Antiprogestin Cortisol Receptor Blocker Yes 2000 Jan. 1, 2001 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.