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Appendix 2: HCPCS Codes and Ndcs Associated with Cancer Treatment Drugs Administered Or Taken

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Appendix 2: HCPCS Codes and Ndcs Associated with Cancer Treatment Drugs Administered Or Taken Patient-Centered Oncology Payment Model (PCOP): Quantitative Analysis for the PRT – Appendix 2 April 2, 2020 Appendix 2: HCPCS codes and NDCs associated with Cancer Treatment Drugs Administered or Taken This appendix shows the HCPCS codes and NDCs associated with the drugs listed in Appendix F of the PCOP proposal. Drug name HCPCS Code(s) NDC(s) ADENOSINUM TRIPHOSPHORICUM DINATRUM, COENZYME A, CO-ENZYME Q-10, PINEAL 437420355 GLAND (SUIS), SARCOLACTICUM ACIDUM, MELATONIN, PYRROLE, TRYPTOPHAN, ARSENICUM ALBUM, AVENA SATIVA, CHAMOMILLA, COFFEA CRUDA, MERCURIUS CORROSIVUS, PASSIFLORA INCARNATA, SILICEA, ZINCU ADENOSINUM TRIPHOSPHORICUM DINATRUM, COENZYME A, PINEAL GLAND (SUIS), 437420367, 437420721 SARCOLACTICUM ACIDUM, UBIDECARENONUM, MELATONIN, PYRROLE, TRYPTOPHAN, ARSENICUM ALBUM, AVENA SATIVA, CHAMOMILLA, COFFEA CRUDA, MERCURIUS CORROSIVUS, PASSIFLORA INCARNATA, SILICEA, ZINCU ADENOSINUM TRIPHOSPHORICUM DINATRUM, PANTOTHENIC ACID, PINEAL GLAND (SUIS), 621850024 SARCOLACTICUM ACIDUM, UBIDECARENONUM, L-TRYPTOPHAN, MELATONIN, PYRROLE, ARSENICUM ALBUM, AVENA SATIVA, CHAMOMILLA, COFFEA CRUDA, MERCURIUS CORROSIVUS, PASSIFLORA INCARNATA, SILICE ADENOSINUM TRIPHOSPHORICUM DINATRUM, PANTOTHENIC ACID, PINEAL GLAND (SUIS), 437420729 SARCOLACTICUM ACIDUM, UBIDECARENONUM, MELATONIN, PYRROLE, TRYPTOPHAN, ARSENICUM ALBUM, AVENA SATIVA, CHAMOMILLA, COFFEA CRUDA, MERCURIUS CORROSIVUS, PASSIFLORA INCARNATA, SILICEA ADENOSINUM TRIPHOSPHORICUM DINATRUM, PANTOTHENIC ACID, UBIDECARENONUM, 437420727, 437420998 PINEAL GLAND (SUIS), SARCOLACTICUM ACIDUM, MELATONIN, PYRROLE, TRYPTOPHAN, ARSENICUM ALBUM, AVENA SATIVA, CHAMOMILLA, COFFEA CRUDA, MERCURIUS CORROSIVUS, PASSIFLORA INCARNATA, SILICEA ADO-TRASTUZUMAB EMTANSINE C9131, J9354 502420087, 502420088 ADRENAL, ALLIUM CEPA, AMBROSIA ARTEMISIAEFOLIA 541187977 ADRENAL, ARCTIUM LAPPA, ATP, BELLADONNA, CHEMICAL ISODES 541187981 1 Drug name HCPCS Code(s) NDC(s) ADRENALINUM, ALLIUM SATIVUM, ANETHUM GRAVEOLENS, ARSENICUM ALBUM, 579551511 ARSENICUM IODATUM, ASAFOETIDA, BELLADONNA, CEREUS BONPLANDII, CHAMOMILLA, COFFEA CRUDA, ERODIUM, IMPATIENS GLANDULIFERA, FLOS, IODIUM, MANDRAGORA OFFICINARUM, SOLIDAGO VIRGAUREA, THYROIDINU ADRENALINUM, ALOE SOCOTRINA, ARSENICUM ALBUM, BAPTISIA TINCTORIS, BERBERIS 697800012 ACQUIFOLIUM, BERBERIS VULGARIS, BRYONIA, CHELIDONIUM MAJUS, CROTALUS HORRIDUS, DIGITALIS PURPUREA, FERRUM METALLICUM, GLONOINUM, GLYCYRRHIZA GLABRA, HYDROCOTYLE ASIATICA, IODIUM, I ADRENALINUM, ALOE, ARSENICUM ALB., BAPTISIA, BERBER. AQUI., BERBER. VULG., BRYONIA, 557142364, 557142365 CHELIDONIUM MAJUS, CROTALUS HORRIDUS, DIGITALIS, FERRUM METALLICUM, GLONOINUM, GLYCYRRHIZA GLABRA , HYDROCOTYLE, IODIUM, IRIS VERSICOLOR, LACHESIS, LYCOPODIUM, NAT. MUR. ADRENALINUM, ALOE, ARSENICUM ALB., BAPTISIA, BERBER. AQUI., BERBER. VULG., BRYONIA, 353780002 CHELIDONIUM MAJUS, CROTALUS HORRIDUS, DIGITALIS, FERRUM METALLICUM, GLONOINUM, GLYCYRRHIZA GLABRA, HYDROCOTYLE, IODIUM, IRIS VERSICOLOR, LACHESIS, LYCOPODIUM, NAT. MUR., N ADRENALINUM, ANTIMONIUM CRUDUM, ARSENICUM ALBUM, NATRUM MURIATICUM, 579550049 PHOSPHORICUM ACIDUM, PHOSPHORUS, PIX LIQUID, SELENIUM METALLICUM, SILICEA, SULPHUR, THUJA OCCIDENTALIS ADRENALINUM, ANTIMONIUM CRUDUM, ARSENICUM ALBUM, NATRUM MURIATICUM, 579555049 PHOSPHORICUM ACIDUM, PHOSPHORUS, PIX LIQUIDA, SELENIUM METALLICUM, SILICEA, SULPHUR, THUJA OCCIDENTALIS ADRENALINUM, ANTIMONIUM TARTARICUM, ARALIA RACEMOSA, ARSENICUM ALBUM, 579550044 ERIODICTYON CALIFORNICUM, EUCALYPTUS GLOBULUS, GRINDELIA, IPECACUANHA, LOBELIA INFLATA, NATRUM SULPHURICUM, QUEBRACHO ADRENALINUM, ARG. NIT., ARSENICUM ALB., BRYONIA, CINCHONA, GRAPHITES, IODIUM, IRIS 557144512, 557144513 VERSICOLOR, LACHESIS, LYCOPODIUM, NAT. MUR., PHOSPHORUS, PHYTOLACCA, SULPHUR, THYROIDINUM 2 Drug name HCPCS Code(s) NDC(s) ADRENALINUM, CANDIDA ALBICANS THYROIDINUM, TORULA CEREVISIAE, TRITICUM, 557144484, 557144485 USTILAGO MAIDIS, ANTIMON. CRUD., ARSENICUM ALB., BAPTISIA, BERBER. AQUI, BRYONIA CALC. PHOS., CINCHONA, HELONIAS DIOICA, HYDRASTIS, IODIUM, IRIS VERSICOLOR, KALI CARB., LACHESIS , LYC ADRENALINUM, CANDIDA ALBICANS, THYROIDINUM, TORULA CEREVISIAE, TRITICUM, 557142230, 557142231, USTILAGO MAIDIS, ANTIMON. CRUD, ARSENICUM ALB., BAPTISIA, BERBER. AQUI., BRYONIA, 557142400, 557142401, CALC. PHOS., CINCHONA, HELONIAS DIOICA, HYDRASTIS, IODIUM, IRIS VERSICOLOR, KALI 557144815 CARB., LACHESIS, LY ADRENALINUM, TARENTULA CUBENSIS, ACONITUM NAP., ARG. NIT., ARSENICUM ALB., 557141514, 557141714 BAPTISIA, CHAMOMILLA, COFFEA CRUDA, CYPRIPEDIUM, DIGITALIS, GELSEMIUM, HUMULUS, HYOSCYAMUS, IGNATIA, IMPATIENS GLANDULIFERA FLOS, IODIUM, LACHESIS, LYCOPODIUM, NAT. MUR., NUX VOM. ADRENALINUM, TARENTULA CUBENSIS, ACONITUM NAP., ARG. NIT., ARSENICUM ALB., 557142316, 557142317, BAPTISIA, CHAMOMILLA, CYPRIPEDIUM, DIGITALIS, GELSEMIUM, HUMULUS, IGNATIA, 557144540, 557144541, IMPATIENS GLANDULIFERA FLOS, IODIUM, LACHESIS, LYCOPODIUM, NAT. MUR., NUX VOM., 557144833, SCUTELLARIA LATERIFLORA ADRENLINUM, COUMARINUM, TYRAMINE, ARTERIA SUIS, ASCORBIC ACID, CACTUS 437420004, 437420690 GRANDIFLORUS, COENZYME A, GLONOINUM, HEART (SUIS), SARCOLACTICUM ACIDUM, UBIDECARENONUM, VEIN (SUIS), ADRENOCORTICOTROPHIN, ARSENICUM ALBUM, AURUM METALLICUM, BELLADONNA, DIGITALIS PURP AESCULOS 30C, ANTIMONIUM TART 30C, ARSENICUM 30C, BARYTA MUR 30C, BRYONIA 30C, 596670093 CAUSTICUM 30C, DULCAMARA 30C, HEPAR SULPH. 30C, PHOSPHOROUS 30C, SANGUINARIA 30C , SENICIO 30C, STANNUM MET 30C, SULPHUR 30C, QUEBRACHO 30C AESCULUS HIPPOCASTANUM, AMMONIUM MURIATICUM, ARSENICUM ALBUM, 579556030 BELLADONNA, CAPSICUM ANNUUM, CAUSTICUM, COLCHICUM AUTUMNALE, COLOCYNTHIS, GNAPHALIUM POLYCEPHALUM, IGNATIA AMARA, MAGNESIA PHOSPHORIA, RHUS TOXICODENDRON AESCULUS HIPPOCASTANUM, FLOS, AGRIMONIA EUPATORIA, FLOS, APOCYNUM 579553021 CANNABINUM, ARSENICUM ALBUM, ASARUM EUROPAEUM, AVENA SATIVA, CAPSICUM ANNUUM, CARBONEUM SULPHURATUM, GELSEMIUM SEMPERVIRENS, HELIANTHUS ANNUUS, JUGLANS REGIA, FLOS, LONICERA CAPRIFOLIUM, FL 3 Drug name HCPCS Code(s) NDC(s) AESCULUS HIPPOCASTANUM, FLOS, AGRIMONIA EUPATORIA, FLOS, APOCYNUM 579553020 CANNABINUM, ARSENICUM ALBUM, ASARUM EUROPAEUM, AVENA SATIVA, CAPSICUM ANNUUM, CARBONEUM SULPHURATUM, GELSUMIUM SEMPERVIRENS, HELIANTHUS ANNUUS, JUGLANS REGIA, FLOS, LONICERA CAPRIFOLIUM, FL AESCULUS HIPPOCASTANUM, FLOS, ALOE SOCOTRINA, ARNICA MONTANA, ARSENICUM 579552531 ALBUM, BORAGO OFFICINALIS, CALCAREA CARBONICA, CARPINUS BETULUS, FLOS, CHAMOMILLA, GELSEMIUM SEMPERVIRENS, GRAPHITES, IPECACUANHA, KALI SULPHURICUM, MENTHA PIPERITA, NITRICUM ACIDUM AESCULUS HIPPOCASTANUM, FLOS, ALOE SOCOTRINA, ARNICA, MONTANA, ARSENICUM 579552532 ALBUM, BORAGO OFFICINALIS, CALCAREA CARBONICA, CARPINUS BETULUS, FLOS, CHAMOMILLA, GELSEMIUM SEMPERVIRENS, GRAPHITES, IPECAUANHA, KALI SULPHURICUM, MENTHA PIPERITA, NITRICUM ACIDUM AETHUSA CYNAPIUM, ARSENIC TRIOXIDE, OYSTER SHELL CALICUM CARBONATE, CRUDE, 434060059 MATRICARIA CHAMOMILLA, CITRULLUS COLOCYNTHIS FRUIT PULP, IRON, LYCOPODIUM CLAVATUM SPORE, MERCURIUS SOLOBILIS, PHOSPHORUS, PODOPHYLLUM, ANEMONE PULSATILLA, DELPHINIUM STRAPHISAGRIA AETHUSA CYNAPIUM, ARSENICUM ALBUM, COCCULUS INDICUS, IPECACUANHA, 449110074 KREOSOTUM, PETROLEUM, PULSATILLA (VULGARIS), SANGUINARIA CANADENSIS, TABACUM AETHUSA CYNAPIUM, ARSENICUM ALBUM, COCCULUS INDICUS, IPECACUANHA, 575200402 KREOSOTUM, PETROLEUM, PULSATILLA, SANGUINARIA CANADENSIS, TABACUM AFATINIB 005970137, 005970138, 005970141, 127140161, 127140162, 127140163 AFLIBERCEPT C9291, C9296, 617550005 J0178, Q2046 AGARICUS MUSC., ARSENICUM ALB., AUR. MET, BERBER. AQUI., CALADIUM SEGUINUM, 557144486, 557144487 CANDIDA ALBICANS, CANTHARIS, CONIUM, GRAPHITES, HELONIAS DIOICA, HYDRASTIS, KALI CARB., KREOSOTUM, LYCOPODIUM, MERC. VIV., MUREX PURPUREA, NAT. MUR, NITRICUM AC., PULSATILLA, RHUS 4 Drug name HCPCS Code(s) NDC(s) AGARICUS MUSC., ARSENICUM ALB., AUR. MET., BERBER. AQUI., CALADIUM SEGUINUM, 557142290, 557142291, CANDIDA ALBICANS, CANTHARIS, CONIUM, GRAPHITES, HELONIAS DIOICA, HYDRASTIS, KALI 557142438, 557144823 CARB., KREOSOTUM, LYCOPODIUM, MERC. VIV., MUREX PURPUREA, NAT. MUR., NITRICUM AC., PULSATILLA, RH AGARICUS MUSC., ARSENICUM ALB., BISMUTHUM METALLICUM, BRYONIA, CAPSICUM, 557141104, 557141113, CARBO VEG., GLONOINUM, IPECAC., IRIS VERSICOLOR, LAUROCERASUS, LYCOPODIUM, 557142450 MEZEREUM, NUX VOM., PULSATILLA, RANUNC. BULB. , THERIDION, VERATRUM ALB., ZINC. MET., ZINGIBER, CHAMOMILLA AGARICUS MUSCARIUS, ALUMINA, ANAGALLIS ARVENSIS, ANTIMONIUM TARTARICUM, APIS 580667002 MELLIFICA, ARSENICUM ALBUM, ARSENICUM IODATUM, BOVISTA, CAUSTICUM, DOLICHOS PRURIENS, FAGAPYRUM ESCULENTUM, GRAPHITES, KALI MURIATICUM, LAC DEFLORATUM, MURIATICUM ACIDUM, OLEANDE AGARICUS MUSCARIUS, ARSENICUM ALBUM, HYPERICUM PERFORATUM, PHOSPHORUS, 687030255 SILICEA AGARICUS MUSCARIUS, COCCUS CACTI, CONIUM MACULATUM, LYCOPODIUM CLAVATUM, 438570429, 438570471, PHOSPHORUS, ALUMINIUM METALLICUM, ANTIMONIUM CRUDUM, ARGENTUM 438570518 METALLICUM, ARSENICUM ALBUM, AURUM METALLICUM, BARYTA CARBONICA, BERYLLIUM METALLICUM, BISMUTHUM METALLICUM, BORON, BROM AGARICUS MUSCARIUS, COCCUS CACTI, CONIUM MACULATUM, LYCOPODIUM CLAVATUM, 438570375 PHOSPHORUS, EPSTEIN-BARR VIRUS NOSODE, GELSEMIUM SEMPERVIRENS, LATRODECTUS MACTANS, MORBILLINUM, POLIOMYETILIS VIRUS, RHUS TOX, TARENTULA CUBENSIS, SALMONELLA TYPHI, LANTHANUM METALL AGARICUS MUSCARIUS, COCCUS CACTI, CONIUM MACULATUM, LYCOPODIUM CLAVATUM, 438570342 PHOSPHORUS, GELSEMIUM SEMPERVIRENS, LATRODECTUS MACTANS, RHUS TOX, TARENTULA CUBENSIS, SALMONELLA TYPHI, CLOSTRIDIUM PERFRINGENS, ALUMINUM METALLICUM, ANTIMONIUM CRUDUM, ARGENTUM MET AGARICUS MUSCARIUS, SYMPHYTUM OFFICINALE, HYPERICUM PERFORATUM, ARNICA 437720030
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