Jurisdiction A DME MAC Fee Schedules

October 2006 Quarterly Oral Anticancer Drug Fees
Effective October 1, 2006 through December 31, 2006

NOTE: Inclusion of a fee amount does not necessarily indicate coverage

Drug Name	Strength	Per Tablet Fee
Busulfan	2 mg	$2.139
Capecitabine	150 mg	$3.829
Capecitabine	500 mg	$12.753
Cyclophosphamide	25 mg	$0.995
Cyclophosphamide	50 mg	$1.990
Etoposide	50 mg	$32.014
Melphalan	2 mg	$4.336
Methotrexate	2.5 mg	$0.253
Methotrexate	5 mg	$0.506
Methotrexate	7.5 mg	$0.759
Methotrexate	10 mg	$1.012
Methotrexate	15 mg	$1.518
Temozolomide	5 mg	$7.296
Temozolomide	20 mg	$29.184
Temozolomide	100 mg	$145.920
Temozolomide	250 mg	$364.800