Pharmacy Fee Search Help

The Pharmacy Fee Search allows you to search for reimbursement amounts for drugs prescribed in relation to a Workers' Compensation claim. After entering the search criteria (see below for descriptions and requirements), just click the "Search" button to get the results.

Please note, you are not responsible for payment of bills for treatment related to your Workers' Compensation case. Please be advised that if any authorized provider refuses to treat you, you should notify the office of Health Provider Administration in writing as soon as possible.

If you would like to start a new Pharmacy Fee Search, just select this.

Disclaimer

The Workers' Compensation Board makes every effort to keep the information presented in the Pharmacy Fee Search accurate and up-to-date.  The information in this program was obtained from the New York State Department of Health.  The Board is not responsible for inaccurate information in the Medicaid fee schedule.  This information was last updated on July 1, 2008.

For prescription drugs or medicines dispensed on or after July 7, 2008, the fee schedule is Average Wholesale Price (AWP) minus 12% for brand plus the dispensing fee and AWP minus 20% for generic plus the dispensing fee.  The Medicaid fee schedule does not apply to prescription drugs or medicine dispensed on or after July 7, 2008.

Table of Contents

  1. Availability Information
  2. Search Criteria
  3. Search Results
  4. Contact Information

Information

  1. Availability Information:
    For information about when this search page is available, please view the Pharmacy Fee Search Availability page.

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  2. Search Criteria:
    • Dispense Date
      • This is the date the prescription was filled. Reimbursement amounts may vary depending on the date a drug was dispensed.
      • This is a required field, so a date in MM/DD/YYYY must be entered.
    • NDC
      • Enter the NDC (National Drug Code), if it is known. This code will consist of 11 digits.
      • This field is not required, but either this field or the Keywords field (described below) must be filled in.
    • Keywords
      • Enter a few words or partial words to search drug descriptions.
      • This field is not required, but either this field or the NDC field (described above) must be filled in.

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  3. Search Results:
    • When searching by NDC, at most one result will be listed.
      • If you are sure the NDC and the Dispense Date are correct and there are no matches, that means that this particular drug was not covered on that Dispense Date.
      • You may want to try a Keywords search when there are no matches using the NDC.
    • Results of searches based on Keywords will usually contain multiple rows.
      • The results most closely matching the search criteria will be displayed first in the list.
      • These results are limited to a maximum number of rows. When this occurs, you will be informed in the search results summary paragraph on how many rows were not included in the result set. It is advised that you add additional Keywords to reduce the number of matches.

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  4. Contact Information:
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If you are ready to start a new Pharmacy Fee Search, just select this.