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Workers' compensation pharmacy fee schedule - simple prescription

This data is provided as a service to the workers' compensation community. Please send comments or questions to DWCFeeSchedule@dir.ca.gov .

You may download the current Medi-Cal pharmacy fee rates here (Zip file, 7.50 MB, updated 6/4/2008 - also available via ftp to www.dir.ca.gov, anonymous login). The file's record layout and instructions are included in the zip file, and may also be viewed here.

You may look up the current price of simple prescriptions by completing the form below and clicking "price". For compound prescription pricing, click here. If you are working from a file with 11 digit NDC numbers, you may use this form, or a form with a single NDC number entry field.

An NDC number is either 10 or 11 digits, made up of three segments (manufacturer/distributor, drug identifier, package code), with the number of digits in each in segment in one of the following patterns:
11 digit: 5-4-2
10 digit: 4-4-2, 5-3-2, or 5-4-1

NDC number: Please include the correct number
of leading zeros, e.g. 0093 0014 16
Metric decimal number of units: e.g. 100 ea (tablets), 2.5 grams (ointments), 240 ml (or cc's - fluids)
Usual and customary price: (including any dispensing fee) e.g. $12.48
Date of service: e.g. 01/05/2004
Nursing home: Check this box if patient is in a Nursing Home
No substitutions: Check this box only if the prescription explicitly requires a brand-name drug
Clear form

All fields except "nursing home" and "no substitutions" are required

Effective Jan. 6, 2006, the price calculator and the price data file are being updated weekly, as DWC receives updated price data from the Department of Health Services.