Weight loss drugs and New York Medicaid

New York Medicaid publishes its own rule for these products, and it is the first thing below. A payment count is not a coverage rule, so the federal record of what the program paid sits under it, and this page says which it is showing you.

By the Covered Weight editorial team · Updated Aug 11, 2026. Research and sourcing by Evan Reid.

What NYRx publishes as the rule

This is what New York publishes, not what will happen to a claim. The program pays for two of the seven products here and prints a short list of parameters beside each. Neither list names obesity: one names cardiovascular disease, the other obstructive sleep apnea. A reader whose reason is weight on its own is looking at rows the program has published no answer for, and this record says so rather than guessing. Every row answers for one use. The same molecule sells under one brand for weight management and another for type 2 diabetes, and this record did not read what the program does for the diabetes use. The payment file below counts prescriptions the program paid for and never records why any was written, so it can neither confirm nor contradict a published rule. Managed long term care plans and the Essential Plan sit outside the move that put every other member on this one list. None of it can tell you what will happen to your own claim.

Who actually pays this claim

New York moved the drug benefit out of managed care on 1 April 2023. Since then a member enrolled in mainstream managed care gets prescriptions through NYRx, the state's own pharmacy program, which the health department says was the point: one uniform list of covered drugs instead of one per plan. So the plan on a member's card is not what settles the drug rule, and there is no plan by plan drug list to compare. The department names two exceptions on the same page, managed long term care plans and the Essential Plan.

A managed care member and a fee-for-service member meet the same drug list. That is what the 2023 move was for, in the health department's own words, and it is why this record carries one answer per product rather than one per plan. Two limits are on the face of the department's own page: managed long term care plans and the Essential Plan were left out of the move, and what governs them was not read for this record.

What New York Medicaid publishes for each product, for weight loss
Drug	For what	What the document says	Since
semaglutideWegovy®	obesity	Not publishedWho to ask: 1-877-309-9493^1,2,3 Why, in the program’s words New York publishes nothing that answers this. The program pays for this product, requires a prior authorization, and publishes a coverage overview for it, and every parameter in that overview names cardiovascular disease or a body mass index beside it. None of them is met by weight alone. The program publishes no second set of parameters for a request whose only reason is weight management, so what happens to one is not stated in any document read here. That is a finding rather than a gap, and the way to close it is to ask the program.	2026-07-16
tirzepatideZepbound®	obesity	Not publishedWho to ask: 1-877-309-9493^3,4 Why, in the program’s words New York publishes nothing that answers this. The program pays for this product and requires a prior authorization, and the first parameter printed beside it names obstructive sleep apnea. Weight alone does not meet it. The program publishes no second set of parameters for a request whose only reason is weight management, so what happens to one is not stated in any document read here.	2026-07-16
liraglutideSaxenda®	obesity	Not covered^5,6 Why, in the program’s words This product is not on New York's list of drugs the pharmacy benefit pays for. The state publishes that list itself and says on the same page that only drugs which appear on it are reimbursable. Read on 2026-08-09, the whole list was searched for the brand and for the generic name across every package size and carried no entry for this product; the generic name returns entries for the product sold for the other use, which is what makes the absence a statement about this product rather than about the molecule. The product is the one on this page whose only approved use is weight management, so its absence from the list is the answer for that use rather than a detail about one of several uses.	Not dated
semaglutideOzempic®	obesity	Not publishedWho to ask: 1-877-309-9493^7,8 Why, in the program’s words New York publishes no criteria for this product for weight management. What it does publish for it sits under a preferred drug list class headed type 2 diabetes, and the criterion printed beside that class asks the prescriber to confirm a diagnosis the food and drug administration or the compendia support. Weight management is not among the uses this product is sold for, so that criterion is a requirement a weight management request would have to answer rather than an answer to it. Read this row for the weight loss use only. This record did not read what the program does for the use the product is sold for, so it says nothing about that.	2026-07-16
semaglutideRybelsus®	obesity	Not publishedWho to ask: 1-877-309-9493^7,8 Why, in the program’s words New York publishes no criteria for this product for weight management. What it does publish for it sits under a preferred drug list class headed type 2 diabetes, and the criterion printed beside that class asks the prescriber to confirm a diagnosis the food and drug administration or the compendia support. Weight management is not among the uses this product is sold for, so that criterion is a requirement a weight management request would have to answer rather than an answer to it. Read this row for the weight loss use only. This record did not read what the program does for the use the product is sold for, so it says nothing about that.	2026-07-16
tirzepatideMounjaro®	obesity	Not publishedWho to ask: 1-877-309-9493^7,8 Why, in the program’s words New York publishes no criteria for this product for weight management. What it does publish for it sits under a preferred drug list class headed type 2 diabetes, and the criterion printed beside that class asks the prescriber to confirm a diagnosis the food and drug administration or the compendia support. Weight management is not among the uses this product is sold for, so that criterion is a requirement a weight management request would have to answer rather than an answer to it. Read this row for the weight loss use only. This record did not read what the program does for the use the product is sold for, so it says nothing about that.	2026-07-16
liraglutideVictoza®	obesity	Not publishedWho to ask: 1-877-309-9493^7,8 Why, in the program’s words New York publishes no criteria for this product for weight management. What it does publish for it sits under a preferred drug list class headed type 2 diabetes, and the criterion printed beside that class asks the prescriber to confirm a diagnosis the food and drug administration or the compendia support. Weight management is not among the uses this product is sold for, so that criterion is a requirement a weight management request would have to answer rather than an answer to it. Read this row for the weight loss use only. This record did not read what the program does for the use the product is sold for, so it says nothing about that.	2026-07-16

Show the 2 rows for the same molecules under a different use

What New York Medicaid publishes for the same products under other indications
Drug	For what	What the document says	Since
semaglutideWegovy®	cardiovascular risk reduction	Covered with conditions^1,2,3,10Limit: 2 treatment attempts per lifetime³ Why, in the program’s words New York pays for this product and puts a prior authorization in front of it. The program publishes a coverage overview for this one product, and every parameter in it points at the heart rather than at the scale: the prescriber is asked to confirm a diagnosis of cardiovascular disease, a body mass index of 40 or above, and that the member is taking part in lifestyle changes that support cardiovascular health. A member may start the drug twice in a lifetime. What the program publishes is what a request has to carry, and carrying all of it is not the same as being approved.	2026-07-16
tirzepatideZepbound®	obstructive sleep apnea	Covered with conditions^3,4,11Limit: 2 treatment attempts per lifetime³ Why, in the program’s words New York pays for this product and puts a prior authorization in front of it. The parameters printed beside it ask the prescriber to confirm a diagnosis of obstructive sleep apnea, a body mass index of 40 or above, and that the member is taking part in lifestyle changes. A member may start the drug twice in a lifetime. The program publishes no separate coverage overview for this product, so its row in the preferred drug list is the whole of what it says.	2026-07-16

Nobody published it: who holds the answer, and the exact question to ask

6 rows above report that we searched the document and found no answer. The office that publishes the document is the one that can answer it.

NYRx, the New York Medicaid Pharmacy Program⁹
Phone 1-877-309-9493
Where the answer would be published
The question to ask, worded to name the document:
- I am a New York Medicaid member. Does NYRx publish any prior authorization criteria for this drug when it is prescribed for weight management on its own, and if it does not, what happens to a request that names weight management as the reason?

One drug, two brands, two different answers

Some of the products above are the same drug sold under a second brand name for a different condition. New York Medicaid answers each brand separately, so a row on this page tells you about one brand and one use. It does not tell you what the other brand of the same drug is treated as.

semaglutide appears here under more than one brand name. The Ozempic® row answers obesity. The Rybelsus® row answers obesity. The Wegovy® rows answer cardiovascular risk reduction and obesity.
tirzepatide appears here under more than one brand name. The Mounjaro® row answers obesity. The Zepbound® rows answer obesity and obstructive sleep apnea.

Your prescriber and your pharmacy decide what is written and filled. This page reports what the program published about each product, one use at a time.

What NYRx says a request has to carry

This file carries what NYRx says a request has to carry. A list of what a request has to carry is not a list of conditions that get a request approved: every item here can be in the envelope and the answer is still a decision the program makes on that request, and nothing on this page can tell you how yours will be decided. Both records answer for a use that is not obesity. One is semaglutide sold as Wegovy where the program asks for a cardiovascular disease diagnosis, the other is tirzepatide sold as Zepbound where it asks for obstructive sleep apnea. The weight loss rows on this page are a different question with a different answer, and none of this reaches them.

semaglutide, sold as Wegovy®, for cardiovascular risk reduction

The 4 things a request has to carry, 3 of them required

What NYRx asks a prior authorization request to carry for semaglutide, sold as Wegovy®
What the program asks for	Who provides it	Form
A confirmed diagnosis of cardiovascular disease^2,3The program names one diagnosis for this product and this is it. It does not name obesity, and nothing published says what happens to a request that names weight on its own.	Your prescriber	No form named
A body mass index of 40 or above^2,10The two documents print this threshold with different characters. The product's own coverage overview reads as a greater-than sign in its text layer and the preferred drug list prints a greater-than-or-equal sign. Both are stored on this page, from both documents.	Your prescriber	No form named
Confirmation that the member is taking part in lifestyle changes that support cardiovascular health^2,10The program says what the changes are for, and it is the same condition the first item names.	Your prescriber	No form named
The request comes from the prescriber, not from the member¹²The documents word this one as optionalThe program addresses these parameters to prescribers and asks them to work the parameters into what they prescribe. A member who wants a request sent has to ask the prescriber to send it.	Your prescriber	No form named

NYRx publishes no a body mass index number, no a period of supervised weight management, no an age floor, no an age ceiling for this route. Those lines are empty here because the program printed nothing on them, not because they were skipped.

tirzepatide, sold as Zepbound®, for obstructive sleep apnea

The 3 things a request has to carry, 3 of them required

What NYRx asks a prior authorization request to carry for tirzepatide, sold as Zepbound®
What the program asks for	Who provides it	Form
A confirmed diagnosis of obstructive sleep apnea³The program names one diagnosis for this product and this is it. It does not name obesity.	Your prescriber	No form named
A body mass index of 40 or above³The same threshold the program prints for the other product it pays for on this page, and the same character.	Your prescriber	No form named
Confirmation that the member is taking part in lifestyle changes¹¹The parameter ends here. On the other product the program names what the changes are for; on this one it does not, and this record does not fill the gap.	Your prescriber	No form named

Does this page reach your plan?

Which document decides your case depends on who pays your claims.

Why that changes the answer

A state program follows the state's own published rules. A marketplace plan is measured against the state benchmark. An employer plan that pays claims out of the employer's funds follows its own plan document and no state rule reaches it, and most people with job-based coverage are on one of those.

Which document governs your plan?

This tool needs JavaScript, because it runs entirely in your browser and sends nothing to us. With JavaScript off, start with the plan-type guides in the navigation instead. The question below is an example of what it asks, not an answer about your plan.

Question 1 of 333%

Where does your health coverage come from?

Pick the one that pays for your prescriptions and your medical visits.

Open the full version on its own page

This record counts prescriptions New York's Medicaid program paid for, quarter by quarter, as reported to the federal government. It is not a coverage rule and it is not a promise. A count can be low because the program pays for few, because the reporting cell was too small to publish, or because most enrollees are in managed care that reports separately. A missing or hidden cell is never a zero, and the coverage rule lives in the state's own drug list rather than here.

How these figures are counted

Figures are for 2026Q1 and combine both payment routes, the claims the program pays directly and the claims its managed care plans pay. Thirteen jurisdictions report only the first and eighteen report only the second, so combining them is the only way one table can be read across the country.

What New York Medicaid’s record shows

In 2026Q1, the published federal record shows paid prescriptions for 6 of the 8 products tracked on this page. 3 of them carry a published number in every one of the 21 quarters on file. Across the 168 quarterly cells this page reads, 88 carry a number a reader can see.

Every published figure for Zepbound and Wegovy is a floor, because at least one reporting cell was withheld for being too small to publish. The real totals are higher than the numbers shown below.

Compare every GLP-1 product against New York Medicaid to see which licence each one carries and which the program paid for.

Paid prescriptions, 2026Q1

Read this table against the rule above it. These are prescriptions the program paid for, and a paid prescription is a record of what happened rather than permission for what happens next. The published rule is at the top of this page.

Prescriptions paid for by New York Medicaid in 2026Q1
Drug	Paid prescriptions	How to read it
tirzepatideZepbound®	withheld as a small cell paid prescriptions in the quarter (2026Q1)every reporting cell was withheld, so nothing is observable¹³	Withheld
tirzepatideMounjaro®	at least 75,910 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld¹⁴	At least
semaglutideWegovy®	at least 1,945 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld¹⁵	At least
semaglutideOzempic®	112,157 paid prescriptions in the quarter (2026Q1)¹⁶	Count
semaglutideRybelsus®	at least 5,876 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld¹⁷	At least
liraglutideSaxenda®	no row published paid prescriptions in the quarter (2026Q1)the dataset publishes no row for this product, state and quarter¹⁸	No rowChecked 2026-08-11, 0 rows returned.
liraglutideVictoza®	180 paid prescriptions in the quarter (2026Q1)¹⁹	Count
liraglutideliraglutide (generic)®	675 paid prescriptions in the quarter (2026Q1)²⁰	Count

Count: Every matching reporting cell was published, so this is the number of paid prescriptions.
At least: At least one reporting cell was withheld for being too small to publish, so the true number is higher than this one.
Withheld: Rows exist and every one was withheld for being too small to publish. That is not a zero, and it is not an answer about coverage.
No row: The federal file carries no row for this product in this quarter. That is not a zero, and it is not an answer about coverage.

21 quarters, 2021Q1 to 2026Q1

The same federal record, quarter by quarter. One quarter cannot tell you whether New York Medicaid pays for a drug routinely or barely at all, and a single withheld cell reads as absence when it is not. Every figure carries the query it came from.

If you are not certain this program is your coverage at all, check which kind of plan you have first. The document that governs your case differs by coverage type, and so does where an appeal goes.

For the whole country in one place, including how much of the federal file is withheld before any of these numbers are published, the national snapshot sits above this page.

Show all 21 quarters, 2021Q1 to 2026Q1

Prescriptions paid for by New York Medicaid, by drug and quarter, 2021Q1 to 2026Q1
Drug	2021Q1	2021Q2	2021Q3	2021Q4	2022Q1	2022Q2	2022Q3	2022Q4	2023Q1	2023Q2	2023Q3	2023Q4	2024Q1	2024Q2	2024Q3	2024Q4	2025Q1	2025Q2	2025Q3	2025Q4	2026Q1
tirzepatideZepbound®	no row published paid prescriptions in the quarter (2021Q1)the dataset publishes no row for this product, state and quarter²¹No row	no row published paid prescriptions in the quarter (2021Q2)the dataset publishes no row for this product, state and quarter²¹No row	no row published paid prescriptions in the quarter (2021Q3)the dataset publishes no row for this product, state and quarter²¹No row	no row published paid prescriptions in the quarter (2021Q4)the dataset publishes no row for this product, state and quarter²¹No row	no row published paid prescriptions in the quarter (2022Q1)the dataset publishes no row for this product, state and quarter²²No row	no row published paid prescriptions in the quarter (2022Q2)the dataset publishes no row for this product, state and quarter²²No row	no row published paid prescriptions in the quarter (2022Q3)the dataset publishes no row for this product, state and quarter²²No row	no row published paid prescriptions in the quarter (2022Q4)the dataset publishes no row for this product, state and quarter²²No row	no row published paid prescriptions in the quarter (2023Q1)the dataset publishes no row for this product, state and quarter²³No row	no row published paid prescriptions in the quarter (2023Q2)the dataset publishes no row for this product, state and quarter²³No row	no row published paid prescriptions in the quarter (2023Q3)the dataset publishes no row for this product, state and quarter²³No row	no row published paid prescriptions in the quarter (2023Q4)the dataset publishes no row for this product, state and quarter²³No row	no row published paid prescriptions in the quarter (2024Q1)the dataset publishes no row for this product, state and quarter²⁴No row	no row published paid prescriptions in the quarter (2024Q2)the dataset publishes no row for this product, state and quarter²⁴No row	no row published paid prescriptions in the quarter (2024Q3)the dataset publishes no row for this product, state and quarter²⁴No row	no row published paid prescriptions in the quarter (2024Q4)the dataset publishes no row for this product, state and quarter²⁴No row	no row published paid prescriptions in the quarter (2025Q1)the dataset publishes no row for this product, state and quarter²⁵No row	withheld as a small cell paid prescriptions in the quarter (2025Q2)every reporting cell was withheld, so nothing is observable²⁵Withheld	at least 11 paid prescriptions in the quarter (2025Q3)a floor, because some reporting cells were withheld²⁵At least	withheld as a small cell paid prescriptions in the quarter (2025Q4)every reporting cell was withheld, so nothing is observable²⁵Withheld	withheld as a small cell paid prescriptions in the quarter (2026Q1)every reporting cell was withheld, so nothing is observable¹³Withheld
tirzepatideMounjaro®	no row published paid prescriptions in the quarter (2021Q1)the dataset publishes no row for this product, state and quarter²⁶No row	no row published paid prescriptions in the quarter (2021Q2)the dataset publishes no row for this product, state and quarter²⁶No row	no row published paid prescriptions in the quarter (2021Q3)the dataset publishes no row for this product, state and quarter²⁶No row	no row published paid prescriptions in the quarter (2021Q4)the dataset publishes no row for this product, state and quarter²⁶No row	no row published paid prescriptions in the quarter (2022Q1)the dataset publishes no row for this product, state and quarter²⁷No row	withheld as a small cell paid prescriptions in the quarter (2022Q2)every reporting cell was withheld, so nothing is observable²⁷Withheld	at least 198 paid prescriptions in the quarter (2022Q3)a floor, because some reporting cells were withheld²⁷At least	at least 812 paid prescriptions in the quarter (2022Q4)a floor, because some reporting cells were withheld²⁷At least	at least 1,876 paid prescriptions in the quarter (2023Q1)a floor, because some reporting cells were withheld²⁸At least	at least 7,834 paid prescriptions in the quarter (2023Q2)a floor, because some reporting cells were withheld²⁸At least	at least 13,100 paid prescriptions in the quarter (2023Q3)a floor, because some reporting cells were withheld²⁸At least	at least 17,478 paid prescriptions in the quarter (2023Q4)a floor, because some reporting cells were withheld²⁸At least	at least 20,999 paid prescriptions in the quarter (2024Q1)a floor, because some reporting cells were withheld²⁹At least	at least 23,628 paid prescriptions in the quarter (2024Q2)a floor, because some reporting cells were withheld²⁹At least	at least 32,247 paid prescriptions in the quarter (2024Q3)a floor, because some reporting cells were withheld²⁹At least	at least 35,634 paid prescriptions in the quarter (2024Q4)a floor, because some reporting cells were withheld²⁹At least	at least 42,051 paid prescriptions in the quarter (2025Q1)a floor, because some reporting cells were withheld³⁰At least	at least 50,110 paid prescriptions in the quarter (2025Q2)a floor, because some reporting cells were withheld³⁰At least	58,874 paid prescriptions in the quarter (2025Q3)³⁰Count	at least 67,829 paid prescriptions in the quarter (2025Q4)a floor, because some reporting cells were withheld³⁰At least	at least 75,910 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld¹⁴At least
semaglutideWegovy®	no row published paid prescriptions in the quarter (2021Q1)the dataset publishes no row for this product, state and quarter³¹No row	no row published paid prescriptions in the quarter (2021Q2)the dataset publishes no row for this product, state and quarter³¹No row	no row published paid prescriptions in the quarter (2021Q3)the dataset publishes no row for this product, state and quarter³¹No row	withheld as a small cell paid prescriptions in the quarter (2021Q4)every reporting cell was withheld, so nothing is observable³¹Withheld	withheld as a small cell paid prescriptions in the quarter (2022Q1)every reporting cell was withheld, so nothing is observable³²Withheld	withheld as a small cell paid prescriptions in the quarter (2022Q2)every reporting cell was withheld, so nothing is observable³²Withheld	withheld as a small cell paid prescriptions in the quarter (2022Q3)every reporting cell was withheld, so nothing is observable³²Withheld	withheld as a small cell paid prescriptions in the quarter (2022Q4)every reporting cell was withheld, so nothing is observable³²Withheld	withheld as a small cell paid prescriptions in the quarter (2023Q1)every reporting cell was withheld, so nothing is observable³³Withheld	no row published paid prescriptions in the quarter (2023Q2)the dataset publishes no row for this product, state and quarter³³No row	withheld as a small cell paid prescriptions in the quarter (2023Q3)every reporting cell was withheld, so nothing is observable³³Withheld	no row published paid prescriptions in the quarter (2023Q4)the dataset publishes no row for this product, state and quarter³³No row	no row published paid prescriptions in the quarter (2024Q1)the dataset publishes no row for this product, state and quarter³⁴No row	withheld as a small cell paid prescriptions in the quarter (2024Q2)every reporting cell was withheld, so nothing is observable³⁴Withheld	withheld as a small cell paid prescriptions in the quarter (2024Q3)every reporting cell was withheld, so nothing is observable³⁴Withheld	withheld as a small cell paid prescriptions in the quarter (2024Q4)every reporting cell was withheld, so nothing is observable³⁴Withheld	withheld as a small cell paid prescriptions in the quarter (2025Q1)every reporting cell was withheld, so nothing is observable³⁵Withheld	withheld as a small cell paid prescriptions in the quarter (2025Q2)every reporting cell was withheld, so nothing is observable³⁵Withheld	withheld as a small cell paid prescriptions in the quarter (2025Q3)every reporting cell was withheld, so nothing is observable³⁵Withheld	at least 197 paid prescriptions in the quarter (2025Q4)a floor, because some reporting cells were withheld³⁵At least	at least 1,945 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld¹⁵At least
semaglutideOzempic®	at least 20,013 paid prescriptions in the quarter (2021Q1)a floor, because some reporting cells were withheld³⁶At least	at least 24,387 paid prescriptions in the quarter (2021Q2)a floor, because some reporting cells were withheld³⁶At least	at least 27,830 paid prescriptions in the quarter (2021Q3)a floor, because some reporting cells were withheld³⁶At least	at least 31,836 paid prescriptions in the quarter (2021Q4)a floor, because some reporting cells were withheld³⁶At least	at least 35,639 paid prescriptions in the quarter (2022Q1)a floor, because some reporting cells were withheld³⁷At least	at least 42,183 paid prescriptions in the quarter (2022Q2)a floor, because some reporting cells were withheld³⁷At least	at least 48,423 paid prescriptions in the quarter (2022Q3)a floor, because some reporting cells were withheld³⁷At least	at least 53,349 paid prescriptions in the quarter (2022Q4)a floor, because some reporting cells were withheld³⁷At least	at least 63,827 paid prescriptions in the quarter (2023Q1)a floor, because some reporting cells were withheld³⁸At least	83,741 paid prescriptions in the quarter (2023Q2)³⁸Count	at least 100,175 paid prescriptions in the quarter (2023Q3)a floor, because some reporting cells were withheld³⁸At least	at least 79,332 paid prescriptions in the quarter (2023Q4)a floor, because some reporting cells were withheld³⁸At least	at least 86,117 paid prescriptions in the quarter (2024Q1)a floor, because some reporting cells were withheld³⁹At least	at least 101,278 paid prescriptions in the quarter (2024Q2)a floor, because some reporting cells were withheld³⁹At least	at least 116,223 paid prescriptions in the quarter (2024Q3)a floor, because some reporting cells were withheld³⁹At least	at least 110,020 paid prescriptions in the quarter (2024Q4)a floor, because some reporting cells were withheld³⁹At least	at least 114,910 paid prescriptions in the quarter (2025Q1)a floor, because some reporting cells were withheld⁴⁰At least	at least 117,584 paid prescriptions in the quarter (2025Q2)a floor, because some reporting cells were withheld⁴⁰At least	at least 117,403 paid prescriptions in the quarter (2025Q3)a floor, because some reporting cells were withheld⁴⁰At least	at least 114,474 paid prescriptions in the quarter (2025Q4)a floor, because some reporting cells were withheld⁴⁰At least	112,157 paid prescriptions in the quarter (2026Q1)¹⁶Count
semaglutideRybelsus®	2,559 paid prescriptions in the quarter (2021Q1)⁴¹Count	3,977 paid prescriptions in the quarter (2021Q2)⁴¹Count	5,454 paid prescriptions in the quarter (2021Q3)⁴¹Count	at least 6,521 paid prescriptions in the quarter (2021Q4)a floor, because some reporting cells were withheld⁴¹At least	7,710 paid prescriptions in the quarter (2022Q1)⁴²Count	at least 9,009 paid prescriptions in the quarter (2022Q2)a floor, because some reporting cells were withheld⁴²At least	at least 10,128 paid prescriptions in the quarter (2022Q3)a floor, because some reporting cells were withheld⁴²At least	at least 11,210 paid prescriptions in the quarter (2022Q4)a floor, because some reporting cells were withheld⁴²At least	at least 12,583 paid prescriptions in the quarter (2023Q1)a floor, because some reporting cells were withheld⁴³At least	at least 9,939 paid prescriptions in the quarter (2023Q2)a floor, because some reporting cells were withheld⁴³At least	at least 8,662 paid prescriptions in the quarter (2023Q3)a floor, because some reporting cells were withheld⁴³At least	at least 7,911 paid prescriptions in the quarter (2023Q4)a floor, because some reporting cells were withheld⁴³At least	7,259 paid prescriptions in the quarter (2024Q1)⁴⁴Count	7,253 paid prescriptions in the quarter (2024Q2)⁴⁴Count	7,170 paid prescriptions in the quarter (2024Q3)⁴⁴Count	6,251 paid prescriptions in the quarter (2024Q4)⁴⁴Count	at least 6,105 paid prescriptions in the quarter (2025Q1)a floor, because some reporting cells were withheld⁴⁵At least	at least 6,126 paid prescriptions in the quarter (2025Q2)a floor, because some reporting cells were withheld⁴⁵At least	at least 6,121 paid prescriptions in the quarter (2025Q3)a floor, because some reporting cells were withheld⁴⁵At least	at least 5,900 paid prescriptions in the quarter (2025Q4)a floor, because some reporting cells were withheld⁴⁵At least	at least 5,876 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld¹⁷At least
liraglutideSaxenda®	withheld as a small cell paid prescriptions in the quarter (2021Q1)every reporting cell was withheld, so nothing is observable⁴⁶Withheld	no row published paid prescriptions in the quarter (2021Q2)the dataset publishes no row for this product, state and quarter⁴⁶No row	withheld as a small cell paid prescriptions in the quarter (2021Q3)every reporting cell was withheld, so nothing is observable⁴⁶Withheld	withheld as a small cell paid prescriptions in the quarter (2021Q4)every reporting cell was withheld, so nothing is observable⁴⁶Withheld	withheld as a small cell paid prescriptions in the quarter (2022Q1)every reporting cell was withheld, so nothing is observable⁴⁷Withheld	withheld as a small cell paid prescriptions in the quarter (2022Q2)every reporting cell was withheld, so nothing is observable⁴⁷Withheld	withheld as a small cell paid prescriptions in the quarter (2022Q3)every reporting cell was withheld, so nothing is observable⁴⁷Withheld	withheld as a small cell paid prescriptions in the quarter (2022Q4)every reporting cell was withheld, so nothing is observable⁴⁷Withheld	no row published paid prescriptions in the quarter (2023Q1)the dataset publishes no row for this product, state and quarter⁴⁸No row	no row published paid prescriptions in the quarter (2023Q2)the dataset publishes no row for this product, state and quarter⁴⁸No row	no row published paid prescriptions in the quarter (2023Q3)the dataset publishes no row for this product, state and quarter⁴⁸No row	no row published paid prescriptions in the quarter (2023Q4)the dataset publishes no row for this product, state and quarter⁴⁸No row	no row published paid prescriptions in the quarter (2024Q1)the dataset publishes no row for this product, state and quarter⁴⁹No row	no row published paid prescriptions in the quarter (2024Q2)the dataset publishes no row for this product, state and quarter⁴⁹No row	no row published paid prescriptions in the quarter (2024Q3)the dataset publishes no row for this product, state and quarter⁴⁹No row	no row published paid prescriptions in the quarter (2024Q4)the dataset publishes no row for this product, state and quarter⁴⁹No row	no row published paid prescriptions in the quarter (2025Q1)the dataset publishes no row for this product, state and quarter⁵⁰No row	no row published paid prescriptions in the quarter (2025Q2)the dataset publishes no row for this product, state and quarter⁵⁰No row	no row published paid prescriptions in the quarter (2025Q3)the dataset publishes no row for this product, state and quarter⁵⁰No row	no row published paid prescriptions in the quarter (2025Q4)the dataset publishes no row for this product, state and quarter⁵⁰No row	no row published paid prescriptions in the quarter (2026Q1)the dataset publishes no row for this product, state and quarter¹⁸No row
liraglutideVictoza®	9,479 paid prescriptions in the quarter (2021Q1)⁵¹Count	9,221 paid prescriptions in the quarter (2021Q2)⁵¹Count	8,092 paid prescriptions in the quarter (2021Q3)⁵¹Count	6,508 paid prescriptions in the quarter (2021Q4)⁵¹Count	5,837 paid prescriptions in the quarter (2022Q1)⁵²Count	5,490 paid prescriptions in the quarter (2022Q2)⁵²Count	5,259 paid prescriptions in the quarter (2022Q3)⁵²Count	4,825 paid prescriptions in the quarter (2022Q4)⁵²Count	4,695 paid prescriptions in the quarter (2023Q1)⁵³Count	at least 4,185 paid prescriptions in the quarter (2023Q2)a floor, because some reporting cells were withheld⁵³At least	at least 3,789 paid prescriptions in the quarter (2023Q3)a floor, because some reporting cells were withheld⁵³At least	at least 2,947 paid prescriptions in the quarter (2023Q4)a floor, because some reporting cells were withheld⁵³At least	at least 2,389 paid prescriptions in the quarter (2024Q1)a floor, because some reporting cells were withheld⁵⁴At least	at least 1,969 paid prescriptions in the quarter (2024Q2)a floor, because some reporting cells were withheld⁵⁴At least	1,194 paid prescriptions in the quarter (2024Q3)⁵⁴Count	at least 598 paid prescriptions in the quarter (2024Q4)a floor, because some reporting cells were withheld⁵⁴At least	351 paid prescriptions in the quarter (2025Q1)⁵⁵Count	147 paid prescriptions in the quarter (2025Q2)⁵⁵Count	164 paid prescriptions in the quarter (2025Q3)⁵⁵Count	154 paid prescriptions in the quarter (2025Q4)⁵⁵Count	180 paid prescriptions in the quarter (2026Q1)¹⁹Count
liraglutideliraglutide (generic)®	no row published paid prescriptions in the quarter (2021Q1)the dataset publishes no row for this product, state and quarter⁵⁶No row	no row published paid prescriptions in the quarter (2021Q2)the dataset publishes no row for this product, state and quarter⁵⁶No row	no row published paid prescriptions in the quarter (2021Q3)the dataset publishes no row for this product, state and quarter⁵⁶No row	no row published paid prescriptions in the quarter (2021Q4)the dataset publishes no row for this product, state and quarter⁵⁶No row	no row published paid prescriptions in the quarter (2022Q1)the dataset publishes no row for this product, state and quarter⁵⁷No row	no row published paid prescriptions in the quarter (2022Q2)the dataset publishes no row for this product, state and quarter⁵⁷No row	no row published paid prescriptions in the quarter (2022Q3)the dataset publishes no row for this product, state and quarter⁵⁷No row	no row published paid prescriptions in the quarter (2022Q4)the dataset publishes no row for this product, state and quarter⁵⁷No row	no row published paid prescriptions in the quarter (2023Q1)the dataset publishes no row for this product, state and quarter⁵⁸No row	no row published paid prescriptions in the quarter (2023Q2)the dataset publishes no row for this product, state and quarter⁵⁸No row	no row published paid prescriptions in the quarter (2023Q3)the dataset publishes no row for this product, state and quarter⁵⁸No row	no row published paid prescriptions in the quarter (2023Q4)the dataset publishes no row for this product, state and quarter⁵⁸No row	no row published paid prescriptions in the quarter (2024Q1)the dataset publishes no row for this product, state and quarter⁵⁹No row	no row published paid prescriptions in the quarter (2024Q2)the dataset publishes no row for this product, state and quarter⁵⁹No row	469 paid prescriptions in the quarter (2024Q3)⁵⁹Count	at least 876 paid prescriptions in the quarter (2024Q4)a floor, because some reporting cells were withheld⁵⁹At least	at least 968 paid prescriptions in the quarter (2025Q1)a floor, because some reporting cells were withheld⁶⁰At least	at least 908 paid prescriptions in the quarter (2025Q2)a floor, because some reporting cells were withheld⁶⁰At least	at least 785 paid prescriptions in the quarter (2025Q3)a floor, because some reporting cells were withheld⁶⁰At least	at least 730 paid prescriptions in the quarter (2025Q4)a floor, because some reporting cells were withheld⁶⁰At least	675 paid prescriptions in the quarter (2026Q1)²⁰Count

What this page does not tell you

It does not tell you the criteria. The rule at the top of this page says what New York Medicaid covers and what it excludes; it does not carry the checklist a prescriber has to satisfy to get a request approved for a use that is still open. That document is published separately and this site cites it as it reads it rather than summarising it from memory.

It also does not tell you which condition a paid prescription was written for. The same molecule is sold under one brand for type 2 diabetes and another for weight management, and a program can pay for one while excluding the other on the same day. Where a distinction like that matters, the record carries the indication and the page says so.

Documents this page reads

60 documents, cited by number above. Each opens to its section, its effective date, and the quote the fact came from.

New York NYRx Wegovy overview, authorization required
NYRx Drug Coverage Overview: Wegovy, NYRx Drug Utilization Review Program
New York State Department of Health · Provider bulletin · Effective Jul 16, 2026 · 11/20/25 | Rev. 07/23/26 · Read Aug 9, 2026
Wegovy® is subject to prior authorization (PA) criteria under the NYRx Drug Utilization Review (DUR) Program
The opening statement of the product's own coverage overview, read on 2026-08-09. This document is one of roughly thirty the program publishes per drug class, and this product has one of its own where the other six products on this page do not.
Read Aug 9, 2026 · effective Jul 16, 2026
New York NYRx Wegovy overview, the diagnosis parameter
NYRx Drug Coverage Overview: Wegovy, Prior Authorization Requirements, Additional/Alternate Parameter(s)
New York State Department of Health · Provider bulletin · Effective Jul 16, 2026 · 11/20/25 | Rev. 07/23/26 · Read Aug 9, 2026
Confirm diagnosis of cardiovascular disease
The first of the three parameters in the product's own coverage overview, read on 2026-08-09. The document names one diagnosis and it is not obesity, which is the fact the weight management rows on this page turn on.
Read Aug 9, 2026 · effective Jul 16, 2026
New York NYRx drug list, the Wegovy review row
NYRx, the Medicaid Pharmacy Program Preferred Drug List, Drug Utilization Review (DUR) Program, Frequency / Quantity / Duration and Additional / Alternate Parameters, page 74
New York State Department of Health · Preferred drug list · Effective Jul 16, 2026 · Revised: July 16, 2026 · Read Aug 9, 2026
semaglutide (Wegovy®) LIFETIME QUANTITY LIMIT: • Confirm diagnosis of • Two treatment attempts per cardiovascular disease lifetime • Confirm patient BMI of
The product's own row in the review table, read from the list's PDF text layer on 2026-08-09. The document lays this row out as three table columns and the PDF text layer reads across them, so the words of the second column and the third are interleaved in the order stored here. Nothing was reworded, reordered or added; only the runs of spacing between columns were collapsed. Read in the document the row carries a lifetime limit of two treatment attempts and three parameters, the first of which names cardiovascular disease.
Read Aug 9, 2026 · effective Jul 16, 2026
New York NYRx drug list, the review program
NYRx, the Medicaid Pharmacy Program Preferred Drug List, Overview of Contents, Drug Utilization Review (DUR) Program, page 1
New York State Department of Health · Preferred drug list · Effective Jul 16, 2026 · Revised: July 16, 2026 · Read Aug 9, 2026
The DUR helps to ensure that prescriptions for outpatient drugs are appropriate, medically necessary, and not likely to result in adverse medical consequences.
The program description on the list's first page, read on 2026-08-09. It is stored because the two products this record answers for sit in that program rather than in the preferred and non-preferred tables, so a reader following the citation lands on the right part of a 85 page document.
Read Aug 9, 2026 · effective Jul 16, 2026
New York reimbursable drug list, the boundary
Medicaid Pharmacy List of Reimbursable Drugs, New York Medicaid Pharmacy List of Reimbursable Drugs, the page introduction
New York State Department of Health · Preferred drug list · Read Aug 9, 2026
Only those prescription and non-prescription drugs which appear on the list are reimbursable under the fee-for-service Medicaid Pharmacy Program.
The introduction to the list, read on 2026-08-09 at the state's own electronic Medicaid system. It is the sentence that turns an absence into a finding: without it, a product missing from the list would only mean the list is incomplete.
Read Aug 9, 2026
New York reimbursable drug list, what it misses
Medicaid Pharmacy List of Reimbursable Drugs, New York Medicaid Pharmacy List of Reimbursable Drugs, Attention Prescribers
New York State Department of Health · Preferred drug list · Read Aug 9, 2026
The Medicaid Pharmacy List of Reimbursable drugs includes only those drugs covered under the Pharmacy benefit and is not inclusive of all covered practitioner administered drugs.
The publisher's own bound on the list, read on 2026-08-09. It is stored beside the sentence above because an absence from this list is an absence from the pharmacy benefit and says nothing about a drug given in a clinic.
Read Aug 9, 2026
New York NYRx drug list, the diabetes class criterion
NYRx, the Medicaid Pharmacy Program Preferred Drug List, VI. Endocrine and Metabolic Agents, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists, Type 2 Diabetes, page 34
New York State Department of Health · Preferred drug list · Effective Jul 16, 2026 · Revised: July 16, 2026 · Read Aug 9, 2026
Confirm diagnosis of FDA-approved or compendia-supported indication and Medicaid covered indication
The clinical criterion printed beside the class, read on 2026-08-09. The class heading names type 2 diabetes and the products under it are the ones sold for that use. It is stored because it is the nearest published thing to an answer for a weight management prescription of one of those products, and it is a requirement rather than an answer.
Read Aug 9, 2026 · effective Jul 16, 2026
New York NYRx drug list, non-preferred needs authorization
NYRx, the Medicaid Pharmacy Program Preferred Drug List, Overview of Contents, Preferred Drug Program (PDP), page 1
New York State Department of Health · Preferred drug list · Effective Jul 16, 2026 · Revised: July 16, 2026 · Read Aug 9, 2026
Non-preferred drugs in these classes require prior authorization (PA), unless indicated otherwise.
The first of the three rules the list states about itself, read on 2026-08-09.
Read Aug 9, 2026 · effective Jul 16, 2026
New York NYRx drug list, the program phone number
NYRx, the Medicaid Pharmacy Program Preferred Drug List, Overview of Contents, contact block at the foot of page 1
New York State Department of Health · Preferred drug list · Effective Jul 16, 2026 · Revised: July 16, 2026 · Read Aug 9, 2026
To contact the NYRx Clinical Call Center please call 1-877-309-9493
The contact line at the foot of the list's first page, read on 2026-08-09. It backs the phone number this record gives a reader who has to ask the program a question it does not publish the answer to.
Read Aug 9, 2026 · effective Jul 16, 2026
New York NYRx drug list, the rest of the Wegovy row
NYRx, the Medicaid Pharmacy Program Preferred Drug List, Drug Utilization Review (DUR) Program, Additional / Alternate Parameters on the semaglutide row, page 74
New York State Department of Health · Preferred drug list · Effective Jul 16, 2026 · Revised: July 16, 2026 · Read Aug 9, 2026
Confirm patient BMI of ≥ 40kg/m2 • Confirm patient is participating in lifestyle modifications that support cardiovascular health
The tail of the same row, read from the list's PDF text layer on 2026-08-09. By this point the third column runs on its own, so these words are contiguous in the document rather than interleaved. It is stored separately from the row above because the row above had to stop at the 200 character limit and this is the half that carries the number.
Read Aug 9, 2026 · effective Jul 16, 2026
New York NYRx drug list, the rest of the Zepbound row
NYRx, the Medicaid Pharmacy Program Preferred Drug List, Drug Utilization Review (DUR) Program, Additional / Alternate Parameters on the tirzepatide row, page 74
New York State Department of Health · Preferred drug list · Effective Jul 16, 2026 · Revised: July 16, 2026 · Read Aug 9, 2026
lifetime • Confirm patient BMI of ≥ 40kg/m2 • Confirm patient is participating in lifestyle modifications
The tail of the same row, read from the list's PDF text layer on 2026-08-09. It is stored separately because the row above had to stop at the 200 character limit. The third parameter on this row ends at lifestyle modifications, where the row above it for the other product carries three further words naming what the modifications are for.
Read Aug 9, 2026 · effective Jul 16, 2026
New York NYRx Wegovy overview, who submits
NYRx Drug Coverage Overview: Wegovy, What Prescribers Need to Do
New York State Department of Health · Provider bulletin · Effective Jul 16, 2026 · 11/20/25 | Rev. 07/23/26 · Read Aug 9, 2026
Prescribers should become familiar with the Wegovy coverage criteria parameters in the DUR program and incorporate this information when prescribing for Medicaid members.
The instruction the document gives prescribers, read on 2026-08-09. It is stored because it settles who submits a request under these parameters, which is the question a member asks first.
Read Aug 9, 2026 · effective Jul 16, 2026
SDUD 2026, Zepbound, NY
State Drug Utilization Data 2026, Datastore query result, product_name like ZEPBOUND%, state NY, 2026
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 11, 2026
{"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "MCOU", "product_name": "ZEPBOUND ", "suppression_used": "true", "number_of_prescriptions": null}
Read Aug 11, 2026 · effective Jul 10, 2026
SDUD 2026, Mounjaro, NY
State Drug Utilization Data 2026, Datastore query result, product_name like MOUNJARO%, state NY, 2026
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 11, 2026
{"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "MOUNJARO ", "suppression_used": "false", "number_of_prescriptions": "19455"}
Read Aug 11, 2026 · effective Jul 10, 2026
SDUD 2026, Wegovy, NY
State Drug Utilization Data 2026, Datastore query result, product_name like WEGOVY%, state NY, 2026
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 11, 2026
{"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "WEGOVY ", "suppression_used": "false", "number_of_prescriptions": "904"}
Read Aug 11, 2026 · effective Jul 10, 2026
SDUD 2026, Ozempic, NY
State Drug Utilization Data 2026, Datastore query result, product_name like OZEMPIC%, state NY, 2026
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 11, 2026
{"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "OZEMPIC ", "suppression_used": "false", "number_of_prescriptions": "46080"}
Read Aug 11, 2026 · effective Jul 10, 2026
SDUD 2026, Rybelsus, NY
State Drug Utilization Data 2026, Datastore query result, product_name like RYBELSUS%, state NY, 2026
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 11, 2026
{"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "RYBELSUS ", "suppression_used": "false", "number_of_prescriptions": "2414"}
Read Aug 11, 2026 · effective Jul 10, 2026
SDUD 2026, Saxenda, NY
State Drug Utilization Data 2026, Datastore query result, product_name like SAXENDA%, state NY, 2026
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like SAXENDA%, state NY, 2026", "result_count": 0}
Read Aug 11, 2026 · effective Jul 10, 2026
SDUD 2026, Victoza, NY
State Drug Utilization Data 2026, Datastore query result, product_name like VICTOZA%, state NY, 2026
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 11, 2026
{"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "VICTOZA 3-", "suppression_used": "false", "number_of_prescriptions": "91"}
Read Aug 11, 2026 · effective Jul 10, 2026
SDUD 2026, Liraglutid, NY
State Drug Utilization Data 2026, Datastore query result, product_name like LIRAGLUTID%, state NY, 2026
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 11, 2026
{"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "LIRAGLUTID", "suppression_used": "false", "number_of_prescriptions": "207"}
Read Aug 11, 2026 · effective Jul 10, 2026
SDUD 2021, Zepbound, NY
State Drug Utilization Data 2021, Datastore query result, product_name like ZEPBOUND%, state NY, 2021
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2021 file, distribution 99089534-5317-54ee-85a8-b11558e4c907, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like ZEPBOUND%, state NY, 2021", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2022, Zepbound, NY
State Drug Utilization Data 2022, Datastore query result, product_name like ZEPBOUND%, state NY, 2022
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2022 file, distribution 54f6377c-5819-50cb-8b11-fc9a64e60246, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like ZEPBOUND%, state NY, 2022", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2023, Zepbound, NY
State Drug Utilization Data 2023, Datastore query result, product_name like ZEPBOUND%, state NY, 2023
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2023 file, distribution df8055e5-3a20-5434-8a89-0e16073c8134, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like ZEPBOUND%, state NY, 2023", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2024, Zepbound, NY
State Drug Utilization Data 2024, Datastore query result, product_name like ZEPBOUND%, state NY, 2024
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2024 file, distribution 7c764387-5eaf-57da-bc5e-b9b7e0b86bad, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like ZEPBOUND%, state NY, 2024", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2025, Zepbound, NY
State Drug Utilization Data 2025, Datastore query result, product_name like ZEPBOUND%, state NY, 2025
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2025 file, distribution a613f4ae-0615-572c-812a-a381379914cd, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2025", "quarter": "3", "utilization_type": "MCOU", "product_name": "ZEPBOUND ", "suppression_used": "false", "number_of_prescriptions": "11"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2021, Mounjaro, NY
State Drug Utilization Data 2021, Datastore query result, product_name like MOUNJARO%, state NY, 2021
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2021 file, distribution 99089534-5317-54ee-85a8-b11558e4c907, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like MOUNJARO%, state NY, 2021", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2022, Mounjaro, NY
State Drug Utilization Data 2022, Datastore query result, product_name like MOUNJARO%, state NY, 2022
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2022 file, distribution 54f6377c-5819-50cb-8b11-fc9a64e60246, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2022", "quarter": "4", "utilization_type": "MCOU", "product_name": "MOUNJARO ", "suppression_used": "false", "number_of_prescriptions": "306"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2023, Mounjaro, NY
State Drug Utilization Data 2023, Datastore query result, product_name like MOUNJARO%, state NY, 2023
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2023 file, distribution df8055e5-3a20-5434-8a89-0e16073c8134, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2023", "quarter": "4", "utilization_type": "FFSU", "product_name": "MOUNJARO ", "suppression_used": "false", "number_of_prescriptions": "5822"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2024, Mounjaro, NY
State Drug Utilization Data 2024, Datastore query result, product_name like MOUNJARO%, state NY, 2024
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2024 file, distribution 7c764387-5eaf-57da-bc5e-b9b7e0b86bad, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2024", "quarter": "4", "utilization_type": "FFSU", "product_name": "MOUNJARO ", "suppression_used": "false", "number_of_prescriptions": "10003"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2025, Mounjaro, NY
State Drug Utilization Data 2025, Datastore query result, product_name like MOUNJARO%, state NY, 2025
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2025 file, distribution a613f4ae-0615-572c-812a-a381379914cd, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2025", "quarter": "4", "utilization_type": "FFSU", "product_name": "MOUNJARO ", "suppression_used": "false", "number_of_prescriptions": "17277"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2021, Wegovy, NY
State Drug Utilization Data 2021, Datastore query result, product_name like WEGOVY%, state NY, 2021
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2021 file, distribution 99089534-5317-54ee-85a8-b11558e4c907, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2021", "quarter": "4", "utilization_type": "MCOU", "product_name": "WEGOVY ", "suppression_used": "true", "number_of_prescriptions": null}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2022, Wegovy, NY
State Drug Utilization Data 2022, Datastore query result, product_name like WEGOVY%, state NY, 2022
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2022 file, distribution 54f6377c-5819-50cb-8b11-fc9a64e60246, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2022", "quarter": "4", "utilization_type": "MCOU", "product_name": "WEGOVY ", "suppression_used": "true", "number_of_prescriptions": null}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2023, Wegovy, NY
State Drug Utilization Data 2023, Datastore query result, product_name like WEGOVY%, state NY, 2023
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2023 file, distribution df8055e5-3a20-5434-8a89-0e16073c8134, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2023", "quarter": "3", "utilization_type": "MCOU", "product_name": "WEGOVY ", "suppression_used": "true", "number_of_prescriptions": null}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2024, Wegovy, NY
State Drug Utilization Data 2024, Datastore query result, product_name like WEGOVY%, state NY, 2024
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2024 file, distribution 7c764387-5eaf-57da-bc5e-b9b7e0b86bad, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2024", "quarter": "4", "utilization_type": "MCOU", "product_name": "WEGOVY ", "suppression_used": "true", "number_of_prescriptions": null}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2025, Wegovy, NY
State Drug Utilization Data 2025, Datastore query result, product_name like WEGOVY%, state NY, 2025
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2025 file, distribution a613f4ae-0615-572c-812a-a381379914cd, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2025", "quarter": "4", "utilization_type": "FFSU", "product_name": "WEGOVY ", "suppression_used": "false", "number_of_prescriptions": "129"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2021, Ozempic, NY
State Drug Utilization Data 2021, Datastore query result, product_name like OZEMPIC%, state NY, 2021
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2021 file, distribution 99089534-5317-54ee-85a8-b11558e4c907, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2021", "quarter": "4", "utilization_type": "MCOU", "product_name": "OZEMPIC ", "suppression_used": "false", "number_of_prescriptions": "17228"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2022, Ozempic, NY
State Drug Utilization Data 2022, Datastore query result, product_name like OZEMPIC%, state NY, 2022
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2022 file, distribution 54f6377c-5819-50cb-8b11-fc9a64e60246, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2022", "quarter": "4", "utilization_type": "MCOU", "product_name": "OZEMPIC ", "suppression_used": "false", "number_of_prescriptions": "26349"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2023, Ozempic, NY
State Drug Utilization Data 2023, Datastore query result, product_name like OZEMPIC%, state NY, 2023
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2023 file, distribution df8055e5-3a20-5434-8a89-0e16073c8134, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2023", "quarter": "3", "utilization_type": "FFSU", "product_name": "OZEMPIC ", "suppression_used": "false", "number_of_prescriptions": "53132"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2024, Ozempic, NY
State Drug Utilization Data 2024, Datastore query result, product_name like OZEMPIC%, state NY, 2024
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2024 file, distribution 7c764387-5eaf-57da-bc5e-b9b7e0b86bad, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2024", "quarter": "3", "utilization_type": "FFSU", "product_name": "OZEMPIC ", "suppression_used": "false", "number_of_prescriptions": "54120"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2025, Ozempic, NY
State Drug Utilization Data 2025, Datastore query result, product_name like OZEMPIC%, state NY, 2025
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2025 file, distribution a613f4ae-0615-572c-812a-a381379914cd, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2025", "quarter": "2", "utilization_type": "FFSU", "product_name": "OZEMPIC ", "suppression_used": "false", "number_of_prescriptions": "51743"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2021, Rybelsus, NY
State Drug Utilization Data 2021, Datastore query result, product_name like RYBELSUS%, state NY, 2021
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2021 file, distribution 99089534-5317-54ee-85a8-b11558e4c907, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2021", "quarter": "3", "utilization_type": "MCOU", "product_name": "RYBELSUS ", "suppression_used": "false", "number_of_prescriptions": "2590"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2022, Rybelsus, NY
State Drug Utilization Data 2022, Datastore query result, product_name like RYBELSUS%, state NY, 2022
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2022 file, distribution 54f6377c-5819-50cb-8b11-fc9a64e60246, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2022", "quarter": "4", "utilization_type": "MCOU", "product_name": "RYBELSUS ", "suppression_used": "false", "number_of_prescriptions": "4802"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2023, Rybelsus, NY
State Drug Utilization Data 2023, Datastore query result, product_name like RYBELSUS%, state NY, 2023
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2023 file, distribution df8055e5-3a20-5434-8a89-0e16073c8134, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2023", "quarter": "1", "utilization_type": "MCOU", "product_name": "RYBELSUS ", "suppression_used": "false", "number_of_prescriptions": "5299"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2024, Rybelsus, NY
State Drug Utilization Data 2024, Datastore query result, product_name like RYBELSUS%, state NY, 2024
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2024 file, distribution 7c764387-5eaf-57da-bc5e-b9b7e0b86bad, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2024", "quarter": "1", "utilization_type": "FFSU", "product_name": "RYBELSUS ", "suppression_used": "false", "number_of_prescriptions": "3115"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2025, Rybelsus, NY
State Drug Utilization Data 2025, Datastore query result, product_name like RYBELSUS%, state NY, 2025
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2025 file, distribution a613f4ae-0615-572c-812a-a381379914cd, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2025", "quarter": "1", "utilization_type": "FFSU", "product_name": "RYBELSUS ", "suppression_used": "false", "number_of_prescriptions": "2445"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2021, Saxenda, NY
State Drug Utilization Data 2021, Datastore query result, product_name like SAXENDA%, state NY, 2021
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2021 file, distribution 99089534-5317-54ee-85a8-b11558e4c907, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2021", "quarter": "4", "utilization_type": "MCOU", "product_name": "SAXENDA ", "suppression_used": "true", "number_of_prescriptions": null}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2022, Saxenda, NY
State Drug Utilization Data 2022, Datastore query result, product_name like SAXENDA%, state NY, 2022
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2022 file, distribution 54f6377c-5819-50cb-8b11-fc9a64e60246, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2022", "quarter": "4", "utilization_type": "MCOU", "product_name": "SAXENDA ", "suppression_used": "true", "number_of_prescriptions": null}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2023, Saxenda, NY
State Drug Utilization Data 2023, Datastore query result, product_name like SAXENDA%, state NY, 2023
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2023 file, distribution df8055e5-3a20-5434-8a89-0e16073c8134, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like SAXENDA%, state NY, 2023", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2024, Saxenda, NY
State Drug Utilization Data 2024, Datastore query result, product_name like SAXENDA%, state NY, 2024
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2024 file, distribution 7c764387-5eaf-57da-bc5e-b9b7e0b86bad, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like SAXENDA%, state NY, 2024", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2025, Saxenda, NY
State Drug Utilization Data 2025, Datastore query result, product_name like SAXENDA%, state NY, 2025
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2025 file, distribution a613f4ae-0615-572c-812a-a381379914cd, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like SAXENDA%, state NY, 2025", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2021, Victoza, NY
State Drug Utilization Data 2021, Datastore query result, product_name like VICTOZA%, state NY, 2021
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2021 file, distribution 99089534-5317-54ee-85a8-b11558e4c907, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2021", "quarter": "1", "utilization_type": "MCOU", "product_name": "VICTOZA 3-", "suppression_used": "false", "number_of_prescriptions": "5456"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2022, Victoza, NY
State Drug Utilization Data 2022, Datastore query result, product_name like VICTOZA%, state NY, 2022
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2022 file, distribution 54f6377c-5819-50cb-8b11-fc9a64e60246, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2022", "quarter": "1", "utilization_type": "MCOU", "product_name": "VICTOZA 3-", "suppression_used": "false", "number_of_prescriptions": "3112"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2023, Victoza, NY
State Drug Utilization Data 2023, Datastore query result, product_name like VICTOZA%, state NY, 2023
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2023 file, distribution df8055e5-3a20-5434-8a89-0e16073c8134, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2023", "quarter": "2", "utilization_type": "FFSU", "product_name": "VICTOZA 3-", "suppression_used": "false", "number_of_prescriptions": "2546"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2024, Victoza, NY
State Drug Utilization Data 2024, Datastore query result, product_name like VICTOZA%, state NY, 2024
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2024 file, distribution 7c764387-5eaf-57da-bc5e-b9b7e0b86bad, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2024", "quarter": "1", "utilization_type": "FFSU", "product_name": "VICTOZA 3-", "suppression_used": "false", "number_of_prescriptions": "1551"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2025, Victoza, NY
State Drug Utilization Data 2025, Datastore query result, product_name like VICTOZA%, state NY, 2025
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2025 file, distribution a613f4ae-0615-572c-812a-a381379914cd, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2025", "quarter": "1", "utilization_type": "FFSU", "product_name": "VICTOZA 3-", "suppression_used": "false", "number_of_prescriptions": "183"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2021, Liraglutid, NY
State Drug Utilization Data 2021, Datastore query result, product_name like LIRAGLUTID%, state NY, 2021
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2021 file, distribution 99089534-5317-54ee-85a8-b11558e4c907, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like LIRAGLUTID%, state NY, 2021", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2022, Liraglutid, NY
State Drug Utilization Data 2022, Datastore query result, product_name like LIRAGLUTID%, state NY, 2022
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2022 file, distribution 54f6377c-5819-50cb-8b11-fc9a64e60246, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like LIRAGLUTID%, state NY, 2022", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2023, Liraglutid, NY
State Drug Utilization Data 2023, Datastore query result, product_name like LIRAGLUTID%, state NY, 2023
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2023 file, distribution df8055e5-3a20-5434-8a89-0e16073c8134, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "product_name": "product_name like LIRAGLUTID%, state NY, 2023", "result_count": 0}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2024, Liraglutid, NY
State Drug Utilization Data 2024, Datastore query result, product_name like LIRAGLUTID%, state NY, 2024
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2024 file, distribution 7c764387-5eaf-57da-bc5e-b9b7e0b86bad, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2024", "quarter": "4", "utilization_type": "FFSU", "product_name": "LIRAGLUTID", "suppression_used": "false", "number_of_prescriptions": "566"}
Read Aug 11, 2026 · effective Jul 13, 2026
SDUD 2025, Liraglutid, NY
State Drug Utilization Data 2025, Datastore query result, product_name like LIRAGLUTID%, state NY, 2025
Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 13, 2026 · SDUD 2025 file, distribution a613f4ae-0615-572c-812a-a381379914cd, CMS modified 2026-07-13 · Read Aug 11, 2026
{"state": "NY", "year": "2025", "quarter": "1", "utilization_type": "FFSU", "product_name": "LIRAGLUTID", "suppression_used": "false", "number_of_prescriptions": "504"}
Read Aug 11, 2026 · effective Jul 13, 2026

How the quoted row is presented, for 36 of these documents

One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.

How the quoted row is presented, for 12 of these documents

The query in url returns an empty result set, which is the evidence. An absence cannot be quoted, so the record states the query and its count instead.

Common questions

Does a paid claim mean New York Medicaid covers the drug for weight loss?

No. A paid claim shows that a prescription was filled and paid for. It does not say which condition it was prescribed for, and the same molecule is often paid for diabetes while being excluded for obesity. The program drug list and its prior authorization criteria decide the rule.

Why does a number say "at least"?

Because a reporting cell that is too small to publish is withheld rather than printed. When any matching cell was withheld, the total shown is a floor and the real number is higher. Printing that floor as if it were a count would be a false number with a citation attached to it.

What does an empty row mean?

It means no paid claim for that product appeared in the published federal file for that quarter. It is not a zero and it is not a coverage decision. Every empty row on this page carries the query that returned nothing and the date it was run, so you can check it.

Where does the rule actually live?

In New York Medicaid's own published documents, and the top of this page is where they are quoted. Each row there names the document it was read from, the section, and the sentence, so you can open the same page the reader of this site read. The payment table below it answers a different question and cannot settle the rule.