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 drug list and its prior authorization criteria. This page publishes the payment record because it is complete and re-summable for every jurisdiction; the rule documents are being read separately and will be cited here as they land.

Weight loss drugs and New York Medicaid

The federal government publishes how many prescriptions each state program paid for, quarter by quarter. The table below is that record for New York, drug by drug, with the query that returns each number. A payment count is not a coverage rule, and this page says which of the two it is showing you.

By the Covered Weight editorial team · Updated Aug 3, 2026. Research and sourcing by Evan Reid.

What this record is

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.

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.

Paid prescriptions, 2026Q1

Prescriptions paid for by New York Medicaid in 2026Q1
Drug	Paid prescriptions	How to read it	The query behind it
tirzepatideZepbound®	withheld as a small cell paid prescriptions in the quarter (2026Q1)every reporting cell was withheld, so nothing is observable	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.	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 3, 2026 Read the line this comes from {"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "MCOU", "product_name": "ZEPBOUND ", "suppression_used": "true", "number_of_prescriptions": null} 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.
tirzepatideMounjaro®	at least 75,910 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld	At least one reporting cell was withheld for being too small to publish, so the true number is higher than this one.	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 3, 2026 Read the line this comes from {"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "MOUNJARO ", "suppression_used": "false", "number_of_prescriptions": "19455"} 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.
semaglutideWegovy®	at least 1,945 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld	At least one reporting cell was withheld for being too small to publish, so the true number is higher than this one.	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 3, 2026 Read the line this comes from {"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "WEGOVY ", "suppression_used": "false", "number_of_prescriptions": "904"} 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.
semaglutideOzempic®	112,157 paid prescriptions in the quarter (2026Q1)	Every matching reporting cell was published, so this is the number of paid prescriptions.	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 3, 2026 Read the line this comes from {"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "OZEMPIC ", "suppression_used": "false", "number_of_prescriptions": "46080"} 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.
semaglutideRybelsus®	at least 5,876 paid prescriptions in the quarter (2026Q1)a floor, because some reporting cells were withheld	At least one reporting cell was withheld for being too small to publish, so the true number is higher than this one.	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 3, 2026 Read the line this comes from {"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "RYBELSUS ", "suppression_used": "false", "number_of_prescriptions": "2414"} 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.
liraglutideSaxenda®	no row published paid prescriptions in the quarter (2026Q1)the dataset publishes no row for this product, state and quarter	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.Checked 2026-08-03, 0 rows returned.	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 3, 2026 Read the line this comes from {"state": "NY", "product_name": "product_name like SAXENDA%, state NY, 2026", "result_count": 0} 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.
liraglutideVictoza®	180 paid prescriptions in the quarter (2026Q1)	Every matching reporting cell was published, so this is the number of paid prescriptions.	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 3, 2026 Read the line this comes from {"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "VICTOZA 3-", "suppression_used": "false", "number_of_prescriptions": "91"} 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.
liraglutideliraglutide (generic)®	675 paid prescriptions in the quarter (2026Q1)	Every matching reporting cell was published, so this is the number of paid prescriptions.	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 3, 2026 Read the line this comes from {"state": "NY", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "LIRAGLUTID", "suppression_used": "false", "number_of_prescriptions": "207"} 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.

Does this page reach your plan?

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

What this page does not tell you

It does not tell you the rule. A payment record says what happened; a drug list and its prior authorization criteria say what will happen when the next prescription arrives. Those documents are published separately by each program, several of them only as vendor-hosted files that change without notice, and this site cites them as it reads them rather than summarising them 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.

If you have already been told no

A denial has a route and a clock, and both are worth knowing before you argue the merits. Read how to appeal a denial in New York for the order the steps run in and which body reviews a final no.