ACA Federal Upper Limits (FUL)
States running Medicaid programs aren't allowed to pay pharmacies more than a certain amount for generic drugs. This dataset shows exactly what that limit is for every generic drug, broken down by month. The limit is set by the federal government at 175% of what manufacturers actually sell them for on average. If you run a pharmacy and take Medicaid, this is what you'll get reimbursed. If you study healthcare costs or policy, this shows how the government caps what it pays for generics.
- Source rows:
- 2,165,244
- Coverage:
- 2016-01-01T00:00:00Z – 2026-12-31T00:00:00Z
CSV: all rows from the default table.
Table filters, sorting and pagination are not included.
Explore data
Views organize this dataset for different questions.
Loading views…
All
Full dataset without transformation
View defined in OpenData · Source: cms
Dataset overview
This overview is independent of the table. Table selections and filters do not change it.
Questions this data answers
- What's the maximum Medicaid reimbursement for a specific generic drug this month?
- How have federal upper limits changed for a particular drug over time?
- Which generic drugs have reimbursement rates above the 175% threshold?
- What's the weighted average manufacturer price used to calculate the federal upper limit?
Download
CSV: all rows from the default table.
Table filters, sorting and pagination are not included.
Columns
14 columns in this table.