Formoterol fumarate, inh
Products billed under this code include Formoterol Fumarate, Perforomist.
Payment limit per 20 MCG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under this code include Formoterol Fumarate, Perforomist.
Payment limit per 20 MCG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Formoterol Fumarate | Teva Pharmaceuticals USA, Inc. | 00093-4061-06 | 60 | $82.38 |
| Formoterol Fumarate | Mylan Pharmaceuticals Inc. | 00378-1631-91 | 60 | $82.38 |
| Formoterol Fumarate | Mylan Pharmaceuticals Inc. | 00378-1631-93 | 30 | $41.19 |
| Formoterol Fumarate | Micro Labs Limited | 42571-0463-62 | 60 | $82.38 |
| Formoterol Fumarate | Micro Labs Limited | 42571-0463-73 | 30 | $41.19 |
| Formoterol Fumarate | Rhodes Pharmaceuticals | 42858-0094-35 | 30 | $41.19 |
| Formoterol Fumarate | Rhodes Pharmaceuticals | 42858-0094-62 | 60 | $82.38 |
| Formoterol Fumarate | Dr. Reddy's Laboratories Inc. | 43598-0778-30 | 30 | $41.19 |
| Formoterol Fumarate | Dr. Reddy's Laboratories Inc. | 43598-0778-60 | 60 | $82.38 |
| Formoterol Fumarate | Ingenus Pharmaceuticals LLC | 50742-0394-30 | 30 | $41.19 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Formoterol Fumarate | Ingenus Pharmaceuticals LLC | 50742-0394-60 | 60 | $82.38 |
| Formoterol Fumarate | Alembic Pharmaceuticals Inc. | 62332-0655-30 | 30 | $41.19 |
| Formoterol Fumarate | Alembic Pharmaceuticals Inc. | 62332-0655-60 | 60 | $82.38 |
| Formoterol Fumarate | Lupin Pharmaceuticals, Inc. | 70748-0261-30 | 30 | $41.19 |
| Formoterol Fumarate | Lupin Pharmaceuticals, Inc. | 70748-0261-60 | 60 | $82.38 |
| Formoterol Fumarate | Lifestar Pharma | 70756-0608-60 | 60 | $82.38 |
| Formoterol Fumarate | Lifestar Pharma | 70756-0608-70 | 30 | $41.19 |
| Formoterol Fumarate | Northstar RxLLC | 72603-0620-30 | 30 | $41.19 |
| Formoterol Fumarate | Northstar RxLLC | 72603-0620-60 | 60 | $82.38 |
| Formoterol Fumarate | Aucta Pharmaceuticals, Inc. | 73289-0060-01 | 30 | $41.19 |
| Formoterol Fumarate | Aucta Pharmaceuticals, Inc. | 73289-0060-02 | 60 | $82.38 |
| Formoterol Fumarate | Ritedose Pharmaceuticals, LLC | 76204-0030-01 | 30 | $41.19 |
| Formoterol Fumarate | Ritedose Pharmaceuticals, LLC | 76204-0030-02 | 60 | $82.38 |
| Perforomist | Viatris Specialty LLC | 49502-0605-30 | 30 | $41.19 |
| Perforomist | Viatris Specialty LLC | 49502-0605-61 | 60 | $82.38 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $1.373 | −$0.174 | 20 MCG | Formoterol fumarate, inh | v1, posted September 17, 2026 |
| 3Q26 | $1.547 | −$0.236 | 20 MCG | Formoterol fumarate, inh | v1, posted September 15, 2026 |
| 2Q26 | $1.783 | −$0.413 | 20 MCG | Formoterol fumarate, inh | v1, posted September 15, 2026 |
| 1Q26 | $2.196 | −$0.532 | 20 MCG | Formoterol fumarate, inh | v1, posted September 15, 2026 |
| 4Q25 | $2.728 | +$0.762 | 20 MCG | Formoterol fumarate, inh | v1, posted September 8, 2026 |
| 3Q25 | $1.966 | +$0.267 | 20 MCG | Formoterol fumarate, inh | v1, posted March 10, 2026 |
| 2Q25 | $1.699 | −$0.189 | 20 MCG | Formoterol fumarate, inh | v1, posted March 10, 2026 |
| 1Q25 | $1.888 | −$0.493 | 20 MCG | Formoterol fumarate, inh | v1, posted December 19, 2025 |
| 4Q24 | $2.381 | −$0.822 | 20 MCG | Formoterol fumarate, inh | v1, posted June 11, 2025 |
| 3Q24 | $3.203 | −$0.365 | 20 MCG | Formoterol fumarate, inh | v1, posted June 11, 2025 |
| 2Q24 | $3.568 | −$0.533 | 20 MCG | Formoterol fumarate, inh | v1, posted March 11, 2025 |
| 1Q24 | $4.101 | −$0.778 | 20 MCG | Formoterol fumarate, inh | v1, posted December 19, 2024 |
| 4Q23 | $4.879 | −$0.31 | 20 MCG | Formoterol fumarate, inh | v1, posted October 10, 2024 |
| 3Q23 | $5.189 | −$1.138 | 20 MCG | Formoterol fumarate, inh | v1, posted June 5, 2024 |
| 2Q23 | $6.327 | −$0.141 | 20 MCG | Formoterol fumarate, inh | v1, posted February 23, 2024 |
| 1Q23 | $6.468 | −$0.308 | 20 MCG | Formoterol fumarate, inh | v1, posted December 6, 2023 |
| 4Q22 | $6.776 | −$1.015 | 20 MCG | Formoterol fumarate, inh | v1, posted June 22, 2023 |
| 3Q22 | $7.791 | −$1.127 | 20 MCG | Formoterol fumarate, inh | v1, posted June 9, 2023 |
| 2Q22 | $8.918 | −$0.958 | 20 MCG | Formoterol fumarate, inh | v1, posted December 14, 2022 |
| 1Q22 | $9.876 | −$1.541 | 20 MCG | Formoterol fumarate, inh | v1, posted June 8, 2022 |
| 4Q21 | $11.417 | −$0.197 | 20 MCG | Formoterol fumarate, inh | v1, posted June 2, 2022 |
| 3Q21 | $11.614 | +$0.597 | 20 MCG | Formoterol fumarate, inh | v1, posted June 2, 2022 |
| 2Q21 | $11.017 | −$0.639 | 20 MCG | Formoterol fumarate, inh | v1, posted March 1, 2022 |
| 1Q21 | $11.656 | – | 20 MCG | Formoterol fumarate, inh | v1, posted December 10, 2021 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.