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  5. NDC Package Code: 21130-383-04 Adult Cough Relief Dm

NDC Package 21130-383-04 Adult Cough Relief Dm

Dextromethorphan Hbr Liquid Oral - View Billable Units, 11-Digit Format, RxNorm

Table of Contents

    1. Package Information
    2. Frequently Asked Questions

Package Information

Find all the important details about this NDC Package code, including the 11-Digit NDC Billing number, billing units, wholesale price, RxNorm crosswalk, active ingredients, pharmacologic clasess, etc.

NDC Package Code:
21130-383-04
Package Description:
1 BOTTLE, PLASTIC in 1 BOX / 118 mL in 1 BOTTLE, PLASTIC
Product Code:
21130-383
Proprietary Name:
Adult Cough Relief Dm
Non-Proprietary Name:
Dextromethorphan Hbr
Substance Name:
Dextromethorphan Hydrobromide
Usage Information:
This medication is used for temporary relief of coughs without phlegm that are caused by certain infections of the air passages (e.g., sinusitis, common cold). This product should not usually be used for an ongoing cough from smoking or long-term breathing problems (e.g., chronic bronchitis, emphysema) unless directed by your doctor. This product contains dextromethorphan. It is a cough suppressant that works by decreasing the feeling of needing to cough. Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Ask your doctor or pharmacist for more details about using your product safely. These products do not cure or shorten the length of the common cold and may cause serious side effects. To decrease the risk for serious side effects, carefully follow all dosage directions. Do not use this product to make a child sleepy. Do not give other cough-and-cold medication that might contain the same or similar ingredients (see also Drug Interactions section). Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).
11-Digit NDC Billing Format:
21130038304
NDC to RxNorm Crosswalk:
  • RxCUI: 1090496 - dextromethorphan HBr 15 MG in 5 mL Oral Solution
  • RxCUI: 1090496 - dextromethorphan hydrobromide 3 MG/ML Oral Solution
  • RxCUI: 1090496 - dextromethorphan hydrobromide 15 MG per 5 ML Oral Solution
  • RxCUI: 1090496 - dextromethorphan hydrobromide 30 MG per 10 ML Oral Solution
    • Product Type:
    Human Otc Drug
    Labeler Name:
    Safeway, Inc.
    Dosage Form:
    Liquid - A dosage form consisting of a pure chemical in its liquid1 state. This dosage form term should not be applied to solutions.
    Administration Route(s):
  • Oral - Administration to or by way of the mouth.
    • Active Ingredient(s):
  • DEXTROMETHORPHAN HYDROBROMIDE 30 mg/10mL
    • Pharmacologic Class(es):
  • Sigma-1 Agonist - [EPC] (Established Pharmacologic Class)
  • Sigma-1 Receptor Agonists - [MoA] (Mechanism of Action)
  • Uncompetitive N-methyl-D-aspartate Receptor Antagonist - [EPC] (Established Pharmacologic Class)
  • Uncompetitive NMDA Receptor Antagonists - [MoA] (Mechanism of Action)
    • Sample Package:
    No
    FDA Application Number:
    part341
    Marketing Category:
    OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
    Start Marketing Date:
    06-30-2014
    End Marketing Date:
    06-30-2025
    Exclude Flag:
    N
    Code Structure:

    The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

    * Please review the disclaimer below.

    Frequently Asked Questions

    What is NDC 21130-383-04?

    The NDC Packaged Code 21130-383-04 is assigned to a package of 1 bottle, plastic in 1 box / 118 ml in 1 bottle, plastic of Adult Cough Relief Dm, a human over the counter drug labeled by Safeway, Inc.. The product's dosage form is liquid and is administered via oral form.

    Is NDC 21130-383 included in the NDC Directory?

    Yes, Adult Cough Relief Dm with product code 21130-383 is active and included in the NDC Directory. The product was first marketed by Safeway, Inc. on June 30, 2014.

    What is the 11-digit format for NDC 21130-383-04?

    The 11-digit format is 21130038304. The 11-digit billing format might be required by the Centers for Medicare & Medicaid Services (CMS) and other payers in billing claim forms.

    This package code is originally configured in a 5-3-2 segment 10-digit format and by adding a zero within the original NDC package code we can obtain the converted 11-digit format in a 5-4-2 segment configuration. The table below shows the 11-digit code conversion:

    10-Digit Format10-Digit Original Code11-Digit Format11-Digit Code
    5-3-221130-383-045-4-221130-0383-04