Extra Strength Gas Relief Tablet, Chewable
NDC Package 21130-441-18

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

Extra Strength Gas Relief (simethicone antigas) tablets is ▪adults and Childrens 12 years and older: chew 1 to 2 tablets thoroughly as needed after meals and at bedtime▪do not exceed 4 tablets in a 24 hour period except under the advice and supervision of  a physician. This formulation utilizes a tablet, chewable delivery system. Marketed by Safeway, this product is identified by NDC 21130-441 and is authorized under FDA application M002.

Identification & Billing

NDC Package Code
21130-441-18
Package Description
2 BLISTER PACK in 1 CARTON / 9 TABLET, CHEWABLE in 1 BLISTER PACK
Product Code
21130-441
11-Digit Billing Format
21130044118
RxNorm Crosswalk
RxCUI: 314221 - simethicone 125 MG Chewable Tablet

Clinical Specifications

Proprietary Name
Extra Strength Gas Relief
Non-Proprietary Name
Simethicone Antigas
Substance Name
Dimethicone, Unspecified
Dosage Form
Tablet, Chewable - A solid dosage form containing medicinal substances with or without suitable diluents that is intended to be chewed, producing a pleasant tasting residue in the oral cavity that is easily swallowed and does not leave a bitter or unpleasant after-taste.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
DIMETHICONE, UNSPECIFIED 125 mg/1
Pharmacologic Class
Skin Barrier Activity - [PE] (Physiologic Effect)
Usage Information
▪adults and Childrens 12 years and older: chew 1 to 2 tablets thoroughly as needed after meals and at bedtime▪do not exceed 4 tablets in a 24 hour period except under the advice and supervision of  a physician

Regulatory & Marketing

Labeler Name
Safeway
Product Type
Human Otc Drug
FDA Application #
M002
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
10-01-2020
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

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 full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 21130-441-18 identifies a specific commercial package of 2 blister pack in 1 carton / 9 tablet, chewable in 1 blister pack of Extra Strength Gas Relief, a human over the counter drug labeled by Safeway. This tablet, chewable is formulated for oral use and contains dimethicone, unspecified as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Safeway on October 01, 2020. The current certification is valid through December 31, 2026.

How is this Safeway product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 21130044118. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
21130-441-18
11-Digit CMS (5-4-2)
21130-0441-18

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.