Signature Care Maximum Strength Urinary Pain Relief Tablet
NDC Package 21130-792-24

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

Package Information

Signature Care Maximum Strength Urinary Pain Relief (phenazopyridine hydrochloride) tablets is ■ adults and children 12 years and over:take 2 tablets 3 times daily with a full glass of water, with or after meals as needed■ children under 12 years: consult a doctor■ Do not use for more than 2 days (12 tablets) without consulting a doctor. This formulation utilizes a tablet delivery system. Marketed by Safeway, this product is identified by NDC 21130-792.

Identification & Billing

NDC Package Code
21130-792-24
Package Description
1 BLISTER PACK in 1 CARTON / 24 TABLET in 1 BLISTER PACK
Product Code
21130-792
11-Digit Billing Format
21130079224
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Signature Care Maximum Strength Urinary Pain Relief
Non-Proprietary Name
Phenazopyridine Hydrochloride
Substance Name
Phenazopyridine Hydrochloride
Dosage Form
Tablet - A solid dosage form containing medicinal substances with or without suitable diluents.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
PHENAZOPYRIDINE HYDROCHLORIDE 99.5 mg/1
Usage Information
■ adults and children 12 years and over:take 2 tablets 3 times daily with a full glass of water, with or after meals as needed■ children under 12 years: consult a doctor■ Do not use for more than 2 days (12 tablets) without consulting a doctor

Regulatory & Marketing

Labeler Name
Safeway
Product Type
Human Otc Drug
Marketing Category
UNAPPROVED DRUG OTHER - An unapproved drug product in a marketing category that is not reflected on a particular list.
Start Marketing Date
12-23-2019
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 21130-792-24 identifies a specific commercial package of 1 blister pack in 1 carton / 24 tablet in 1 blister pack of Signature Care Maximum Strength Urinary Pain Relief, a human over the counter drug labeled by Safeway. This tablet is formulated for oral use and contains phenazopyridine hydrochloride 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 December 23, 2019. 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: 21130079224. 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)
21130-792-24
11-Digit CMS (5-4-2)
21130-0792-24

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