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  5. NDC Package Code: 21130-817-58 Severe Congestion And Cough Relief

NDC Package 21130-817-58 Severe Congestion And Cough Relief

View Billable Units, 11-Digit Format, RxNorm

Table of Contents

    1. Package Information
    2. Frequently Asked Questions

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was inactivated by the FDA.

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:
21130-817-58
Package Description:
177 mL in 1 BOTTLE
Product Code:
21130-817
Proprietary Name:
Severe Congestion And Cough Relief
Usage Information:
Do not take more than 6 doses in 24-hour periodmeasure only with dosing cup provideddo not use dosing cup  with other productsdose as follows or as directed by a doctorAdults and children 12 years and older: 20 mL  in dosing cup provided every 4 hoursChildren under 12 years of age: Do not use
11-Digit NDC Billing Format:
21130081758
NDC to RxNorm Crosswalk:
  • RxCUI: 1043543 - dextromethorphan HBr 5 MG / guaiFENesin 100 MG / phenylephrine HCl 2.5 MG in 5 mL Oral Solution
  • RxCUI: 1043543 - dextromethorphan hydrobromide 1 MG/ML / guaifenesin 20 MG/ML / phenylephrine hydrochloride 0.5 MG/ML Oral Solution
  • RxCUI: 1043543 - dextromethorphan HBr 20 MG / guaifenesin 400 MG / phenylephrine HCl 10 MG per 20 ML Oral Solution
  • RxCUI: 1043543 - dextromethorphan HBr 5 MG / guaifenesin 100 MG / phenylephrine HCl 2.5 MG per 5 ML Oral Solution
    • Labeler Name:
    Safeway
    Sample Package:
    No
    Start Marketing Date:
    11-11-2015
    Listing Expiration Date:
    12-31-2023
    Exclude Flag:
    I
    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 21130-817-58?

    The NDC Packaged Code 21130-817-58 is assigned to a package of 177 ml in 1 bottle of Severe Congestion And Cough Relief, labeled by Safeway. The product's dosage form is and is administered via form.

    Is NDC 21130-817 included in the NDC Directory?

    No, Severe Congestion And Cough Relief with product code 21130-817 is excluded from the NDC Directory because it's listing has been INACTIVATED by FDA. The product was first marketed by Safeway on November 11, 2015 and its listing in the NDC Directory is set to expire on December 31, 2023 if the product is not updated or renewed by the manufacturer.

    What is the 11-digit format for NDC 21130-817-58?

    The 11-digit format is 21130081758. 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
    5-3-221130-817-585-4-221130-0817-58