Magnesium Hydroxide
NDC Package 21695-903-16

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
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.

Magnesium Hydroxide is laxative: ° shake well before using ° drink a full glass (8 ounces) of liquid with each dose ° may be taken as a single or divided doseAntacid: ° do not take more than 12 teaspoons in 24 hours ° do not use maximum dosage for more than 2 weeksLaxative:adults and children 12 years and older: 2 to 4 tablespoons children 6 to under 12 years: 1 to 2 tablespoonschildren 2 to under 6 years: 1 to 3 teaspoonschildren under 2 years: ask a doctorAntacid:adults and children 12 years and older: 1 to 3 teaspoons with water, up to 4 times dailychildren under 12 years: ask a doctor. Marketed by Rebel Distributors Corp, this product is identified by NDC 21695-903 and is authorized under FDA application part331.

Identification & Billing

NDC Package Code
21695-903-16
Package Description
473 mL in 1 BOTTLE
Product Code
21695-903
11-Digit Billing Format
21695090316
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
Units Per Package
473 ML
RxNorm Crosswalk
  • RxCUI: 253017 - magnesium hydroxide 1200 MG in 15 mL Oral Suspension
  • RxCUI: 253017 - magnesium hydroxide 80 MG/ML Oral Suspension
  • RxCUI: 253017 - magnesium hydroxide 1200 MG per 15 ML Oral Suspension
  • RxCUI: 253017 - milk of magnesia 2400 MG per 30 ML Oral Suspension
  • RxCUI: 253017 - milk of magnesia 400 MG per 5 ML Oral Suspension

Clinical Specifications

Proprietary Name
Magnesium Hydroxide
Dosage Form
-
Usage Information
Laxative: ° shake well before using ° drink a full glass (8 ounces) of liquid with each dose ° may be taken as a single or divided doseAntacid: ° do not take more than 12 teaspoons in 24 hours ° do not use maximum dosage for more than 2 weeksLaxative:adults and children 12 years and older: 2 to 4 tablespoons children 6 to under 12 years: 1 to 2 tablespoonschildren 2 to under 6 years: 1 to 3 teaspoonschildren under 2 years: ask a doctorAntacid:adults and children 12 years and older: 1 to 3 teaspoons with water, up to 4 times dailychildren under 12 years: ask a doctor

Regulatory & Marketing

Labeler Name
Rebel Distributors Corp
FDA Application #
part331
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
03-22-2010
Listing Expiration
12-31-2017
Exclude Flag
I
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 21695-903-16 identifies a specific commercial package of 473 ml in 1 bottle of Magnesium Hydroxide, labeled by Rebel Distributors Corp. This product is billed per "ML" milliliter and contains an estimated amount of 473 billable units per package. This is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

This product code is currently listed as inactive or excluded from the primary directory. It was introduced to the market by Rebel Distributors Corp on March 22, 2010. The current certification is valid through December 31, 2017.

How is this Rebel Distributors Corp product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 21695090316. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. There are 473 total billable units per package. 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)
21695-903-16
11-Digit CMS (5-4-2)
21695-0903-16

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