Kroger Chest Congestion Relief Tablet
NDC Package 30142-472-30

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

Package Information

Kroger Chest Congestion Relief (dextromethorphan hydrobromide / guaifenesin) tablets is ■ Adults and children 12 years of age and over:take 1 tablet every 4 hours as needed.■ Children 6 to 10 under 12 years of age: take 1/2 tablet every 4 hours as needed.■ Children under 6 years of age: consult a doctor. This formulation utilizes a tablet delivery system. Marketed by The Kroger Co, this product is identified by NDC 30142-472 and is authorized under FDA application M012.

Identification & Billing

NDC Package Code
30142-472-30
Package Description
1 BOTTLE in 1 CARTON / 30 TABLET in 1 BOTTLE
Product Code
30142-472
11-Digit Billing Format
30142047230
RxNorm Crosswalk
  • RxCUI: 1147685 - dextromethorphan HBr 20 MG / guaiFENesin 400 MG Oral Tablet
  • RxCUI: 1147685 - dextromethorphan hydrobromide 20 MG / guaifenesin 400 MG Oral Tablet
  • RxCUI: 1147685 - guaifenesin 400 MG / dextromethorphan HBr 20 MG Oral Tablet

Clinical Specifications

Proprietary Name
Kroger Chest Congestion Relief DM
Non-Proprietary Name
Dextromethorphan Hydrobromide / Guaifenesin
Substance Name
Dextromethorphan Hydrobromide; Guaifenesin
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)
Pharmacologic Class
Usage Information
■ Adults and children 12 years of age and over:take 1 tablet every 4 hours as needed.■ Children 6 to 10 under 12 years of age: take 1/2 tablet every 4 hours as needed.■ Children under 6 years of age: consult a doctor.    Do not exceed 6 doses in a 24 hour period or as directed by a doctor

Regulatory & Marketing

Labeler Name
The Kroger Co
Product Type
Human Otc Drug
FDA Application #
M012
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
03-10-2021
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 30142-472-30 identifies a specific commercial package of 1 bottle in 1 carton / 30 tablet in 1 bottle of Kroger Chest Congestion Relief DM, a human over the counter drug labeled by The Kroger Co. This tablet is formulated for oral use and contains dextromethorphan hydrobromide; guaifenesin 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 The Kroger Co on March 10, 2021. The current certification is valid through December 31, 2026.

How is this The Kroger Co product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 30142047230. 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)
30142-472-30
11-Digit CMS (5-4-2)
30142-0472-30

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