Kroger Cool Mint Boost Mouth
NDC Package 30142-978-33

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.

Kroger Cool Mint Boost Mouth is adults and children 12 years of age and older: vigorously swish 20 milliliters of rinse between your teeth twice a day for 30 seconds and then spit out. Marketed by The Kroger Company, this product is identified by NDC 30142-978 and is authorized under FDA application part356.

Identification & Billing

NDC Package Code
30142-978-33
Package Description
1000 mL in 1 BOTTLE, PLASTIC
Product Code
30142-978
11-Digit Billing Format
30142097833
RxNorm Crosswalk
  • RxCUI: 1043619 - eucalyptol 0.092 % / menthol 0.042 % / methyl salicylate 0.06 % / thymol 0.064 % Mouthwash
  • RxCUI: 1043619 - eucalyptol 0.92 MG/ML / menthol 0.42 MG/ML / methyl salicylate 0.6 MG/ML / thymol 0.64 MG/ML Mouthwash

Clinical Specifications

Proprietary Name
Kroger Cool Mint Boost Mouth
Dosage Form
-
Usage Information
Adults and children 12 years of age and older: vigorously swish 20 milliliters of rinse between your teeth twice a day for 30 seconds and then spit out. Do not swallowChildren 6 years to under 12 years of age: supervise use.Children under 6 years of age: do not use

Regulatory & Marketing

Labeler Name
The Kroger Company
FDA Application #
part356
Marketing Category
OTC MONOGRAPH NOT FINAL - A product marketed pursuant to an Over-the-Counter (OTC) Drug Monograph that is not final.
Start Marketing Date
02-14-2018
Listing Expiration
12-31-2023
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 30142-978-33 identifies a specific commercial package of 1000 ml in 1 bottle, plastic of Kroger Cool Mint Boost Mouth, labeled by The Kroger Company. 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 The Kroger Company on February 14, 2018. The current certification is valid through December 31, 2023.

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

For medical billing and reimbursement, this package follows the 11-digit CMS format: 30142097833. 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)
30142-978-33
11-Digit CMS (5-4-2)
30142-0978-33

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