Acetaminophen, Dextromethorphan Hbr, Guailfenesin,phenlyephrine Hcl Capsule, Liquid Filled
NDC Package 41226-628-16

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

Package Information

Acetaminophen, Dextromethorphan Hbr, Guailfenesin, Phenlyephrine Hcl capsules is iNDICATIONS & USAGE temporarily relieves these common cold and flu symptoms: nasal congestion - headache - cough - minor aches and pains - sore throat - temporarily reduces fever - promotes nasal and/or sinus drainage - helps . This formulation utilizes a capsule, liquid filled delivery system. Marketed by Kroger Company, this product is identified by NDC 41226-628 and is authorized under FDA application M012.

Identification & Billing

NDC Package Code
41226-628-16
Package Description
16 CAPSULE, LIQUID FILLED in 1 BLISTER PACK
Product Code
41226-628
11-Digit Billing Format
41226062816
RxNorm Crosswalk
  • RxCUI: 1656815 - acetaminophen 325 MG / dextromethorphan HBr 10 MG / guaiFENesin 200 MG / phenylephrine HCl 5 MG Oral Capsule
  • RxCUI: 1656815 - acetaminophen 325 MG / dextromethorphan hydrobromide 10 MG / guaifenesin 200 MG / phenylephrine hydrochloride 5 MG Oral Capsule
  • RxCUI: 1656815 - APAP 325 MG / Dextromethorphan Hydrobromide 10 MG / Guaifenesin 200 MG / Phenylephrine Hydrochloride 5 MG Oral Capsule

Clinical Specifications

Proprietary Name
Acetaminophen, Dextromethorphan Hbr, Guailfenesin, Phenlyephrine Hcl
Non-Proprietary Name
Acetaminophen, Dextromethorphan Hbr, Guailfenesin, Phenlyephrine Hcl
Substance Name
Acetaminophen; Dextromethorphan Hydrobromide; Guaifenesin; Phenylephrine Hydrochloride
Dosage Form
Capsule, Liquid Filled - A solid dosage form in which the drug is enclosed within a soluble, gelatin shell which is plasticized by the addition of a polyol, such as sorbitol or glycerin, and is therefore of a somewhat thicker consistency than that of a hard shell capsule; typically, the active ingredients are dissolved or suspended in a liquid vehicle.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Pharmacologic Class
Usage Information
INDICATIONS & USAGE temporarily relieves these common cold and flu symptoms: nasal congestion - headache - cough - minor aches and pains - sore throat - temporarily reduces fever - promotes nasal and/or sinus drainage - helps ... temporarily relieves these common cold and flu symptoms: nasal congestion headache cough minor aches and pains sore throat temporarily reduces fever promotes nasal and/or sinus drainage helps loosen phlegm (mucus) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and make coughs more productive

Regulatory & Marketing

Labeler Name
Kroger Company
Product Type
Human Otc Drug
FDA Application #
M012
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
12-21-2020
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 41226-628-16 identifies a specific commercial package of 16 capsule, liquid filled in 1 blister pack of Acetaminophen, Dextromethorphan Hbr, Guailfenesin, Phenlyephrine Hcl, a human over the counter drug labeled by Kroger Company. This capsule, liquid filled is formulated for oral use and contains acetaminophen; dextromethorphan hydrobromide; guaifenesin; phenylephrine 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 Kroger Company on December 21, 2020. The current certification is valid through December 31, 2026.

How is this Kroger Company product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 41226062816. 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)
41226-628-16
11-Digit CMS (5-4-2)
41226-0628-16

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