Dollar General Effervescent Pain Reliever Tablet, Effervescent
NDC Package 55910-040-36

11-digit billing NDC: 55910004036
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

Dollar General Effervescent Pain Reliever (aspirin) tablets is ■ do not exceed recommended dosage■ to avoid serious injury, completely dissolve tablets in 4 oz. This formulation utilizes a tablet, effervescent delivery system. Marketed by Dolgencorp, Inc, this product is identified by NDC 55910-040 and is authorized under FDA application M013.

Identification & Billing

NDC Package Code
55910-040-36
Package Description
18 POUCH in 1 CARTON / 2 TABLET, EFFERVESCENT in 1 POUCH
Product Code
55910-040
11-Digit Billing Format
55910004036
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Dollar General Effervescent Pain Reliever
Non-Proprietary Name
Aspirin
Substance Name
Aspirin
Dosage Form
Tablet, Effervescent - A solid dosage form containing mixtures of acids (e.g., citric acid, tartaric acid) and sodium bicarbonate, which release carbon dioxide when dissolved in water; it is intended to be dissolved or dispersed in water before administration.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
ASPIRIN 325 mg/1
Pharmacologic Class
Usage Information
■ do not exceed recommended dosage■ to avoid serious injury, completely dissolve tablets in 4 oz. of water before takingadults and children 12 years and over: 2 tablets every 4 hours, or as directed by a doctor - do not exceed 8 tablets in 24 hours60 years and over: 2 tablets every 4 hours, or as directed by a doctor - do not exceed 4 tablets in 24 hourschildren under 12 years: consult a doctorTake this product any time – morning, noon or night – when you need relief from headaches, backaches, body aches or muscle pain.Place two (2) tablets in 4 oz. of water. Dissolve tablets completely.You do not have to drink any of the residue that may be on the bottom of the glass. The medicines are in the water.

Regulatory & Marketing

Labeler Name
Dolgencorp, Inc
Product Type
Human Otc Drug
FDA Application #
M013
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
08-01-2024
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 55910-040-36 identifies a specific commercial package of 18 pouch in 1 carton / 2 tablet, effervescent in 1 pouch of Dollar General Effervescent Pain Reliever, a human over the counter drug labeled by Dolgencorp, Inc. This tablet, effervescent is formulated for oral use and contains aspirin 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 Dolgencorp, Inc on August 01, 2024. The current certification is valid through December 31, 2026.

How is this Dolgencorp, Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 55910004036. 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)
55910-040-36
11-Digit CMS (5-4-2)
55910-0040-36

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