NDC codes

FDA NDC Directory
Product NDC (as listed)11822-9996Labeler and product segments. Claims need a package NDC.
Product NDC at billing width11822-9996Add the package segment from the table below.
Package NDCs as listed with the FDA, and the 11-digit 5-4-2 form used on claims. The highlighted digit is the added leading zero.
Package NDC11-digit (billing)PackageCopy
11822-9996-1118229996011 BLISTER PACK in 1 CARTON (11822-9996-1) / 14 TABLET, EXTENDED RELEASE in 1 BLISTER PACKMarketed from Jun 28, 2022
11822-9996-2118229996022 BLISTER PACK in 1 CARTON (11822-9996-2) / 14 TABLET, EXTENDED RELEASE in 1 BLISTER PACKMarketed from Jun 28, 2022

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 5-4-2). Formatting the NDC does not by itself make it billable — the product, package and quantity must match what was dispensed or administered, and payer rules apply. Conversion rules

Product information

Brand name (proprietary)
Guaifenesin and Dextromethorphan Hydrobromide HBR
Generic name (nonproprietary)
guaifenesin and dextromethorphan hydrobromide
Active ingredients
Guaifenesin — 1200 mg/1Dextromethorphan hydrobromide — 60 mg/1
Dosage form
Tablet, Extended release
Route
Oral
Labeler
RITE-AID
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 214781
Marketing start
Listing expires
Other FDA classes
Decreased Respiratory Secretion Viscosity (Physiologic effect)Increased Respiratory Secretions (Physiologic effect)Sigma-1 Receptor Agonists (Mechanism)Uncompetitive NMDA Receptor Antagonists (Mechanism)
Identifiers
Product ID 11822-9996_3b1ee432-8657-4ef6-9b89-cf0127157e64SPL ID 3b1ee432-8657-4ef6-9b89-cf0127157e64SPL set ID 2343f031-d658-498a-b5d1-6dcdb26b3cf0RxCUI 1099074UNII 495W7451VQ, 9D2RTI9KYH
Pharmacologic class
Expectorant; Sigma-1 Agonist; Uncompetitive N-methyl-D-aspartate Receptor Antagonist

Billing references

What Med-Code can say about coding this product, and where each statement comes from. Nothing here is inferred from the name alone.

HCPCS codeNo match

No HCPCS code in Med-Code's directory. Oral products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N411822999601 followed by a unit qualifier and the quantity

Package 11822-9996-01. Unit qualifiers: F2 (international unit), GR (gram), ME (milligram), ML (milliliter), UN (unit (each)). The qualifier and quantity depend on what was given. About the N4 qualifier

Product label

Current FDA label (SPL), effective .

Indications (excerpt from the label)

Uses helps loosen phlegm (mucus) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and make coughs more productive temporarily relieves: cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants the intensity of coughing the impulse to cough to help you get to sleep

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 214781

Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.

FDA NDC Directory listings under ANDA 214781
ProductStrengthForm · routeLabelerProduct NDC
Guaifenesin and Dextromethorphan HBrGuaifenesin 600 mg/1; Dextromethorphan hydrobromide 30 mg/1Tablet, Extended releaseOralPUBLIX SUPER MARKETS, INC41415-998
Guaifenesin and Dextromethorphan HBrGuaifenesin 1200 mg/1; Dextromethorphan hydrobromide 60 mg/1Tablet, Extended releaseOralPUBLIX SUPER MARKETS, INC41415-999
Mucus Relief - DM Maximum Strengthguaifenesin, dextromethorphan hbrDextromethorphan hydrobromide 60 mg/1; Guaifenesin 1200 mg/1Tablet, Extended releaseOralYYBA CORP73581-405
Guaifenesin and Dextromethorphan HBrGuaifenesin 1200 mg/1; Dextromethorphan hydrobromide 60 mg/1Tablet, Extended releaseOralOHM LABORATORIES INC51660-110
Guaifenesin and Dextromethorphan HBrGuaifenesin 600 mg/1; Dextromethorphan hydrobromide 30 mg/1Tablet, Extended releaseOralOHM LABORATORIES INC51660-301
Guaifenesin and Dextromethorphan HBrGuaifenesin 600 mg/1; Dextromethorphan hydrobromide 30 mg/1Tablet, Extended releaseOralSUN PHARMACEUTICAL INDUSTRIES, INC.63304-106
Guaifenesin and Dextromethorphan HBrGuaifenesin 1200 mg/1; Dextromethorphan hydrobromide 60 mg/1Tablet, Extended releaseOralSUN PHARMACEUTICAL INDUSTRIES, INC.63304-110
Guaifenesin And Dextromethorphan HBrGuaifenesin 600 mg/1; Dextromethorphan hydrobromide 30 mg/1Tablet, Extended releaseOralKroger Company30142-948
Guaifenesin And Dextromethorphan HBrGuaifenesin 1200 mg/1; Dextromethorphan hydrobromide 60 mg/1Tablet, Extended releaseOralKroger Company30142-963
Guaifenesin and Dextromethorphan HydrobromideGuaifenesin 1200 mg/1; Dextromethorphan hydrobromide 60 mg/1Tablet, Extended releaseOralCVS PHARMACY, INC51316-600

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