Over-the-counter drug · OTC MONOGRAPH DRUG
Daytime Nighttime Cold Flu Relief NDC 21130-058
acetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl · Kit · Safeway, Inc.
NDC codes
FDA NDC DirectoryProduct NDC (as listed)21130-058Labeler and product segments. Claims need a package NDC.
Product NDC at billing width21130-0058Add the package segment from the table below.
| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 21130-058-48 | 2113000584821130005848 | 1 KIT in 1 KIT (21130-058-48) * 16 BLISTER PACK in 1 CARTON / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK * 32 BLISTER PACK in 1 CARTON / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACKMarketed from Jun 30, 2019 |
How the 11-digit form is made: The product segment has 3 digits, so one leading zero is added to it (5-3-2 → 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)
- Daytime Nighttime Cold Flu Relief
- Generic name (nonproprietary)
- acetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl
- Dosage form
- Kit
- Labeler
- Safeway, Inc.NDC labeler code 21130
- Product type
- Over-the-counter drug
- Marketing category
- OTC monograph drugApplication M 012
- Marketing start
- Listing expires
- Identifiers
- Product ID 21130-058_70be45e9-99a9-4f46-8a28-fddd8cabe3cfSPL ID 70be45e9-99a9-4f46-8a28-fddd8cabe3cfSPL set ID a8df5c04-0f92-4013-b3e5-2b45009a7b8dRxCUI 1086997, 1094549, 2634564
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 drug-specific HCPCS code in Med-Code's directory for this product. The directory is curated and not complete — check the current CMS HCPCS file before billing.
- NDC on a medical claim
N421130005848followed by a unit qualifier and the quantityPackage 21130-0058-48. 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 DAYTIME temporarily relieves common cold and flu symptoms cough due to minor throat and bronchial irritation nasal congestion headache minor aches and pains fever sore throat NIGHTTIME temporarily relieves common cold and flu symptoms cough due to minor throat and bronchial irritation sore throat headache minor aches and pains fever runny nose and sneezing
Excerpt only. Read the full label for complete information.
About NDC 21130-058
- What is NDC 21130-058?
- 21130-058 is the product NDC for Daytime Nighttime Cold Flu Relief kit, listed with the FDA by Safeway, Inc.. It has 1 package NDC, shown above in 10- and 11-digit form.
- What drug is associated with this NDC?
- Daytime Nighttime Cold Flu Relief (Acetaminophen, Dextromethorphan HBr, Doxylamine succinate, Phenylephrine HCl).
- Who is the labeler?
- Safeway, Inc., NDC labeler code 21130. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
- What other NDCs exist for Daytime Nighttime Cold Flu Relief?
- 13 other product NDCs are listed under this name. See all Daytime Nighttime Cold Flu Relief NDCs.
- Is there a related HCPCS / J-code?
- Not in Med-Code's curated HCPCS directory. See Billing references above.
Related NDCs: other Daytime Nighttime Cold Flu Relief products
Other finished products listed under the same name: strengths, forms and labelers.
| Product | Strength | Form · route | Labeler | Product NDC | Package NDCs (11-digit) |
|---|---|---|---|---|---|
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | Family Dollar (FAMILY WELLNESS) | 55319-566 | 55319-0566-24 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | FSA Store Inc. (Caring Mills) | 81522-901 | 81522-0901-48 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | KitOral | WinCo Foods, LLC | 67091-393 | 67091-0393-48 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | United Natural Foods, Inc. dba UNFI | 41163-901 | 41163-0901-48 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | Harris Teeter, LLC | 69256-901 | 69256-0901-48 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | EQUATE (Wal-Mart Stores, Inc.) (see also WAL-MART INC) | 49035-192 | 49035-0192-48 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | Safeway, Inc. | 21130-901 | 21130-0901-48 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | United Natural Foods, Inc. dba UNFI | 41163-850 | 41163-0850-48 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | Care One (Retail Business Services, LLC.) | 72476-850 | 72476-0850-48 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | Care One (Retail Business Services, LLC.) | 72476-901 | 72476-0901-48 |
Other NDCs under M 012
Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.
| Product | Strength | Form · route | Labeler | Product NDC |
|---|---|---|---|---|
| Cough Reliefdextromethorphan hydrobromide | Dextromethorphan hydrobromide 15 mg/1 | Capsule, Liquid filledOral | Advanced Rx LLC | 80513-311 |
| TARGET Multi Symptom Flu Reliefacetaminophen, dextromethorphan hbr, and acetaminophen, chlorpheniramine maleate, dextromethorphan hbr | — | Kit | TARGET CORPORATION | 82442-559 |
| Geri-Dryl allergy reliefdiphenhydramine hcl | Diphenhydramine hydrochloride 25 mg/1 | Tablet, CoatedOral | VerityRx | 83939-0683 |
| Multi Symptom Cold and Multi Symptom Nighttime Cold Childrensdextromethorphan hbr, guaifenesin, phenylephrine hci, acetaminophen, diphenhydramine hci, phenylephrine hci | — | Kit | TARGET Corporation | 11673-420 |
| Welmedix HomeCare PRO Extra Strength Rapid Rash Reliefpetrolatum, zinc oxide | Petrolatum 49 g/100g; Zinc oxide 15 g/100g | CreamTopical | Welmedix LLC | 24330-410 |
| topcare nite time cold and fluacetaminophen, dextromethorphan hbr, doxylamine succinate | Acetaminophen 325 mg/1 + 2 more ingredients | Capsule, Liquid filledOral | Topco Associates LLC | 36800-143 |
| Allergy Childrensdiphenhydramine hydrochloride | Diphenhydramine hydrochloride 12.5 mg/5mL | LiquidOral | H E B | 37808-012 |
| Mucus Relief Cough Childrensdextromethorphan hbr, guaifensin | Dextromethorphan hydrobromide 5 mg/5mL; Guaifenesin 100 mg/5mL | LiquidOral | H E B | 37808-594 |
| Sunmark Chest Congestion Relief DM DMdextromethorphan hydrobromide / guaifenesin | Dextromethorphan hydrobromide 20 mg/1; Guaifenesin 400 mg/1 | TabletOral | Strategic Sourcing Services LLC | 49348-728 |
| Dual Action Honey Lemon Cough Suppressant Oral Anestheticmenthol | Menthol 8.3 mg/1 | LozengeOral | Ricola Ag | 54305-323 |
| Discount drug mart Extra Moisturizingoxymetazoline hydrochloride | Oxymetazoline hydrochloride .05 g/100mL | SprayNasal | DISCOUNT DRUG MART | 53943-720 |
| Mucus Reliefguaifenesin | Guaifenesin 400 mg/1 | TabletOral | Geri-Care Pharmaceuticals, Corp | 57896-714 |
| Robitussin Maximum Strength Severe Multi-Symptom Cough Cold Flu Nighttimeacetaminophen, diphenhydramine hcl | Acetaminophen 650 mg/20mL; Diphenhydramine hydrochloride 25 mg/20mL | LiquidOral | Haleon US Holdings LLC | 0031-0101 |
| Throat Comfort Orange Mint Cinnamon Dropsmenthol | Menthol 3.6 mg/1 | LozengeOral | Ricola USA Inc. | 63667-342 |
| Non-Drowsy Sinus Severe, Circle Kacetaminophen, guaifenesin, phenylephrine hcl caplet, film-coated | Guaifenesin 200 mg/1 + 2 more ingredients | Tablet, Film coatedOral | Lil' Drug Store products, Inc. | 66715-5632 |
| COLD, Flu and Sore Throatacetaminophen, guaifenesin, dextromethorphan hydrobromide, and phenylephrine hydrochloride | Acetaminophen 325 mg/1 + 3 more ingredients | Capsule, Liquid filledOral | Walgreens | 0363-9016 |
| Mucus Relief All in One Maximum Strengthacetaminophen, diphenhydramine hcl phenylephrine hcl | Acetaminophen 650 mg/20mL + 2 more ingredients | LiquidOral | Walgreens | 0363-9130 |
| Pyrilamine Maleate and Dextromethorphan Hydrobromide | Dextromethorphan hydrobromide 7.5 mg/5mL; Pyrilamine maleate 7.5 mg/5mL | LiquidOral | Westminster Pharmaceuticals, LLC | 69367-398 |
| Daytime Cold and Flu Relief Liquid Filled Softgelsacetaminophen, dextromethorphan hbr, phenylephrine hcl | Acetaminophen 325 mg/1 + 2 more ingredients | Capsule, Liquid filledOral | AptaPharma Inc. | 76281-604 |
| Cough Dropsmenthol | Menthol 5.8 mg/1 | PastilleOral | Topco Associates LLC | 76162-016 |
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