What is NDC 21130-508?

21130-508 is the product NDC for Antacid, Aluminum hydroxide 400 mg/5mL + 2 more ingredients suspension, listed with the FDA by Safeway. It has 1 package NDC, shown above in 10- and 11-digit form.

What drug is associated with this NDC?

Antacid (Aluminum Hydroxide, Magnesium Hydroxide and Simethicone).

What is the active ingredient?

Aluminum hydroxide, Magnesium hydroxide, Dimethicone.

Safeway, 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 Antacid?

16 other product NDCs are listed under this name.

Is there a related HCPCS / J-code?

Not in Med-Code's curated HCPCS directory.

Antacid NDC 21130-508 | National Drug Code

NDC codes

FDA NDC Directory

Product NDC (as listed)21130-508Labeler and product segments. Claims need a package NDC.

Product NDC at billing width21130-0508Add 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 NDC	11-digit (billing)	Package	Copy
21130-508-05	2113005080521130050805	177 mL in 1 BOTTLE (21130-508-05)Marketed from Dec 12, 2015

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): Antacid
Generic name (nonproprietary): aluminum hydroxide, magnesium hydroxide and simethicone
Active ingredients: Aluminum hydroxide — 400 mg/5mLMagnesium hydroxide — 400 mg/5mLDimethicone — 40 mg/5mL
Dosage form: Suspension
Route: Oral
Labeler: SafewayNDC labeler code 21130
Product type: Over-the-counter drug
Marketing category: OTC monograph (final)Application part332
Marketing start: Dec 12, 2015
Listing expires: Dec 31, 2026
Other FDA classes: Increased Large Intestinal Motility (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Small Intestine Fluid/Electrolyte Absorption (Physiologic effect)Magnesium Ion Exchange Activity (Mechanism)Osmotic Activity (Mechanism)Skin Barrier Activity (Physiologic effect)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers: Product ID 21130-508_ac703a32-8e0f-4dd4-b7b8-5fba72b7cd59SPL ID ac703a32-8e0f-4dd4-b7b8-5fba72b7cd59SPL set ID d36b56a4-06f0-47ff-8add-4c327d60be22RxCUI 237870UNII 5QB0T2IUN0, NBZ3QY004S, 92RU3N3Y1OUPC 0321130789567
Pharmacologic class: Calculi Dissolution Agent; Osmotic Laxative

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

N421130050805 followed by a unit qualifier and the quantity

Package 21130-0508-05. 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 Jan 21, 2016.

Indications (excerpt from the label)

Uses relieves: acid indigestion heartburn sour stomach upset stomach and gas associated with these symptoms

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 21130-508

What is NDC 21130-508?: 21130-508 is the product NDC for Antacid, Aluminum hydroxide 400 mg/5mL + 2 more ingredients suspension, listed with the FDA by Safeway. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Antacid (Aluminum Hydroxide, Magnesium Hydroxide and Simethicone).
What is the active ingredient?: Aluminum hydroxide, Magnesium hydroxide, Dimethicone.
Who is the labeler?: Safeway, 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 Antacid?: 16 other product NDCs are listed under this name. See all Antacid NDCs.
Is there a related HCPCS / J-code?: Not in Med-Code's curated HCPCS directory. See Billing references above.

Other finished products listed under the same name: strengths, forms and labelers.

Other Antacid NDCs
Product	Strength	Form · route	Labeler	Product NDC	Package NDCs (11-digit)
Antacidaluminum hydroxide, magnesium hydroxide, simethicone	Aluminum hydroxide 400 mg/10mL + 2 more ingredients	LiquidOral	Guardian Drug Company	53041-509	53041-0509-05
Antacidcalcium carbonate	Calcium carbonate 420 mg/1	TabletOral	ProStat First Aid	58228-0091	58228-0091-01
Antacid	Calcium carbonate 500 mg/g	TabletOral	Xiamen Kang Zhongyuan Biotechnology Co., Ltd.	83698-002	83698-0002-01
Antacidcalcium carbonate	Calcium carbonate 420 mg/1	TabletOral	Trifecta Pharmaceuticals USA LLC	69396-142	69396-0142-0169396-0142-05
Antacidaluminum hydroxide, magnesium hydroxide, simethicone	Aluminum hydroxide 400 mg/10mL + 2 more ingredients	LiquidOral	H E B	37808-554	37808-0554-05
Antacidaluminum hydroxide, magnesium hydroxide, simethicone	Aluminum hydroxide 400 mg/10mL + 2 more ingredients	LiquidOral	Retail Business Services, LLC.	72476-509	72476-0509-05
Antacidaluminum hydroxide, magnesium hydroxide, simethicone	Aluminum hydroxide 400 mg/10mL + 2 more ingredients	LiquidOral	Rugby Laboratories	0536-1293	00536-1293-83
Antacidaluminum hydroxide, magnesium hydroxide, simethicone	Aluminum hydroxide 400 mg/10mL + 2 more ingredients	LiquidOral	Preferred Pharmaceuticals Inc.	68788-8506	68788-8506-03
Antacidaluminum hydroxide, magnesium hydroxide, simethicone	Aluminum hydroxide 800 mg/10mL + 2 more ingredients	LiquidOral	Retail Business Services, LLC.	72476-516	72476-0516-05
Antacidcalcium carbonate	Calcium carbonate 750 mg/1	Tablet, ChewableOral	Meijer Distribution Inc	41250-553	41250-0553-20

All 17 Antacid NDCs

Other NDCs under part332

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

FDA NDC Directory listings under part332
Product	Strength	Form · route	Labeler	Product NDC
Antacidaluminum hydroxide, magnesium hydroxide and simethicone	Aluminum hydroxide 400 mg/5mL + 2 more ingredients	SuspensionOral	CVS	69842-508
Family Wellness Extra Strength Gas Relief Cherrysimethicone	Dimethicone 125 mg/1	Tablet, ChewableOral	Family Dollar Services, Inc.	55319-134
Gas Reliefsimethicone	Dimethicone 80 mg/1	Tablet, ChewableOral	Advance Pharmaceutical Inc.	17714-019
Gas Reliefsimethicone	Dimethicone 125 mg/1	Tablet, ChewableOral	Safeway	21130-135
Infants Non-staining Gas reliefsimethicone	Dimethicone 20 mg/.3mL	Solution/ dropsOral	H E B	37808-014
Simethicone	Dimethicone 125 mg/1	Tablet, ChewableOral	Advance Pharmaceutical Inc.	17714-040
Simethicone	Dimethicone 80 mg/1	Tablet, ChewableOral	Richmond Pharmaceuticals, Inc.	54738-518