What is NDC 21130-569?

21130-569 is the product NDC for Signature Care Migraine Relief, Acetaminophen 250 mg/1 + 2 more ingredients tablet, film coated, listed with the FDA by Safeway. It has 3 package NDCs, shown above in 10- and 11-digit form.

What drug is associated with this NDC?

Signature Care Migraine Relief (Acetaminophen, Aspirin, Caffeine).

What is the active ingredient?

Acetaminophen, Aspirin, Caffeine.

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 Signature Care Migraine Relief?

None: this is the only finished product listed under this name.

Is there a related HCPCS / J-code?

Not in Med-Code's curated HCPCS directory.

Signature Care Migraine Relief NDC 21130-569

NDC codes

FDA NDC Directory

Product NDC (as listed)21130-569Labeler and product segments. Claims need a package NDC.

Product NDC at billing width21130-0569Add 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
21130-569-62	2113005696221130056962	1 BOTTLE in 1 CARTON (21130-569-62) / 24 TABLET, FILM COATED in 1 BOTTLEMarketed from Sep 1, 2015
21130-569-71	2113005697121130056971	1 BOTTLE in 1 CARTON (21130-569-71) / 50 TABLET, FILM COATED in 1 BOTTLEMarketed from Sep 1, 2015
21130-569-78	2113005697821130056978	1 BOTTLE in 1 CARTON (21130-569-78) / 100 TABLET, FILM COATED in 1 BOTTLEMarketed from Sep 1, 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): Signature Care Migraine Relief
Generic name (nonproprietary): acetaminophen, aspirin, caffeine
Active ingredients: Acetaminophen — 250 mg/1Aspirin — 250 mg/1Caffeine — 65 mg/1
Dosage form: Tablet, Film coated
Route: Oral
Labeler: SafewayNDC labeler code 21130
Product type: Over-the-counter drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 075794
Marketing start: Sep 1, 2015
Listing expires: Dec 31, 2026
Other FDA classes: Non-Steroidal (Chemical structure)Central Nervous System Stimulation (Physiologic effect)Cyclooxygenase Inhibitors (Mechanism)Decreased Platelet Aggregation (Physiologic effect)Decreased Prostaglandin Production (Physiologic effect)Xanthines (Chemical structure)
Identifiers: Product ID 21130-569_1e6e02b1-e02b-470a-ab77-ffac79e5c7f6SPL ID 1e6e02b1-e02b-470a-ab77-ffac79e5c7f6SPL set ID 66695667-97a3-4329-8ce0-0fffa8628951RxCUI 308297UNII 362O9ITL9D, R16CO5Y76E, 3G6A5W338E
Pharmacologic class: Central Nervous System Stimulant; Methylxanthine; Nonsteroidal Anti-inflammatory Drug; Platelet Aggregation Inhibitor

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

N421130056962 followed by a unit qualifier and the quantity

Package 21130-0569-62. 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 Mar 27, 2024.

Indications (excerpt from the label)

Use • treats migraine

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 21130-569

What is NDC 21130-569?: 21130-569 is the product NDC for Signature Care Migraine Relief, Acetaminophen 250 mg/1 + 2 more ingredients tablet, film coated, listed with the FDA by Safeway. It has 3 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Signature Care Migraine Relief (Acetaminophen, Aspirin, Caffeine).
What is the active ingredient?: Acetaminophen, Aspirin, Caffeine.
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 Signature Care Migraine Relief?: None: this is the only finished product listed under this name.
Is there a related HCPCS / J-code?: Not in Med-Code's curated HCPCS directory. See Billing references above.

Other NDCs under ANDA 075794

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

FDA NDC Directory listings under ANDA 075794
Product	Strength	Form · route	Labeler	Product NDC
basic care migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Amazon.com Services LLC	72288-295
basic care migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Amazon.com Services LLC	72288-374
Care One migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	American Sales Company	41520-374
DG Health migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Dolgencorp, LLC	55910-374
dg health migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Dolgencorp Inc	55910-448
Equaline migraine formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	United Natural Foods, Inc. dba UNFI	41163-374
foster and thrive migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Strategic Sourcing Services LLC	70677-1133
good neighbor pharmacy migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Amerisource Bergen	24385-365
good sense migraine formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	L. Perrigo Company	0113-0374
good sense migraine formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	L. Perrigo Company	0113-1619
good sense migraine formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Proficient Rx LP	82804-002
good sense migraine formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Sportpharm LLC	85766-180
Leader Migraine Reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Cardinal Health 110, LLC. dba Leader	70000-0247
leader migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Cardinal Health 110, LLC. dba Leader	70000-0611
migraine formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	H E B	37808-374
migraine formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Meijer Distribution Inc	41250-374
migraine formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	HyVee Inc	42507-374
Migraine Formulaacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Meijer, Inc.	79481-0211
migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Walgreen Company	0363-0374
migraine reliefacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	Tablet, Film coatedOral	Walgreen Company	0363-1235

Showing 20 of 27.

Signature Care Migraine Relief (Acetaminophen, aspirin, caffeine) NDC 21130-569