Over-the-counter drug · OTC MONOGRAPH DRUG
Daytime Cold And Flu Relief NDC 21130-638
acetaminophen, dextromethorphan hydrobromide, phenylephrine hydrochloride · Acetaminophen 325 mg/15mL + 2 more ingredients · Solution · Oral · Safeway
NDC codes
FDA NDC DirectoryProduct NDC (as listed)21130-638Labeler and product segments. Claims need a package NDC.
Product NDC at billing width21130-0638Add the package segment from the table below.
| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 21130-638-40 | 2113006384021130063840 | 355 mL in 1 BOTTLE (21130-638-40)Marketed from Sep 30, 2026 |
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 Cold And Flu Relief
- Generic name (nonproprietary)
- acetaminophen, dextromethorphan hydrobromide, phenylephrine hydrochloride
- Active ingredients
- Acetaminophen — 325 mg/15mLDextromethorphan hydrobromide — 10 mg/15mLPhenylephrine hydrochloride — 5 mg/15mL
- Dosage form
- Solution
- Route
- Oral
- Labeler
- SafewayNDC labeler code 21130
- Product type
- Over-the-counter drug
- Marketing category
- OTC monograph drugApplication M 012
- Marketing start
- Listing expires
- Other FDA classes
- Adrenergic alpha1-Agonists (Mechanism)Sigma-1 Receptor Agonists (Mechanism)Uncompetitive NMDA Receptor Antagonists (Mechanism)
- Identifiers
- Product ID 21130-638_3609ce29-3952-4209-8c65-c0c9f72112e2SPL ID 3609ce29-3952-4209-8c65-c0c9f72112e2
- Pharmacologic class
- Sigma-1 Agonist; Uncompetitive N-methyl-D-aspartate Receptor Antagonist; alpha-1 Adrenergic Agonist
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
N421130063840followed by a unit qualifier and the quantityPackage 21130-0638-40. 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
The FDA listing for this product does not reference a label (SPL) set.
About NDC 21130-638
- What is NDC 21130-638?
- 21130-638 is the product NDC for Daytime Cold And Flu Relief, Acetaminophen 325 mg/15mL + 2 more ingredients solution, 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?
- Daytime Cold And Flu Relief (Acetaminophen, dextromethorphan Hydrobromide, Phenylephrine Hydrochloride).
- What is the active ingredient?
- Acetaminophen, Dextromethorphan hydrobromide, Phenylephrine hydrochloride.
- 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 Daytime Cold And Flu Relief?
- 8 other product NDCs are listed under this name. See all Daytime Cold And 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 Cold And 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 Cold and Flu Reliefacetaminophen, dextromethorphan hbr, phenylephrine hcl | Acetaminophen 325 mg/1 + 2 more ingredients | Capsule, Liquid filledOral | SALADO SALES INC. | 57243-604 | 57243-0604-03 |
| Daytime Cold and Flu Reliefacetaminophen dextromethorphan hbr | Acetaminophen 325 mg/15mL; Dextromethorphan hydrobromide 10 mg/15mL | LiquidOral | Family Dollar (FAMILY WELLNESS) | 55319-954 | 55319-0954-12 |
| Daytime Cold And Flu Reliefacetaminophen, dextromethorphan hydrobromide, and phenylephrine hydrochloride | Acetaminophen 325 mg/1 + 2 more ingredients | Capsule, Liquid filledOral | Advanced Rx LLC | 80513-303 | 80513-0303-50 |
| Daytime Cold and Flu Relief | Acetaminophen 325 mg/1 + 2 more ingredients | Capsule, Liquid filledOral | TopCo Associates, LLC | 76162-065 | 76162-0065-16 |
| Daytime Cold and Flu Reliefacetaminophen, dextromethorphan hbr, phenylephrine hcl | Acetaminophen 325 mg/1 + 2 more ingredients | CapsuleOral | BETTER LIVING BRANDS LLC. | 21130-900 | 21130-0900-24 |
| Daytime Cold and Flu Reliefacetaminohpen, dextromethorphan hbr, phenylephrine hcl | Acetaminophen 325 mg/15mL + 2 more ingredients | LiquidOral | CVS PHARMACY | 51316-617 | 51316-0617-12 |
| Daytime Cold and Flu Reliefacetaminohpen, dextromethorphan hbr, guaifenesin phenylephrine hcl | Acetaminophen 650 mg/30mL + 3 more ingredients | LiquidOral | WALGREENS CO. | 0363-7270 | 00363-7270-12 |
| Daytime Cold and Flu Reliefacetaminohpen, dextromethorphan hbr, guaifenesin phenylephrine hcl | Acetaminophen 650 mg/30mL + 3 more ingredients | LiquidOral | The Kroger Co. | 30142-722 | 30142-0722-12 |
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 |
|---|---|---|---|---|
| Tukol Cough and Congestiondextromethorphan hydrobromide, guaifenesin, and phenylephrine hydrochloride | Dextromethorphan hydrobromide 10 mg/5mL + 2 more ingredients | SyrupOral | Genomma Lab USA | 50066-510 |
| DayTime Cold Flu Non Drowsyacetaminophen, dextromethorphan hydrobromide, phenylephrine hydrochloride | Acetaminophen 325 mg/1 + 2 more ingredients | Capsule, Liquid filledOral | Harris Teeter, LLC | 69256-898 |
| Mucinex Childrens Mighty Chews Cough Daytime and Nighttime Combo Packdextromethorphan hbr and doxylamine succinate | — | Kit | Reckitt Benckiser LLC | 72854-083 |
| Cabinet Allergy Relief Refill Diphenhydramine HCIdiphenhydramine hydrochloride | Diphenhydramine hydrochloride 25 mg/1 | TabletOral | Cabinet Health P.B.C. | 82725-3001 |
| MGC Health Cough Drops Honey Herbmenthol | Menthol 2 mg/1 | LozengeOral | Medical Group Care LLC | 83173-143 |
| Allergy Reliefdiphenhydramine hydrochloride | Diphenhydramine hydrochloride 25 mg/1 | Tablet, CoatedOral | Shield Pharmaceuticals Corp | 83059-0021 |
| Vicks NyQuil VapoCOOL COLD and FLUacetaminophen, doxylamine succinate, dextromethorphan hydrobromide | Acetaminophen 325 mg/1 + 2 more ingredients | Tablet, CoatedOral | The Procter & Gamble Manufacturing Company | 84126-353 |
| Cold and Flu Severeacetaminophen, dextromethorphan hbr, guaifenesin, phenylephrine hcl | Acetaminophen 325 mg/1 + 3 more ingredients | Tablet, Film coatedOral | Rite Aid Corporation | 11822-5031 |
| EZ Nite Sleepdiphenhydramine hcl | Diphenhydramine hydrochloride 50 mg/30mL | LiquidOral | Safeway, Inc. | 21130-014 |
| Chest Rubcamphor, eucalyptus oil, menthol | Camphor (Synthetic) 48 mg/g + 2 more ingredients | JellyTopical | Topco Associates LLC | 36800-596 |
| Maximum Strength Mucus Relief DMdextromethorphan hydrobromide and guaifenesin | Dextromethorphan hydrobromide 20 mg/20mL; Guaifenesin 400 mg/20mL | LiquidOral | Wal-Mart Stores,Inc., | 49035-839 |
| DM Maximumdextromethorphan hbr, guaifenesin | Dextromethorphan hydrobromide 20 mg/20mL; Guaifenesin 400 mg/20mL | SolutionOral | CVS WOONSOCKET PRESCRIPTION CENTER, INCORPORATED | 51316-310 |
| Nighttime Cold And Fluacetaminophen, dextromethorphan hydrobromide, doxylamine succinate | Acetaminophen 650 mg/30mL + 2 more ingredients | SolutionOral | CVS WOONSOCKET PRESCRIPTION CENTER, INCORPORATED | 51316-884 |
| Pain Reliever PM Extra Strengthacetaminophen, diphenhydramine hcl | Acetaminophen 500 mg/1; Diphenhydramine hydrochloride 25 mg/1 | Tablet, CoatedOral | Strategic Sourcing Services LLC | 62011-0256 |
| Dual Action Glacier Mint Cough Suppressant Oral Anestheticmenthol | Menthol 8.3 mg/1 | LozengeOral | Ricola USA Inc. | 63667-603 |
| Nighttime Severe Cold and Coughacetaminophen, diphenhydramine, phenylephrine | Acetaminophen 650 mg/1 + 2 more ingredients | Powder, For solutionOral | RARITAN PHARMACEUTICALS INC | 68163-541 |
| Daytime Nighttime Cold Flu Reliefacetaminophen, dextromethorphan hbr, doxylamine succinate, phenylephrine hcl | — | Kit | Harris Teeter, LLC | 69256-901 |
| HBP Chest Congestion and Cough Reliefguaifenesin and dextromethorphan hydrobromide | Dextromethorphan hydrobromide 10 mg/1; Guaifenesin 200 mg/1 | Capsule, Liquid filledOral | Walgreens | 0363-6681 |
| Sinus Relief Severe Congestion and Painacetaminophen, guaifenesin, and phenylephrine hydrochloride | Acetaminophen 325 mg/1 + 2 more ingredients | Tablet, CoatedOral | CARDINAL HEALTH | 70000-0080 |
| Severe Congestion and Painacetaminophen, guaifenesin, and phenylephrine hydrochloride | Acetaminophen 325 mg/1 + 2 more ingredients | Tablet, CoatedOral | Retail Business Services , LLC. | 72476-167 |
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