What is NDC 0121-1762?

0121-1762 is the product NDC for Mag-AL Plus XS, Aluminum hydroxide 400 mg/5mL + 2 more ingredients suspension, listed with the FDA by PAI Holdings, LLC dba PAI Pharma. It has 1 package NDC, shown above in 10- and 11-digit form.

What drug is associated with this NDC?

Mag-AL Plus XS (Aluminum Hydroxide, Magnesium Hydroxide, and Dimethicone).

What is the active ingredient?

Aluminum hydroxide, Magnesium hydroxide, Dimethicone.

PAI Holdings, LLC dba PAI Pharma, NDC labeler code 0121. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.

What other NDCs exist for Mag-AL Plus XS?

1 other product NDC are listed under this name.

Is there a related HCPCS / J-code?

Not in Med-Code's curated HCPCS directory.

Mag-AL Plus XS NDC 0121-1762 | National Drug Code

NDC codes

FDA NDC Directory

Product NDC (as listed)0121-1762Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00121-1762Add 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
0121-1762-30	0012117623000121176230	10 TRAY in 1 CASE (0121-1762-30) / 10 CUP, UNIT-DOSE in 1 TRAY / 30 mL in 1 CUP, UNIT-DOSEMarketed from Jan 14, 2004

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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): Mag-AL Plus XSSuffix: XS
Generic name (nonproprietary): aluminum hydroxide, magnesium hydroxide, and dimethicone
Active ingredients: Aluminum hydroxide — 400 mg/5mLMagnesium hydroxide — 400 mg/5mLDimethicone — 40 mg/5mL
Dosage form: Suspension
Route: Oral
Labeler: PAI Holdings, LLC dba PAI PharmaNDC labeler code 0121
Product type: Over-the-counter drug
Marketing category: OTC monograph drugApplication M 002
Marketing start: Jan 14, 2004
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 0121-1762_b950b648-4292-4b99-ad30-52f554434f27SPL ID b950b648-4292-4b99-ad30-52f554434f27SPL set ID db0c47ab-5296-4195-9fa6-2e338b665094RxCUI 237870UNII 5QB0T2IUN0, NBZ3QY004S, 92RU3N3Y1O
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

N400121176230 followed by a unit qualifier and the quantity

Package 00121-1762-30. 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 Nov 12, 2024.

Indications (excerpt from the label)

Uses for the relief of: acid indigestion heartburn sour stomach upset stomach due to these symptoms pressure and bloating commonly referred to as gas

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 0121-1762

What is NDC 0121-1762?: 0121-1762 is the product NDC for Mag-AL Plus XS, Aluminum hydroxide 400 mg/5mL + 2 more ingredients suspension, listed with the FDA by PAI Holdings, LLC dba PAI Pharma. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Mag-AL Plus XS (Aluminum Hydroxide, Magnesium Hydroxide, and Dimethicone).
What is the active ingredient?: Aluminum hydroxide, Magnesium hydroxide, Dimethicone.
Who is the labeler?: PAI Holdings, LLC dba PAI Pharma, NDC labeler code 0121. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Mag-AL Plus XS?: 1 other product NDC are listed under this name. See all Mag-AL Plus XS 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 Mag-AL Plus XS NDCs
Product	Strength	Form · route	Labeler	Product NDC	Package NDCs (11-digit)
Mag-Al Plus XSmagnesium hydroxide, aluminum hydroxide, simethicone	Aluminum hydroxide 2400 mg/30mL + 2 more ingredients	SuspensionOral	Cardinal Health 107, LLC	55154-9422	55154-9422-05

Other NDCs under M 002

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

FDA NDC Directory listings under M 002
Product	Strength	Form · route	Labeler	Product NDC
Extra Strength Gas Relief Cherrysimethicone	Dimethicone 125 mg/1	Tablet, ChewableOral	Harris Teeter, LLC	69256-134
Gas Relief Extra Strengthsimethicone	Dimethicone 125 mg/1	Capsule, Liquid filledOral	Cardinal Health (Leader) 70000	70000-0529
Extra Strength Gas Reliefsimethicone	Dimethicone, Unspecified 125 mg/1	Tablet, ChewableOral	SAFEWAY	21130-110
Simethicone 250mg	Dimethicone 250 mg/1	Capsule, Liquid filledOral	AMZ789 LLC	73629-006
FEVIA Gas Controlsimethicone	Dimethicone, Unspecified 250 mg/1	Capsule, Liquid filledOral	VIVUNT PHARMA LLC	82706-031
Mylicon Infants Gas Relief Originalsimethicone	Dimethicone 20 mg/.3mL	EmulsionOral	Infirst Healthcare	62372-630
Simethicone	Dimethicone 180 mg/1	Capsule, Liquid filledOral	AMZ789 LLC	73629-002
CVS PHARMACY Gas reliefsimethicone	Dimethicone, Unspecified 80 mg/1	Tablet, ChewableOral	CVS	51316-111
Curist Gas Reliefsimethicone	Dimethicone 180 mg/180mg	Capsule, Liquid filledOral	Little Pharma. Inc.	72559-041
Gas Reliefsimethicone	Dimethicone 125 mg/1	Tablet, ChewableOral	Chain Drug Marketing Association, Inc.	83324-325
Gas Reliefsimethicone	Dimethicone 125 mg/1	Capsule, Liquid filledOral	Family Dollar (FAMILY WELLNESS)	55319-555
Gas Relief Extra Strengthsimethicone	Dimethicone 125 mg/1	Capsule, Liquid filledOral	Care One (Retail Business Services, LLC.)	72476-897
Curist Gas Reliefsimethicone	Dimethicone 250 mg/250mg	Capsule, Liquid filledOral	Little Pharma. Inc.	72559-042
mylanta gassimethicone	Dimethicone 125 mg/1	Capsule, Liquid filledOral	Infirst Healthcare	62372-554
Ultra Strength Gas Reliefsimethicone	Dimethicone 180 mg/1	CapsuleOral	BETTER LIVING BRANDS, LLC	21130-717
Simethicone	Dimethicone 80 mg/1	Tablet, ChewableOral	Aphena Pharma Solutions - Tennessee, LLC	71610-649
FEVIA Gas Controlsimethicone	Dimethicone, Unspecified 250 mg/1	Capsule, Liquid filledOral	VIVUNT PHARMA LLC	82706-031
Mylicon Infants Gas Relief Dye Freesimethicone	Dimethicone 20 mg/.3mL	EmulsionOral	Infirst Healthcare	62372-650
QUITA COLICOS Gas RELIEF Dropssimethicone	Dimethicone 20 mg/.3mL	LiquidOral	DLC Laboratories, Inc.	24286-1533
Antiflatulentsimethicone	Dimethicone 80 mg/1	Tablet, ChewableOral	Aphena Pharma Solutions - Tennessee, LLC	71610-650

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