NDC codes

FDA NDC Directory
Product NDC (as listed)21130-269Labeler and product segments. Claims need a package NDC.
Product NDC at billing width21130-0269Add 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 NDC11-digit (billing)PackageCopy
21130-269-7821130026978100 BLISTER PACK in 1 CARTON (21130-269-78) / 1 GUM, CHEWING in 1 BLISTER PACKMarketed from Dec 28, 2018

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 nicotine
Generic name (nonproprietary)
nicotine polacrilex
Active ingredients
Nicotine — 2 mg/1
Dosage form
Gum, Chewing
Route
Oral
Labeler
SafewayNDC labeler code 21130
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 206394
Marketing start
Listing expires
Other FDA classes
Nicotine (Chemical structure)
Identifiers
Product ID 21130-269_7a80e54e-fed7-4d86-b8e2-cecdcf66193eSPL ID 7a80e54e-fed7-4d86-b8e2-cecdcf66193eSPL set ID a2c00ec8-3762-4594-a1dd-0b5add001d39RxCUI 314119UNII 6M3C89ZY6R
Pharmacologic class
Cholinergic Nicotinic 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

N421130026978 followed by a unit qualifier and the quantity

Package 21130-0269-78. 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)

Use • reduces withdrawal symptoms, including nicotine craving, associated with quitting smoking

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 21130-269

What is NDC 21130-269?
21130-269 is the product NDC for signature care nicotine (nicotine polacrilex), Nicotine 2 mg/1 gum, chewing, 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?
signature care nicotine (Nicotine polacrilex).
What is the active ingredient?
Nicotine.
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 nicotine?
7 other product NDCs are listed under this name. See all signature care nicotine 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 signature care nicotine NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
signature care nicotinenicotine polacrilexNicotine 4 mg/1Gum, ChewingOralSafeway21130-82021130-0820-78
signature care nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralSafeway21130-17221130-0172-02
signature care nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralSafeway21130-18521130-0185-02
signature care nicotinenicotine polacrilexNicotine 4 mg/1Gum, ChewingOralSafeway21130-52221130-0522-25
signature care nicotinenicotine polacrilexNicotine 4 mg/1Gum, ChewingOralSafeway21130-17321130-0173-78
signature care nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralSafeway21130-18621130-0186-78
signature care nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralSafeway21130-70021130-0700-05

Other NDCs under ANDA 206394

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

FDA NDC Directory listings under ANDA 206394
ProductStrengthForm · routeLabelerProduct NDC
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralWalgreen Company0363-7269
coated nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralPublix Super Markets Inc56062-110
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralMeijer Distribution Inc41250-209
basic care nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralAmazon.com Services LLC72288-811
nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralWalgreen Company0363-1012
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralKroger Company30142-208
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralWalgreen Company0363-7050
Up And Up Coated Mint Freeze Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralTarget Corporation82442-100
Basic Care Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralAmazon.com Services LLC72288-292
Foster and Thrive Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralStrategic Sourcing Services LLC70677-1192
nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralMeijer, Inc.79481-0100
up and up nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralTarget Corporation82442-269
Members Mark Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralSam's West Inc68196-012
Berkley and Jensen NICOTINEnicotine polacrilexNicotine 2 mg/1Gum, ChewingOralBJWC68391-012
nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralPublix Super Markets Inc56062-646
signature care nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralSafeway21130-186
topcare nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralTopco Associates LLC36800-269
up and up coated cinnamon nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralTarget Corporation82442-700
good sense nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralL. Perrigo Company0113-8100
members mark nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralSam's West Inc68196-269

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