Over-the-counter drug · NDA

anti-diarrheal (loperamide hydrochloride) NDC 21130-835

Loperamide hydrochloride 2 mg/1 · Capsule, Liquid filled · Oral · Albertsons Companies

NDC codes

FDA NDC Directory
Product NDC (as listed)21130-835Labeler and product segments. Claims need a package NDC.
Product NDC at billing width21130-0835Add 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
21130-835-12211300835122 BLISTER PACK in 1 CARTON (21130-835-12) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACKMarketed from Apr 7, 2025

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)
anti-diarrheal
Generic name (nonproprietary)
loperamide hydrochloride
Active ingredients
Loperamide hydrochloride — 2 mg/1
Dosage form
Capsule, Liquid filled
Route
Oral
Product type
Over-the-counter drug
Marketing category
NDA — New Drug ApplicationApplication NDA 021855
Marketing start
Listing expires
Other FDA classes
Opioid Agonists (Mechanism)
Identifiers
Product ID 21130-835_323643aa-2d51-0968-e063-6394a90aba7aSPL ID 323643aa-2d51-0968-e063-6394a90aba7aSPL set ID 1d4ec76d-ff0d-a55d-e063-6294a90ae22cRxCUI 978006UNII 77TI35393C
Pharmacologic class
Opioid 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

N421130083512 followed by a unit qualifier and the quantity

Package 21130-0835-12. 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 controls symptoms of diarrhea, including Travelers' Diarrhea

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 021855

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

FDA NDC Directory listings under NDA 021855
ProductStrengthForm · routeLabelerProduct NDC
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralNortheast Pharma80136-851
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralSTRATEGIC SOURCING SERVICES70677-1062
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralCHAIN DRUG MARKETING ASSOCIATION INC.83324-208
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralCHAIN DRUG MARKETING ASSOCIATION INC.83324-209
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralHEB37808-988
anti-diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralMEIJER DISTRIBUTION INC41250-210
Imodium A-Dloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralKenvue Brands LLC50580-367
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralTARGET Corporation11673-177
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralStrategic Sourcing Services LLC62011-0390
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralKROGER COMPANY30142-159
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralWALGREENS0363-1176
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralDISCOUNT DRUG MART, INC.53943-176
anti-diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralAmazon.com Services LLC72288-313
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralTOP CARE (Topco Associates LLC)36800-208
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralRite Aid Corporation11822-7834
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralCVS Pharmacy, Inc.69842-061
anti-diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralBionpharma Inc.69452-176
WELMATE Anti Diarrheal Loperamide HCl Softgelsloperamide hydrochlorideLoperamide hydrochloride 2 mg/1CapsuleOralYYBA CORP73581-102
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralAMERISOURCE BERGEN46122-581
Anti-Diarrhealloperamide hydrochlorideLoperamide hydrochloride 2 mg/1Capsule, Liquid filledOralDOLGENCORP, LLC55910-176

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