What is NDC 21130-847?

21130-847 is the product NDC for signature care clearlax (polyethylene glycol 3350), Polyethylene glycol 3350 17 g/17g powder, for solution, listed with the FDA by Safeway. It has 5 package NDCs, shown above in 10- and 11-digit form.

What drug is associated with this NDC?

signature care clearlax (Polyethylene Glycol 3350).

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 clearlax?

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 clearlax NDC 21130-847 | National Drug Code

NDC codes

FDA NDC Directory

Product NDC (as listed)21130-847Labeler and product segments. Claims need a package NDC.

Product NDC at billing width21130-0847Add 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
21130-847-01	21130084701	119 g in 1 BOTTLE (21130-847-01)Marketed from Sep 4, 2015
21130-847-02	21130084702	238 g in 1 BOTTLE (21130-847-02)Marketed from Sep 4, 2015
21130-847-03	21130084703	510 g in 1 BOTTLE (21130-847-03)Marketed from Sep 1, 2015
21130-847-09	21130084709	765 g in 1 BOTTLE (21130-847-09)Marketed from Nov 6, 2017
21130-847-52	21130084752	10 PACKET in 1 CARTON (21130-847-52) / 17 g in 1 PACKETMarketed from Mar 11, 2021

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 clearlax
Generic name (nonproprietary): polyethylene glycol 3350
Active ingredients: Polyethylene glycol 3350 — 17 g/17g
Dosage form: Powder, For solution
Route: Oral
Labeler: SafewayNDC labeler code 21130
Product type: Over-the-counter drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 090685
Marketing start: Sep 1, 2015
Listing expires: Dec 31, 2026
Other FDA classes: Osmotic Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers: Product ID 21130-847_b877c915-fe23-481a-bc42-67d9419127f8SPL ID b877c915-fe23-481a-bc42-67d9419127f8SPL set ID 91d2e780-2aae-411c-b7b3-820302f0f63eRxCUI 876193, 880407UNII G2M7P15E5P
Pharmacologic class: 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

N421130084701 followed by a unit qualifier and the quantity

Package 21130-0847-01. 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 May 13, 2021.

Indications (excerpt from the label)

Use • relieves occasional constipation (irregularity) • generally produces a bowel movement in 1 to 3 days

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 21130-847

What is NDC 21130-847?: 21130-847 is the product NDC for signature care clearlax (polyethylene glycol 3350), Polyethylene glycol 3350 17 g/17g powder, for solution, listed with the FDA by Safeway. It has 5 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: signature care clearlax (Polyethylene Glycol 3350).
What is the active ingredient?: Polyethylene glycol 3350.
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 clearlax?: 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 090685

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

FDA NDC Directory listings under ANDA 090685
Product	Strength	Form · route	Labeler	Product NDC
basic care clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Amazon.com Services LLC	72288-020
basic care clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Amazon.com Services LLC	72288-499
berkley and jensen clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	BJWC	68391-306
care one clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	American Sales Company	41520-306
careone clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Retail Business Services, LLC	72476-723
clear laxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	H E B	37808-306
clear laxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Meijer Distribution Inc	41250-306
clear laxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	HyVee Inc	42507-306
Clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Safeway	21130-637
clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Publix Super Markets Inc	56062-306
clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	H E B	59640-797
Clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Amazon.com Services LLC	72288-033
Clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Amazon.com Services LLC	72288-471
clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Meijer, Inc.	79481-0090
dg health clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Dolgencorp, LLC	55910-306
dg health clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Dolgencorp Inc	55910-846
Dulcolaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	PowderOral	Chattem, Inc.	41167-0223
equaline clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	United Natural Foods, Inc. dba UNFI	41163-306
equate clear laxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Wal-Mart Stores Inc	49035-306
Equate ClearLAXpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	WALMART INC.	79903-114

Showing 20 of 40.

signature care clearlax (Polyethylene glycol 3350) NDC 21130-847