What is NDC 21130-931?

21130-931 is the product NDC for Signature Select Pain Relieving, Benzalkonium chloride .13 g/100mL; Lidocaine hydrochloride 4 g/100mL spray, listed with the FDA by Safeway/Albartsons. It has 1 package NDC, shown above in 10- and 11-digit form.

What drug is associated with this NDC?

Signature Select Pain Relieving (Lidocaine HCL, Benzalkonium chloride).

What is the active ingredient?

Benzalkonium chloride, Lidocaine hydrochloride.

Safeway/Albartsons, 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 Select Pain Relieving?

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 Select Pain Relieving NDC 21130-931

NDC codes

FDA NDC Directory

Product NDC (as listed)21130-931Labeler and product segments. Claims need a package NDC.

Product NDC at billing width21130-0931Add 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
21130-931-01	2113009310121130093101	148 mL in 1 BOTTLE, SPRAY (21130-931-01)Marketed from Oct 1, 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): Signature Select Pain Relieving
Generic name (nonproprietary): lidocaine hcl, benzalkonium chloride
Active ingredients: Benzalkonium chloride — .13 g/100mLLidocaine hydrochloride — 4 g/100mL
Dosage form: Spray
Route: Topical
Labeler: Safeway/AlbartsonsNDC labeler code 21130
Product type: Over-the-counter drug
Marketing category: OTC monograph drugApplication M 003
Marketing start: Oct 1, 2025
Listing expires: Dec 31, 2026
Other FDA classes: Amides (Chemical structure)Local Anesthesia (Physiologic effect)
Identifiers: Product ID 21130-931_414a1a11-867c-10c1-e063-6394a90a39a4SPL ID 414a1a11-867c-10c1-e063-6394a90a39a4SPL set ID 3cab1b0c-4ffd-9c01-e063-6294a90ad15dRxCUI 2047877UNII F5UM2KM3W7, V13007Z41A
Pharmacologic class: Amide Local Anesthetic; Antiarrhythmic

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. Topical products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N421130093101 followed by a unit qualifier and the quantity

Package 21130-0931-01. 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 Oct 16, 2025.

Indications (excerpt from the label)

Uses First aid to help prevent bacterial contamination or skin infection and for temporary relief of pain and itching associated with ■ minor burns ■ sunburn ■ minor cuts ■scrapes ■ insect bites ■ minor skin irritations

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 21130-931

What is NDC 21130-931?: 21130-931 is the product NDC for Signature Select Pain Relieving, Benzalkonium chloride .13 g/100mL; Lidocaine hydrochloride 4 g/100mL spray, listed with the FDA by Safeway/Albartsons. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Signature Select Pain Relieving (Lidocaine HCL, Benzalkonium chloride).
What is the active ingredient?: Benzalkonium chloride, Lidocaine hydrochloride.
Who is the labeler?: Safeway/Albartsons, 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 Select Pain Relieving?: 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 M 003

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

FDA NDC Directory listings under M 003
Product	Strength	Form · route	Labeler	Product NDC
Antisepticethanol	Alcohol .62 mL/mL	GelTopical	McKesson	68599-5322
Hand sanitizer 16.9oz with vitamin Eethyl alcohol 70%	Alcohol 70 mL/100mL	LiquidTopical	Zhejiang Guoyao Jingyue Aerosol Co., Ltd.	75742-021
Mistify Pina Colada Hand Sanitezeralcohol antiseptic	Alcohol 62 mL/100mL	LiquidTopical	Kingkey MBC Life Technology Group Co.,Ltd	73928-178
Solar Flare Hand Sanitizer Sunset Sambaalcohol	Alcohol 62 mL/100mL	SprayTopical	Scent Theory Products LLC	76891-153
Klean Freakbenzalkonium chloride	Benzalkonium chloride .13 g/100g	ClothTopical	KLEAN FREAK, LLC	78982-005
Guardellebenzalkonium chloride	Benzalkonium chloride .13 g/100mL	Aerosol, FoamTopical	Social Medical Supply LLC	85754-000
RITE AID Maximum strength pain relievingbenzalkonium chloride and lidocaine hydrochloride	Benzalkonium chloride .13 g/100mL; Lidocaine hydrochloride 4 g/100mL	LiquidTopical	RITE AID	11822-7220
Hand Sanitizer	Alcohol 70 mL/100mL	GelExtracorporeal	Zhejiang Meimi Technology Co., Ltd.	41366-055
Smart Care Cucumber Melon Hand Sanitizeralcohol	Alcohol 70 mL/100mL	SprayTopical	Shenzhen Lantern Scicence Co.,Ltd.	54860-509
Walgreen Maximum strength pain relieving cleansingbenzalkonium chloride and lidocaine hydrochloride	Benzalkonium chloride .13 g/100mL; Lidocaine hydrochloride 4 g/100mL	LiquidTopical	WALGREENS CO.	0363-7020
American Red Cross 70% Ethyl Alcohol Hand Sanitizerethyl alcohol	Alcohol 70 mL/100mL	GelTopical	Zhejiang Guoyao Jingyue Aerosol Co., Ltd	75742-018
Thompson Burn Cream with Lidocainebenzalkonium chloride, lidocaine	Lidocaine hydrochloride 5 mg/g; Benzalkonium chloride 1.3 mg/g	CreamTopical	Thompson Safety	73408-160
Scentfull Hand Sanitizer Whipped Coconutalcohol	Alcohol 62 mL/100mL	SprayTopical	Scent Theory Products LLC	76891-150
Klean Freakbenzalkonium chloride	Benzalkonium chloride .13 g/100g	ClothTopical	KLEAN FREAK, LLC	78982-002
Hand Sanitizeralcohol 62%	Alcohol .62 g/g	GelTopical	Guangzhou Ailizhuangsi Cosmetics Co., Ltd.	87910-009
Obstetrical Towelettebenzalkonium chloride	Benzalkonium chloride 1.3 mg/g	ClothTopical	Jianerkang Medical Co., Ltd	34645-0015
Hand Sanitizer	Alcohol 70 mL/100mL	GelExtracorporeal	Zhejiang Meimi Technology Co., Ltd.	41366-052
Ashley Belle 1 oz., Moisturizing Hand Sanitizing, Hibiscus Nectarethyl alcohol	Alcohol 70 mL/100mL	SprayTopical	MY IMPORTS USA LLC	51628-4563
Soft Touch Plus Antibacterial Hand Item 1039chloroxylenol	Chloroxylenol .3 g/100mL	SoapTopical	AMERICAN CHEMICAL AND SANITARY SUPPLY INC	50536-139
Hydrogen Peroxide	Hydrogen peroxide 30 mg/mL	SolutionTopical	Perrigo Direct, Inc	50804-871

Showing 20 of 40.

Signature Select Pain Relieving (Lidocaine hcl, benzalkonium chloride) NDC 21130-931