NDC codes

FDA NDC Directory
Product NDC (as listed)0126-0033Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00126-0033Add 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
0126-0033-1600126003316473 mL in 1 BOTTLE, PLASTIC (0126-0033-16)Marketed from Jun 13, 2016

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)
PreviDent Alcohol Free
Generic name (nonproprietary)
sodium fluoride
Active ingredients
Sodium fluoride — .9 mg/mL
Dosage form
Mouthwash
Route
Dental
Product type
Prescription drug
Marketing category
Unapproved drug (other)
Marketing start
Listing expires
Identifiers
Product ID 0126-0033_36206573-587a-4512-9efe-cc75f8af46c9SPL ID 36206573-587a-4512-9efe-cc75f8af46c9SPL set ID 28e4f7cd-9fd8-4c7a-9e4b-d747fefc76c0UNII 8ZYQ1474W7

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 drug-specific HCPCS code in Med-Code's directory for this product. The directory is curated and not complete — check the current CMS HCPCS file before billing.

NDC on a medical claim

N400126003316 followed by a unit qualifier and the quantity

Package 00126-0033-16. 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

Label details couldn’t be retrieved right now. Open the label on DailyMed.

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