NDC codes

FDA NDC Directory
Product NDC (as listed)79903-025Labeler and product segments. Claims need a package NDC.
Product NDC at billing width79903-0025Add 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
79903-025-5979903002559116 g in 1 TUBE (79903-025-59)Marketed from Jul 1, 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)
Gum Detoxify
Generic name (nonproprietary)
stannous fluoride
Active ingredients
Stannous fluoride — .14 g/100g
Dosage form
Paste, Dentifrice
Route
Dental
Labeler
WalmartNDC labeler code 79903
Product type
Over-the-counter drug
Marketing category
OTC monograph drugApplication M 021
Marketing start
Listing expires
Identifiers
Product ID 79903-025_47e61691-612c-f6e9-e063-6294a90a71d3SPL ID 47e61691-612c-f6e9-e063-6294a90a71d3SPL set ID ad3f645d-aaf9-2800-e053-2a95a90ab62fRxCUI 416784UNII 3FTR44B32Q

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

N479903002559 followed by a unit qualifier and the quantity

Package 79903-0025-59. 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)

*aids in the prevention of cavities * helps prevent gingivitis * helps interfere with teh harmful effects of plaque associated with gingivitis * helps control plaque bacteria that contribute to teh development of gingivitis

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 79903-025

What is NDC 79903-025?
79903-025 is the product NDC for Gum Detoxify (stannous fluoride), Stannous fluoride .14 g/100g paste, dentifrice, listed with the FDA by Walmart. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Gum Detoxify (Stannous fluoride).
What is the active ingredient?
Stannous fluoride.
Who is the labeler?
Walmart, NDC labeler code 79903. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Gum Detoxify?
4 other product NDCs are listed under this name. See all Gum Detoxify 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 Gum Detoxify NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
Gum Detoxifystannous fluorideStannous fluoride .15 g/100gPaste, DentifriceDentalWalmart49035-17449035-0174-10
Gum Detoxifystannous fluorideStannous fluoride .14 g/100gGel, DentifriceOralMeijer, Inc.79481-012179481-0121-09
Gum Detoxifystannous fluorideStannous fluoride .14 g/100gPaste, DentifriceDentalRite Aid11822-500611822-5006-09
Gum Detoxifystannous fluorideStannous fluoride .14 g/100gPaste, DentifriceDentalCVS69842-94869842-0948-89

Other NDCs under M 021

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

FDA NDC Directory listings under M 021
ProductStrengthForm · routeLabelerProduct NDC
Auraglow Whiteningsodium fluorideSodium fluoride 2.3 mg/gPaste, DentifriceDentalAuraglow LLC81740-003
Crayola ANTICAVITY STRAWBERRY FLAVORsodium fluorideSodium fluoride .243 g/100gPaste, DentifriceDentalAshtel Studios, Inc.70108-080
Made by Dentists For Kids Eyeball Juice (Watermelon)sodium fluorideSodium fluoride 1.5 mg/gPasteDentalMADE BY DENTISTS INC75065-030
White Glo Advantage Anticavity Professional Whiteningsodium monofluorophosphateSodium monofluorophosphate 7.6 mg/gPasteTopicalWHITE GLO USA INC73656-027
AutoBrush Mintsodium fluorideSodium fluoride .243 g/100mLLiquidOralLander Enterprises, LLC82913-011
Hello Unicorn Splashsodium fluorideSodium fluoride .02 g/100mLMouthwashDentalAccupac LLC44038-0687
Crest 3D White Stain Eraser Icy Clean Mintsodium fluorideSodium fluoride 1.5 mg/gPaste, DentifriceOralThe Procter & Gamble Manufacturing Company69423-773
White Glo Professional Choice Twin Packsodium fluoride—KitWHITE GLO USA INC73656-024
Therabreath Healthy Gumsstannous fluorideStannous fluoride .454 g/100gPaste, DentifriceOralChurch & Dwight Co., Inc.10237-271
Crest 3D White Vibrant Mintsodium fluorideSodium fluoride 1.5 mg/gPaste, DentifriceOralThe Procter & Gamble Manufacturing Company69423-774
Complete Protectionstannous fluorideStannous fluoride .15 g/100gPaste, DentifriceDental, OralTarget11673-366
Anticavitysodium fluorideSodium fluoride .1 mg/mLRinseOralH E B37808-119
Listerine Total Care Alcohol Free Anticavity Fluoride Mouthwash Fresh Mintsodium fluorideSodium fluoride .1 mg/mLMouthwashOralKenvue Brands LLC69968-0924
White Glo Advantage Anticavity Fluoride Purplesodium monofluorophosphateSodium monofluorophosphate 7.6 mg/gPasteTopicalWHITE GLO USA INC73656-026
Hismilesodium fluorideSodium fluoride .243 g/100gGelDentalHISMILE PTY LTD83013-321
Delta Comfort Plus Amenitysodium monofluorophosphate—KitBuzz Products Inc.69491-043
Hismilebanana flavor sodium fluoride anticavity toothpasteSodium fluoride 2.4 mg/gGelDentalHismile Pty Ltd83013-319
TP OW Stainfighter Clean Mintsodium fluorideSodium fluoride 1.1 mg/gPaste, DentifriceDentalColgate-Palmolive Company35000-999
Sodium FluorideSodium fluoride 2.43 mg/gPaste, DentifriceDentalSafco Dental Supply LLC67239-0226
Delta Travel Kit Comfort plussodium monofluorophosphate—KitBuzz Products Inc.69491-039

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