NDC codes

FDA NDC Directory
Product NDC (as listed)0126-0016Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00126-0016Add 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
0126-0016-6100126001661100 mL in 1 BOTTLE (0126-0016-61)Marketed from Jul 6, 2009

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 5000 Dry MouthSuffix: 5000 Dry Mouth
Generic name (nonproprietary)
sodium fluoride
Active ingredients
Sodium fluoride — 6.1 mg/mL
Dosage form
Gel, Dentifrice
Route
Dental
Product type
Prescription drug
Marketing category
Unapproved drug (other)
Marketing start
Listing expires
Identifiers
Product ID 0126-0016_8f71eedc-1ece-48c0-9130-48ca61d872fcSPL ID 8f71eedc-1ece-48c0-9130-48ca61d872fcSPL set ID d93ee76f-454b-40bf-9357-39a2ae3b6ccbRxCUI 392038, 630194UNII 8ZYQ1474W7UPC 0301260016610

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

N400126001661 followed by a unit qualifier and the quantity

Package 00126-0016-61. 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)

INDICATIONS AND USAGE A dental caries preventive; for once daily self-applied topical use. It is well established that 1.1% sodium fluoride is safe and extraordinarily effective as a caries preventive when applied frequently with mouthpiece applicators. 1-4 PreviDent ® 5000 Dry Mouth brand of 1.1% sodium fluoride toothpaste in a squeeze bottle is easily applied onto a toothbrush. This prescription toothpaste should be used once daily in place of your regular toothpaste unless otherwise instructed by your dental professional. May be used in areas where drinking water is fluoridated since topical fluoride cannot produce fluorosis. (See WARNINGS for exception.)

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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