Prescription drug · UNAPPROVED DRUG OTHER
Acclean Anti-Cavity Sensitivity Relief NDC 0404-0174
potassium nitrate, sodium fluoride · Potassium nitrate 5 g/100g; Sodium fluoride 1.1 g/100g · Paste, Dentifrice · Topical · Henry Schein, Inc.
NDC codes
FDA NDC Directory| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 0404-0174-04 | 00404017404 | 1 TUBE in 1 CARTON (0404-0174-04) / 113.4 g in 1 TUBEMarketed from Jan 30, 2025 |
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)
- Acclean Anti-Cavity Sensitivity Relief
- Generic name (nonproprietary)
- potassium nitrate, sodium fluoride
- Active ingredients
- Potassium nitrate — 5 g/100gSodium fluoride — 1.1 g/100g
- Dosage form
- Paste, Dentifrice
- Route
- Topical
- Labeler
- Henry Schein, Inc.
- Product type
- Prescription drug
- Marketing category
- Unapproved drug (other)
- Marketing start
- Listing expires
- Identifiers
- Product ID 0404-0174_170263e7-b523-4250-b542-5bddab28ae43SPL ID 170263e7-b523-4250-b542-5bddab28ae43SPL set ID d5dc57d9-e62d-4b58-a5df-de4e37238dd7RxCUI 637365UNII RU45X2JN0Z, 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 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
N400404017404followed by a unit qualifier and the quantityPackage 00404-0174-04. 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)
Acclean Prescription Strength Anti-Cavity Toothpaste for Sensitivity Relief is indicated for use as part of a professional program for the prevention and control of dental caries.
Excerpt only. Read the full label for complete information.