Prescription drug · UNAPPROVED DRUG OTHER
Acclean Foam Fluoride 60 Second Application NDC 0404-1701
sodium fluoride · Sodium fluoride .0272 g/g · Aerosol, Foam · Dental · Henry Schein
NDC codes
FDA NDC Directory| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 0404-1701-44 | 00404170144 | 125 g in 1 CANISTER (0404-1701-44)Marketed from Apr 28, 2021 |
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 Foam Fluoride 60 Second Application
- Generic name (nonproprietary)
- sodium fluoride
- Active ingredients
- Sodium fluoride — .0272 g/g
- Dosage form
- Aerosol, Foam
- Route
- Dental
- Labeler
- Henry Schein
- Product type
- Prescription drug
- Marketing category
- Unapproved drug (other)
- Marketing start
- Listing expires
- Identifiers
- Product ID 0404-1701_06d4de64-6d8f-6bfb-e063-6294a90a40ebSPL ID 06d4de64-6d8f-6bfb-e063-6294a90a40ebSPL set ID c10af938-0537-2425-e053-2a95a90ad608RxCUI 248389UNII 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
N400404170144followed by a unit qualifier and the quantityPackage 00404-1701-44. 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 For topical application to aid in the protection against dental caries.
Excerpt only. Read the full label for complete information.