Pro-Den Rx (sodium fluoride) NDC 59883-920

NDC codes

FDA NDC Directory

Product NDC (as listed)59883-920Labeler and product segments. Claims need a package NDC.

Product NDC at billing width59883-0920Add 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 NDC	11-digit (billing)	Package	Copy
59883-920-16	59883092016	473 mL in 1 BOTTLE, PLASTIC (59883-920-16)Marketed from Oct 21, 2008

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): Pro-Den Rx
Generic name (nonproprietary): sodium fluoride
Active ingredients: Sodium fluoride — .9 mg/mL
Dosage form: Rinse
Route: Oral
Labeler: Den-mat Holdings, Llc
Product type: Prescription drug
Marketing category: Unapproved drug (other)
Marketing start: Oct 21, 2008
Listing expires: Dec 31, 2026
Identifiers: Product ID 59883-920_82f8dd55-36df-0de0-e053-2991aa0a6bbfSPL ID 82f8dd55-36df-0de0-e053-2991aa0a6bbfSPL set ID e39b19f7-2b3e-4c77-9544-623ebad84870RxCUI 562510, 1488074UNII 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. Oral products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N459883092016 followed by a unit qualifier and the quantity

Package 59883-0920-16. 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

Current FDA label (SPL), effective Feb 28, 2019.

Indications (excerpt from the label)

Indications and Usage: Aids in the prevention of dental caries. May be used more than once a week if recommended by your dentist. Pro-DenRx ® Rinse is ready to use, convenient and thus increases compliance. Weekly rinsing with a neutral 0.2% sodium fluoride solution protects against dental cares in adults and children. May be used in areas where drinking water is fluoridated since topical fluoride cannot produce fluorosis.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)