Gum Detoxify Paste, Dentifrice
NDC Package 49035-174-10

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

Gum Detoxify (stannous fluoride) pastes is - aids in the prevention of cavities - helps prevent gingivitis - helps interfere with the harmful effects of plaque associated with gingivitis - helps control plaque bacteria that contribute to the development of gingivitis. This formulation utilizes a paste, dentifrice delivery system. Marketed by Walmart, this product is identified by NDC 49035-174 and is authorized under FDA application M021.

Identification & Billing

NDC Package Code
49035-174-10
Package Description
1 TUBE in 1 CARTON / 116 g in 1 TUBE
Product Code
49035-174
11-Digit Billing Format
49035017410
RxNorm Crosswalk
  • RxCUI: 416784 - stannous fluoride 0.454 % (fluoride ion 0.16 % ) Toothpaste
  • RxCUI: 416784 - stannous fluoride 0.00454 MG/MG Toothpaste
  • RxCUI: 416784 - stannous fluoride 0.454 % (fluoride ion 0.14 % ) Toothpaste
  • RxCUI: 416784 - stannous fluoride 0.454 % (fluoride ion 0.15 % ) Toothpaste

Clinical Specifications

Proprietary Name
Gum Detoxify
Non-Proprietary Name
Stannous Fluoride
Substance Name
Stannous Fluoride
Dosage Form
Paste, Dentifrice - A paste formulation intended to clean and/or polish the teeth, and which may contain certain additional agents.
Administration Route
Dental - Administration to a tooth or teeth.
Active Ingredient(s)
STANNOUS FLUORIDE .15 g/100g
Usage Information
- aids in the prevention of cavities - helps prevent gingivitis - helps interfere with the harmful effects of plaque associated with gingivitis - helps control plaque bacteria that contribute to the development of gingivitis

Regulatory & Marketing

Labeler Name
Walmart
Product Type
Human Otc Drug
FDA Application #
M021
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
04-20-2026
Listing Expiration
12-31-2027
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 49035-174-10 identifies a specific commercial package of 1 tube in 1 carton / 116 g in 1 tube of Gum Detoxify, a human over the counter drug labeled by Walmart. This paste, dentifrice is formulated for dental use and contains stannous fluoride as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Walmart on April 20, 2026. The current certification is valid through December 31, 2027.

How is this Walmart product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 49035017410. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
49035-174-10
11-Digit CMS (5-4-2)
49035-0174-10

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.