Dg Health Paste, Dentifrice
NDC Package 55910-360-39

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

Package Information

Dg Health (potassium nitrate, sodium fluoride) pastes is usesbuilds increasing protection against painful sensitivity of the teeth to cold, heat, acids, sweets or contactaids in the prevention of dental cavities. This formulation utilizes a paste, dentifrice delivery system. Marketed by Dolgencorp, Llc, this product is identified by NDC 55910-360 and is authorized under FDA application M021.

Identification & Billing

NDC Package Code
55910-360-39
Package Description
1 TUBE in 1 CARTON / 113 g in 1 TUBE
Product Code
55910-360
11-Digit Billing Format
55910036039
RxNorm Crosswalk
  • RxCUI: 1038929 - potassium nitrate 5 % / sodium fluoride 0.24 % Toothpaste
  • RxCUI: 1038929 - potassium nitrate 0.05 MG/MG / sodium fluoride 0.0024 MG/MG Toothpaste
  • RxCUI: 1038929 - K+ nitrate 0.05 MG/MG / Sodium Fluoride 0.0024 MG/MG Toothpaste
  • RxCUI: 1038929 - Pot nitrate 0.05 MG/MG / Sodium Fluoride 0.0024 MG/MG Toothpaste
  • RxCUI: 1038929 - potassium nitrate 5 % / sodium fluoride 0.24 % (fluoride ion 0.14 % ) Toothpaste

Clinical Specifications

Proprietary Name
Dg Health Sensitive Maximum Strength
Non-Proprietary Name
Potassium Nitrate, Sodium Fluoride
Substance Name
Potassium Nitrate; Sodium 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)
Usage Information
Usesbuilds increasing protection against painful sensitivity of the teeth to cold, heat, acids, sweets or contactaids in the prevention of dental cavities

Regulatory & Marketing

Labeler Name
Dolgencorp, Llc
Product Type
Human Otc Drug
FDA Application #
M021
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-13-2019
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 55910-360-39 identifies a specific commercial package of 1 tube in 1 carton / 113 g in 1 tube of Dg Health Sensitive Maximum Strength, a human over the counter drug labeled by Dolgencorp, Llc. This paste, dentifrice is formulated for dental use and contains potassium nitrate; sodium 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 Dolgencorp, Llc on February 13, 2019. The current certification is valid through December 31, 2027.

How is this Dolgencorp, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 55910036039. 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)
55910-360-39
11-Digit CMS (5-4-2)
55910-0360-39

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