Anticavity Mouthwash
NDC Package 72476-005-86

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

Package Information

Anticavity (sodium fluoride) mouthwashes is adults and children 12 years of age and older:use twice daily after brushing your teeth with a toothpastevigorously swish 10 mL (2 teaspoonfuls) of rinse between your teeth for 1 minute and then spit outdo not swallow the rinsedo not eat or drink for 30 minutes after rinsingsupervise children as necessary until capable of using without supervisionchildren under 12 years of age: consult a dentist or doctor. This formulation utilizes a mouthwash delivery system. Marketed by Adusa Distribution, Llc, this product is identified by NDC 72476-005 and is authorized under FDA application M021.

Identification & Billing

NDC Package Code
72476-005-86
Package Description
1000 mL in 1 BOTTLE, PLASTIC
Product Code
72476-005
11-Digit Billing Format
72476000586
RxNorm Crosswalk
  • RxCUI: 313029 - sodium fluoride 0.02 % (fluoride ion 0.01 % ) Oral Rinse
  • RxCUI: 313029 - sodium fluoride 0.2 MG/ML Mouthwash
  • RxCUI: 313029 - sodium fluoride 0.02 % (fluoride ion 0.009 % ) Oral Rinse

Clinical Specifications

Proprietary Name
Anticavity
Non-Proprietary Name
Sodium Fluoride
Substance Name
Sodium Fluoride
Dosage Form
Mouthwash - An aqueous solution which is most often used for its deodorant, refreshing, or antiseptic effect.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
SODIUM FLUORIDE .1 mg/mL
Usage Information
Adults and children 12 years of age and older:use twice daily after brushing your teeth with a toothpastevigorously swish 10 mL (2 teaspoonfuls) of rinse between your teeth for 1 minute and then spit outdo not swallow the rinsedo not eat or drink for 30 minutes after rinsingsupervise children as necessary until capable of using without supervisionchildren under 12 years of age: consult a dentist or doctor

Regulatory & Marketing

Labeler Name
Adusa Distribution, Llc
Product Type
Human Otc Drug
FDA Application #
M021
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
09-12-2005
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 72476-005-86 identifies a specific commercial package of 1000 ml in 1 bottle, plastic of Anticavity, a human over the counter drug labeled by Adusa Distribution, Llc. This mouthwash is formulated for oral use and contains 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 Adusa Distribution, Llc on September 12, 2005. The current certification is valid through December 31, 2027.

How is this Adusa Distribution, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 72476000586. 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)
72476-005-86
11-Digit CMS (5-4-2)
72476-0005-86

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