Soom Green Mouthwash
NDC Package 79717-0010-2

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

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was inactivated by the FDA.

Soom Green Mouthwash is adults and children 6 years of age and older■ Vigorously swish 11 mL between teeth twice a day for 30 seconds then spit out.■ Do not swallow■ Children under 6 years of age: do not use. Marketed by Tecozyme Inc, this product is identified by NDC 79717-0010 and is authorized under FDA application part355.

Identification & Billing

NDC Package Code
79717-0010-2
Package Description
20 POUCH in 1 CARTON / 11 mL in 1 POUCH (79717-0010-1)
Product Code
79717-0010
11-Digit Billing Format
79717001002
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
Soom Green Mouthwash
Dosage Form
-
Usage Information
Adults and children 6 years of age and older■ Vigorously swish 11 mL between teeth twice a day for 30 seconds then spit out.■ Do not swallow■ Children under 6 years of age: do not use

Regulatory & Marketing

Labeler Name
Tecozyme Inc
FDA Application #
part355
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
08-01-2021
Listing Expiration
12-31-2022
Exclude Flag
I
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 79717-0010-2 identifies a specific commercial package of 20 pouch in 1 carton / 11 ml in 1 pouch (79717-0010-1) of Soom Green Mouthwash, labeled by Tecozyme Inc. This is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

This product code is currently listed as inactive or excluded from the primary directory. It was introduced to the market by Tecozyme Inc on August 01, 2021. The current certification is valid through December 31, 2022.

How is this Tecozyme Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 79717001002. 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 (5-4-1)
79717-0010-2
11-Digit CMS (5-4-2)
79717-0010-02

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