Equate Sculpted White Tp Paste, Dentifrice
NDC Package 79903-282-87

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

Package Information

Equate Sculpted White Tp (sodium fluoride) pastes is aids in the prevention of dental cavities. This formulation utilizes a paste, dentifrice delivery system. Marketed by Walmart, this product is identified by NDC 79903-282 and is authorized under FDA application M022.

Identification & Billing

NDC Package Code
79903-282-87
Package Description
1 CARTON in 1 CARTON / 107 g in 1 CARTON
Product Code
79903-282
11-Digit Billing Format
79903028287
RxNorm Crosswalk
  • RxCUI: 891775 - sodium fluoride 0.243 % Toothpaste
  • RxCUI: 891775 - sodium fluoride 0.00243 MG/MG Toothpaste
  • RxCUI: 891775 - sodium fluoride 0.243 % (fluoride ion 0.13 % ) Toothpaste
  • RxCUI: 891775 - sodium fluoride 0.243 % (fluoride ion 0.14 % ) Toothpaste
  • RxCUI: 891775 - sodium fluoride 0.243 % (fluoride ion 0.15 % ) Toothpaste

Clinical Specifications

Proprietary Name
Equate Sculpted White Tp Equate Sculpted White Tp
Non-Proprietary Name
Sodium Fluoride
Substance Name
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
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
SODIUM FLUORIDE .15 g/100g
Usage Information
Aids in the prevention of dental cavities

Regulatory & Marketing

Labeler Name
Walmart
Product Type
Human Otc Drug
FDA Application #
M022
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
12-18-2024
Listing Expiration
12-31-2026
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 79903-282-87 identifies a specific commercial package of 1 carton in 1 carton / 107 g in 1 carton of Equate Sculpted White Tp Equate Sculpted White Tp, a human over the counter drug labeled by Walmart. This paste, dentifrice 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 Walmart on December 18, 2024. The current certification is valid through December 31, 2026.

How is this Walmart product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 79903028287. 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)
79903-282-87
11-Digit CMS (5-4-2)
79903-0282-87

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