Northside Hospital Maternity Backpack Base Kit
NDC Package 85273-215-00

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

Package Information

Northside Hospital Maternity Backpack Base (sodium monofluorophospate) kits is not recommended for infants. This formulation utilizes a kit delivery system. Marketed by Alliance Formulations, this product is identified by NDC 85273-215 and is authorized under FDA application M003.

Identification & Billing

NDC Package Code
85273-215-00
Package Description
6 KIT in 1 BOX / 1 KIT in 1 KIT * 60 mL in 1 BOTTLE, PLASTIC * 4.25 g in 1 TUBE * 60 mL in 1 BOTTLE, PLASTIC * 60 mL in 1 BOTTLE, PLASTIC * 60 mL in 1 BOTTLE, PLASTIC * 10 g in 1 TUBE (84132-100-10) * 53 mL in 1 BOTTLE, PLASTIC (59448-011-01)
Product Code
85273-215
11-Digit Billing Format
85273021500
RxNorm Crosswalk
  • RxCUI: 545626 - sodium monofluorophosphate 0.76 % Toothpaste
  • RxCUI: 545626 - sodium monofluorophosphate 0.0076 MG/MG Toothpaste
  • RxCUI: 545626 - sodium monofluorophosphate 0.76 % (fluoride ion 0.12 % )Toothpaste
  • RxCUI: 545626 - sodium monofluorophosphate 0.76 % (fluoride ion 0.13 % )Toothpaste
  • RxCUI: 545626 - sodium monofluorophosphate 0.76 % (fluoride ion 0.14 % )Toothpaste

Clinical Specifications

Proprietary Name
Northside Hospital Maternity Backpack Base
Non-Proprietary Name
Sodium Monofluorophospate
Dosage Form
Kit - A packaged collection of related material.
Usage Information
Not recommended for infants. Wet hands thoroughly with product & allow to self dry. Children under 6 years of age should be supervised when using this product . Adults & 6+ ChildrenBrush teeth thoroughly after meals or at least twice a day or use as directed by a dentist or physicianChildren under 6 yrs.To minimize swallowing use a pea - sized amount and supervise brushing.Children under 2 yrs.Ask a dentist or physician.NDC NO. 84132-100-10

Regulatory & Marketing

Labeler Name
Alliance Formulations
Product Type
Human Otc Drug
FDA Application #
M003
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
10-20-2025
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 85273-215-00 identifies a specific commercial package of 6 kit in 1 box / 1 kit in 1 kit * 60 ml in 1 bottle, plastic * 4.25 g in 1 tube * 60 ml in 1 bottle, plastic * 60 ml in 1 bottle, plastic * 60 ml in 1 bottle, plastic * 10 g in 1 tube (84132-100-10) * 53 ml in 1 bottle, plastic (59448-011-01) of Northside Hospital Maternity Backpack Base, a human over the counter drug labeled by Alliance Formulations. This kit is formulated for use and contains 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 Alliance Formulations on October 20, 2025. The current certification is valid through December 31, 2026.

How is this Alliance Formulations product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 85273021500. 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)
85273-215-00
11-Digit CMS (5-4-2)
85273-0215-00

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