NDC 00904-1313-09
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
bismuth subsalicylate 262 mg/15 mL Susp 236 mL BOT
Reported by 3 hospitals in the network under the other methodology.
Low
$5
Average
$5
Median
$5
High
$5
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Allina Health Systems Buffalo, MN | $6 | $5 | $2 | 43% | — | $0 – $11 |
| 2 | Allina Health Systems Faribualt, MN | $6 | $5 | $2 | 43% | — | $0 – $11 |
| 3 | Allina Health Systems River Falls, WI | $5 | $5 | $1 | 11% | — | $2 – $11 |
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