Bismatrol
NDC Package 17856-1313-3

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

Package Information

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

Bismatrol is shake well before usefor accurate dosing, use dose cupadults and children 12 years and over: 1 dose (2 tbsp or 30 mL) every 1/2 to 1 hour as neededdo not exceed 8 doses (16 tbsp or 240 mL) in 24 hoursuse until diarrhea stops but not more than 2 dayschildren under 12 years: ask a doctordrink plenty of clear fluids to help prevent dehydration caused by diarrhea. Marketed by Atlantic Biologicals Corp., this product is identified by NDC 17856-1313 and is authorized under FDA application part335.

Identification & Billing

NDC Package Code
17856-1313-3
Package Description
30 mL in 1 CUP
Product Code
17856-1313
11-Digit Billing Format
17856131303
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
Units Per Package
30 ML
RxNorm Crosswalk
  • RxCUI: 308762 - bismuth subsalicylate 525 MG in 30 mL Oral Suspension
  • RxCUI: 308762 - bismuth subsalicylate 17.5 MG/ML Oral Suspension
  • RxCUI: 308762 - bismuth subsalicylate 1.75 % Oral Suspension
  • RxCUI: 308762 - bismuth subsalicylate 262 MG per 15 ML Oral Suspension
  • RxCUI: 308762 - bismuth subsalicylate 524 MG per 30 ML Oral Suspension

Clinical Specifications

Proprietary Name
Bismatrol
Dosage Form
-
Usage Information
Shake well before usefor accurate dosing, use dose cupadults and children 12 years and over: 1 dose (2 tbsp or 30 mL) every 1/2 to 1 hour as neededdo not exceed 8 doses (16 tbsp or 240 mL) in 24 hoursuse until diarrhea stops but not more than 2 dayschildren under 12 years: ask a doctordrink plenty of clear fluids to help prevent dehydration caused by diarrhea

Regulatory & Marketing

Labeler Name
Atlantic Biologicals Corp.
FDA Application #
part335
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
05-30-2008
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (17856-1313). Click a package code to view its specific billing and regulatory data.

17856-1313-1
15 mL in 1 CUP

* 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 17856-1313-3 identifies a specific commercial package of 30 ml in 1 cup of Bismatrol, labeled by Atlantic Biologicals Corp.. This product is billed per "ML" milliliter and contains an estimated amount of 30 billable units per package. 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 Atlantic Biologicals Corp. on May 30, 2008. The current certification is valid through December 31, 2022.

How is this Atlantic Biologicals Corp. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 17856131303. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. There are 30 total billable units per package. 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)
17856-1313-3
11-Digit CMS (5-4-2)
17856-1313-03

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