Code: J0875

Description:
Description: Injection, dalbavancin, 5 mg
HCPCS Category: Drugs administered other than oral method, chemotherapy drugs
Other Descriptions:
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION
DALBAVANCIN 1500MG/300ML IVPB
INJECTION DALBAVANCIN 5MG
DALVANCE IVPB 1500MG/500ML D5W
Related codes:
Code: J0878
DAPTOMYCIN 500 MG INJ
Code: J0879
DAPTOMYCIN 350 MG IV SOLR
Oklahoma
Hospital Address Code Price Last Updated
St. John Owasso 12451 E 100Th St N, Owasso J0875 $15 [source] 4 years ago
St. John Medical Center 1923 S Utica Ave, Tulsa J0875 $15 [source] 4 years ago
St John Sapulpa, Inc. 1004 E Bryan Ave, Sapulpa J0875 $21 [source] 4 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.