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  3. /Commonspirit Kansas, Inc.
  4. /NDC 9999911104

NDC 9999911104

DALBAVANCIN 1125 MG IVPB IN D5W 250 ML RN KIT at Commonspirit Kansas, Inc.

Dodge City, KS

Pricing by billing methodology

Price type

All methodologies

$8.5k

Aggregated across all available billing methodologies for this code.

Case rate

Not reported

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

Fee schedule

$15

Reflects negotiated fee schedule rates with commercial payers.

Per diem

Not reported

Reflects a negotiated per diem rate paid per day of care.

Percent of billed charges

$10.3k

Reflects a negotiated percentage of total billed charges.

Other

—

Reflects a payer-specific billing methodology not covered by the standard categories.

Last updated: Feb 5, 2026

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