Injection, dalbavancin, 5 mg
Short Description: Injection, dalbavancin
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 2016
Effective Date: January 1, 2016
Termination Date:
Short Description: Injection, dalbavancin
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 2016
Effective Date: January 1, 2016
Termination Date: