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NDC 63323051302

gentamicin 20 mg/2 mL Injection (Pediatric) at Jefferson County HMA LLC

Jefferson City, TN

Pricing by billing methodology

Price type

All methodologies

$143

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

$3

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

$170

Reflects a negotiated percentage of total billed charges.

Other

Not reported

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

Last updated: Apr 1, 2026

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