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J0295
AMPICILLIN SULBACTAM 1.5 GM
AMPICILLIN SULBACTAM 1.5 GM
J0456
AZITHROMYCIN
AZITHROMYCIN
J0744
CIPROFLOXACIN IV
CIPROFLOXACIN IV
13429
This health plan covers well newborn care furnished for a newborn enrolled in the plan, or a newborn not enrolled in the plan when services are furnished during the enrolled member's inpatient maternity stay or during an outpatient admission in a licensed outpatient birthing center. These covered services include: