erythromycin 0.5% ophthalmic ointment — United Healthcare
prophylaxis of gonococcal ophthalmia neonatorum in newborns
Initial criteria
- Member or health care provider intends to administer medication to newborn for the prophylaxis of gonococcal ophthalmia neonatorum OR Newborn is 0–1 month of age
Approval duration
up to 1 month from approval