Ranibizumab (Lucentis® Byooviz ™) Injection

Ranibizumab (Lucentis, Byooviz) is covered for FDA‑approved ophthalmic indications (neovascular AMD, RVO‑associated macular edema, DME, DR, mCNV) and certain compendial neovascular uses; other unlisted indications are not covered. Approval (up to 12 months) requires administration by or under the supervision of an ophthalmologist, documentation of the covered diagnosis and meeting specific coverage guidelines, and adherence to dosing limits (0.5 mg intravitreal monthly for neovascular AMD/RVO, 0.3 mg monthly for DME/DR, and 0.5 mg monthly for mCNV limited to ≤3 months).

"Neovascular (wet) age-related macular degeneration (AMD)"

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