Ranibizumab (Lucentis®) Injection

Lucentis (ranibizumab) is covered for FDA‑approved ophthalmic indications (neovascular [wet] AMD, macular edema following RVO, diabetic macular edema and diabetic retinopathy, myopic CNV) and specified compendial neovascular eye uses; uses not listed are excluded. Coverage requires administration by or under the supervision of an ophthalmologist, documentation of the diagnosis and dosing/administration dates, adherence to indication‑specific intravitreal dosing (0.5 mg monthly for AMD/RVO, 0.3 mg monthly for DME/DR, 0.5 mg monthly for up to 3 months for mCNV), and approvals are issued for up to 12 months.

"Diabetic macular edema (DME)"

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