Ranibizumab (Lucentis, Byooviz, and Cimerli)

Ranibizumab (Lucentis, Byooviz, Cimerli) is covered for FDA‑approved ocular neovascular conditions (wet AMD, RVO‑related macular edema, DME, DR, mCNV) and selected compendial neovascular ophthalmic uses and is not covered for diagnoses outside those listed. Approval requires intravitreal administration by or under an ophthalmologist’s supervision, documentation of diagnosis and medical necessity, monthly dosing per policy (0.5 mg monthly for wet AMD, RVO and most neovascular diseases; 0.3 mg monthly for DME/DR; mCNV 0.5 mg monthly limited to up to 3 months) and is authorized for up to 12 months.

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

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