Ranibizumab (Lucentis)

Lucentis (ranibizumab) is covered only for the listed FDA‑approved ocular indications (neovascular AMD; RVO‑related macular edema; DME; DR with DME; mCNV) and excluded for non‑FDA‑approved/off‑label uses, and coverage is conditional on absence of ocular/periocular infection and absence of active intraocular inflammation. Authorization requires documentation of the diagnosis, documentation that infection/inflammation are absent, a planned dosing regimen of 0.3 mg intravitreal approximately every 28 days, and supports up to 12 months of approval.

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

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