Limited Use Note(s)

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RANIBIZUMAB10mg/mL Inj Sol-0.23mL Vial Pk
Reason For Use CodeClinical Criteria
655For the treatment of age-related macular degeneration (AMD), diabetic macular edema (DME), branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO) or choroidal neovascularization, but only for patients established on Lucentis (ranibizumab) therapy prior to July 31, 2023.
LU Authorization Period: 1 year