Drug IndexLucentis (ranibizumab)



Billing

Code: J2778

Description: Ranibizumab injection

Unit: 0.1 mg

Payment: $187.553

Pay quarter: Q1 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

$1,950.00

Total Reimbursement:

$937.77

(ASP: $884.68, Margin: $53.08)

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# Units to bill:

5

Dosage & Frequency

Neovascular (Wet) Age-Related Macular Degeneration (AMD)
Macular Edema Following Retinal Vein Occlusion (RVO)

• 0.5mg IVT every 1 month

Diabetic Macular Edema (DME)
Diabetic Retinopathy (DR)

• 0.3mg IVT every 1 month

Myopic Choroidal Neovascularization (mCNV)

• 0.5mg IVT every 1 month for up to 3 months


Billable NDCs

50242-0080-03

Lucentis (GENENTECH, INC.)

0.5 mg


50242-0082-03

Lucentis PFS (GENENTECH, INC.)

0.30000000000000004 MG



Prior Authorization

Aetna

United Healthcare

Anthem

Cigna


Resources

Website