RANIBIZUMAB

RANIBIZUMAB (10373Y)

ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial
10373Y
Body System:
Manner of administration:Injection
General Schedule
Authority Required

Restriction

Indication: Proliferative diabetic retinopathy (PDR) and/or Diabetic macular oedema (DMO)
Treatment phase: Initial treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $786.69 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lucentis

RANIBIZUMAB (11471R)

ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial
11471R
Body System:
Manner of administration:Injection
General Schedule
Authority Required

Restriction

Indication: Subfoveal choroidal neovascularisation (CNV)
Treatment phase: Initial treatment

Restriction

Indication: Subfoveal choroidal neovascularisation (CNV)
Treatment phase: Initial treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 2 DPMQ: $786.69 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lucentis

RANIBIZUMAB (11981N)

ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial
11981N
Body System:
Manner of administration:Injection
General Schedule
Authority Required

Restriction

Indication: Branch retinal vein occlusion with macular oedema
Treatment phase: Initial treatment

Restriction

Indication: Central retinal vein occlusion with macular oedema
Treatment phase: Initial treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 2 DPMQ: $786.69 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lucentis

RANIBIZUMAB (13137K)

ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial
13137K
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 13406)

Indication: Subfoveal choroidal neovascularisation (CNV)
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 2 DPMQ: $786.69 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lucentis

RANIBIZUMAB (13149C)

ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial
13149C
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 13387)

Indication: Branch retinal vein occlusion with macular oedema
Treatment phase: Continuing treatment

Restriction (Streamlined authority code: 13336)

Indication: Central retinal vein occlusion with macular oedema
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 2 DPMQ: $786.69 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lucentis

RANIBIZUMAB (13156K)

ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial
13156K
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 13392)

Indication: Subfoveal choroidal neovascularisation (CNV)
Treatment phase: Continuing treatment

Restriction (Streamlined authority code: 13340)

Indication: Subfoveal choroidal neovascularisation (CNV)
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 2 DPMQ: $786.69 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lucentis

RANIBIZUMAB (13165X)

ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial
13165X
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17395)

Indication: Proliferative diabetic retinopathy (PDR) and/or Diabetic macular oedema (DMO)
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $786.69 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lucentis

RANIBIZUMAB (1382R)

ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial
1382R
Body System:
Manner of administration:Injection
General Schedule
Authority Required

Restriction

Indication: Subfoveal choroidal neovascularisation (CNV)
Treatment phase: Initial treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 2 DPMQ: $786.69 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lucentis