| Package AWP: | $140,400.00 |
| Package: | 0.05 ML |
| J-Code: | J2778 |
| Strength: | 0.3 MG/0.05 ML |
| Form: | Solution |
| NDC Number: | 50242008202 |
| Generic Name: | Ranibizumab |
| Brand Name: | LUCENTIS |
| Mfg. Part No: | 50242008202 |
| Std Packaging: | EACH |
| Manufacturer: | GENENTECH |
| Replacement: | |
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