Syringe

4Ml — Prefilled Syringe

Also known as: Syringe 40 Mg/0 .4Ml

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 9 hours, 33 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Unknown	✓	—	✓	PA \| QL