Products

    Phenyl-Free® 2 HP

    A high-protein medical food powder for children and adults with documented phenylketonuria (PKU)

    Indication

    Phenyl-Free 2 HP is a high-protein medical food powder that is free of the essential amino acid phenylalanine for children and adults with documented phenylketonuria (PKU). It has all other essential amino acids as well as nonessential amino acids, carbohydrates, fats, essential fatty acids, vitamins and minerals. Phenyl-Free 2 HP is appropriate for women with maternal PKU or for children and adults who require more protein equivalent than provided by Phenyl-Free 2 (40 g vs 22 g per 100 g powder). Use under direct and continuing medical supervision.

    Ingredients

    Ingredients: Amino acids (L-glutamine, L-leucine, potassium aspartate, L-lysine hydrochloride, L-tyrosine, L-proline, L-valine, L-isoleucine, L-alanine, L-arginine, L-threonine, L-serine, glycine, L-histidine, L-methionine, L-tryptophan, L-cystine), sugar, corn syrup solids, soy oil, modified corn starch, calcium phosphate, magnesium phosphate and less than 1%: sodium citrate, potassium chloride, sodium phosphate, potassium citrate, choline chloride, ascorbic acid, taurine, inositol, ferrous sulfate, zinc sulfate, niacinamide, L-carnitine, vitamin E acetate, vitamin A palmitate, calcium pantothenate, cupric sulfate, manganese sulfate, vitamin B12, thiamin hydrochloride, vitamin B6 hydrochloride, riboflavin, folic acid, vitamin D3, chromic chloride, sodium molybdate, sodium selenite, biotin, vitamin K1, sodium iodide, ethyl vanillin.

    Nutrients

     

    Per 100 grams Powder

    Calories

    390

    Protein equivalent, g*

    40

    Fat, g

    6.3

    Carbohydrate, g

    44

    Vitamins/Other Nutrients

     

    Vitamin A, IU

    1960

    Vitamin D, IU

    390

    Vitamin E, IU

    11.8

    Vitamin K, mcg

    51

    Thiamin (Vitamin B1), mcg

    1570

    Riboflavin (Vitamin B2), mcg

    1290

    Vitamin B6, mcg

    1290

    Vitamin B12, mcg

    3.1

    Niacin, mcg

    29000

    Folic acid (Folacin), mcg

    470

    Pantothenic acid, mcg

    6300

    Biotin, mcg

    63

    Vitamin C (Ascorbic acid), mg

    63

    Choline, mg

    67

    Inositol, mg

    63

    Minerals

     

    Calcium, mg

    980

    Phosphorous, mg

    980

    Magnesium, mg

    290

    Iron, mg

    15.7

    Zinc, mg

    15.7

    Manganese, mcg

    1570

    Copper, mcg

    1570

    Iodine, mcg

    50

    Selenium, mcg

    36

    Chromium, mcg

    51

    Molybdenum, mcg

    51

    Sodium, mg

    410

    Potassium, mg

    1180

    Chloride, mg

    980

    Product nutrient values and ingredients are subject to change. Please see product label for current information.

    Protein Equivalent (% Calories)*

    41

    Fat (% Calories)

    15

    Carbohydrate (% Calories)

    44

    Lactose-free

    Suitable for someone with lactose intolerance

    *WARNING: Protein is incomplete since it does not contain the essential amino acid phenylalanine.

    Note: Due to the higher levels of amino acids in Phenyl-Free 2 HP, the taste of amino acids is more prevalent in this product than it is in Phenyl-Free 2.

    AMINO ACID COMPOSITION

    ESSENTIAL AMINO ACIDS

    mg/100 g powder

    Histidine

    1000

    Isoleucine

    2800

    Leucine

    5200

    Lysine

    3200

    Methionine

    880

    Cysteine

    600

    Phenylalanine

    0

    Tyrosine

    4000

    Threonine

    1840

    Tryptophan

    720

    Valine

    3100

    NONESSENTIAL AMINO ACIDS

    mg/100 g powder

    Arginine

    2400

    Alanine

    2600

    Aspartic Acid

    3200

    Glutamine

    6300

    Glycine

    1440

    Proline

    3200

    Serine

    1560

    Product Forms and Ordering Information

    PHENYL-FREE® 2 HP IS AVAILABLE IN POWDER

    When using this information, please note the following:

     

    Coding systems and reimbursement allowable rates vary by payer:

    • Medicare Part B uses HCPCS (Healthcare Common Procedure Coding System) to group products
    • Medicaid systems vary by state; some use HCPCS while others use NDC format code or systems of their own—contact your state provider for more information
    • Private health insurance and managed care companies may use HCPCS, NDC format code or their own system—contact your provider for more information

    Phenyl-Free® 2 HP, Powder
    Item #: 891401
    Description: Powder
    Unit Size: 1 lb can
    Calories/Unit: 1770
    Product Yield/Unit (fl oz): Varies
    Case: 6 cans per case
    HCPCS Code: B4157 or B4162
    NDC Format Code: 00087-5100-10

    PRODUCT BENEFITS

    Phenyl-Free 2 HP provides all the essential amino acids for patients with documented PKU, as well as nonessential amino acids, carbohydrates, fats, essential fatty acids, vitamins and minerals

    • Phenylalanine-free
    • 40 g protein equivalent/100 g powder
    • Higher levels of protein equivalent and most vitamins and minerals than found in Phenyl-Free 2 (40 g protein equivalent vs 22 g per 100 g powder)

    Additional product features:

    • Suitable for someone with lactose intolerance
    • Vanilla scent
    • Can be easily modified with preferred flavor enhancers
    • Mixes easily and stays in suspension well
    • Halal

    Letter of Medical Necessity Phenyl-Free 2 HP

    This letter establishes a medical need for Phenyl-Free 2 HP and might help get your patients' insurance company to reimburse them for the product.

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