Products

    Phenyl-Free® 2

    A medical food powder for children and adults with documented phenylketonuria

    Indication

    Phenyl-Free 2 is a medical food powder that is free of the essential amino acid phenylalanine for children and adults with documented phenylketonuria (PKU). It provides all other essential amino acids as well as nonessential amino acids, carbohydrates, fats, essential fatty acids, vitamins and minerals. Phenyl-Free 2 has less fat and fewer total calories than Phenyl-Free 1 (8.6 g vs 26 g and 410 Cal vs 500 Cal, respectively per 100 g powder). Use under direct and continuing medical supervision.

    Ingredients

    Ingredients: Sugar, 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), corn syrup solids, soy oil, modified corn starch, calcium phosphate, sodium citrate, magnesium phosphate, potassium chloride and less than 1%: sodium phosphate, potassium citrate, choline chloride, ascorbic acid, taurine, inositol, ferrous sulfate, L-carnitine, zinc sulfate, niacinamide, 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 iodide, sodium selenite, biotin, vitamin K1, ethyl vanillin.

    Nutrients

     

    Per 100 grams Powder

    Calories

    410

    Protein equivalent, g*

    22

    Fat, g

    8.6

    Carbohydrate, g

    60

    Vitamins/Other Nutrients

     

    Vitamin A, IU

    1430

    Vitamin D, IU

    290

    Vitamin E, IU

    9.8

    Vitamin K, mcg

    41

    Thiamin (Vitamin B1), mcg

    1220

    Riboflavin (Vitamin B2), mcg

    980

    Vitamin B6, mcg

    980

    Vitamin B12, mcg

    2.4

    Niacin, mcg

    22000

    Folic acid (Folacin), mcg

    350

    Pantothenic acid, mcg

    4900

    Biotin, mcg

    49

    Vitamin C (Ascorbic acid), mg

    49

    Choline, mg

    98

    Inositol, mg

    49

    Minerals

     

    Calcium, mg

    730

    Phosphorous, mg

    730

    Magnesium, mg

    163

    Iron, mg

    12.2

    Zinc, mg

    12.2

    Manganese, mcg

    1310

    Copper, mcg

    1220

    Iodine, mcg

    63

    Selenium, mcg

    29

    Chromium, mcg

    37

    Molybdenum, mcg

    37

    Sodium, mg

    610

    Potassium, mg

    1100

    Chloride, mg

    860

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

    Protein Equivalent (% Calories)*

    22

    Fat (% Calories)

    19

    Carbohydrate (% Calories)

    59

    Lactose-free

    Suitable for someone with lactose intolerance

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

    AMINO ACID COMPOSITION

    ESSENTIAL AMINO ACIDS

    mg/100 g powder

    Histidine

    550

    Isoleucine

    1560

    Leucine

    2900

    Lysine

    1760

    Methionine

    480

    Cysteine

    330

    Phenylalanine

    0

    Tyrosine

    2200

    Threonine

    1010

    Tryptophan

    400

    Valine

    1690

    NONESSENTIAL AMINO ACIDS

    mg/100 g powder

    Arginine

    1320

    Alanine

    1450

    Aspartic Acid

    1740

    Glutamine

    3500

    Glycine

    790

    Proline

    1740

    Serine

    860

    Product Forms and Ordering Information

    PHENYL-FREE 2 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, Powder
    Item #: 891301
    Description: Powder
    Unit Size: 1 lb can
    Calories/Unit: 1860
    Product Yield/Unit (fl oz): Varies
    Case: 6 cans per case
    HCPCS Code: B4157 or B4162
    NDC Format Code: 00087-5100-03

    PRODUCT BENEFITS

    Phenyl-Free 2 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
    • 22 g protein equivalent/100 g powder
    • Higher level of protein equivalent than found in Phenyl-Free 1 (22 g vs. 16.2 g/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

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

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