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Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose 880 mg/100mL / 489 mg/100mL / 5 g/100mL / 438 mg/100mL / 204 mg/100mL / 255 mg/100mL / 311 mg/100mL Medicare Part D Coverage

Brand name: CLINIMIX
Dosage form
INJECTION
Route
INTRAVENOUS
63%
of Medicare Part D plans
cover Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose
3,505 of 5,530 plans
3.8
Avg. formulary tier
$0.00
Median 30-day copay
$0.00–$0.00
Copay range

Formulary Tier Distribution

How Medicare Part D plans classify Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose. Lower tiers = lower copays.

Tier 1 - Preferred Generic 3%
100 plans • avg $0.00/mo
Tier 2 - Generic 0%
5 plans • avg $0.00/mo
Tier 3 - Preferred Brand 7%
237 plans • avg $23.69/mo
Tier 4 - Non-Preferred Drug 90%
3,156 plans • avg $2.13/mo
Tier 6 - Select Care 0%
7 plans • avg $0.00/mo

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Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose Medicare Coverage by State

Coverage rates and average costs vary significantly by state. Click a state to see the specific plans available there.

Frequently Asked Questions about Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose

63% of Medicare Part D plans cover Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose. It is most commonly placed on Tier 4. Coverage varies by plan and geographic area.

The median 30-day copay for Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose on Medicare Part D is $0.00 at a preferred pharmacy. Costs range from $0.00 to $0.00 depending on the plan.

Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose is placed on Tier 4 by most Medicare Part D plans. Lower tier numbers generally mean lower copays.

0% of plans require prior authorization for Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose. Prior authorization means your doctor must confirm the drug is medically necessary before the plan will cover it.

Coverage statistics based on CMS formulary data for plan year 2026. Data updated regularly. Methodology →