Does Php (HMO C-SNP) cover Clinimix E 2.75/5?
Php (HMO C-SNP)
H5852-001-0 · MA_LOCAL · Medicare Part D
Clinimix E 2.75/5
Do you get help with your Medicare drug costs?None of these
Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.
Clinimix E 2.75/5under Php (HMO C-SNP)
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
25%of the price your plan negotiates
Medicare hasn’t published this plan’s negotiated price for this drug yet — that file is updated every three months, and newly launched drugs appear in it late. Your pharmacy can quote the exact amount today. Part D caps what you pay out of pocket at $2,100 for 2026. Before that, you pay the full price until you have paid $615 this year.
This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.
- Tier
- Tier 3
- Approval first
- Required
- Try another first
- No
- Amount limit
- None
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.
Covered forms and strengths (5)
- alanine 10.4 MG/ML / arginine 5.75 MG/ML / calcium chloride 0.004 MEQ/ML / dibasic potassium phosphate 2.61 MG/ML / glucose 150 MG/ML / glycine 5.15 MG/ML / histidine 2.4 MG/ML / isoleucine 3 MG/ML / leucine 3.65 MG/ML / lysine 2.9 MG/ML / magnesium chloride 0.01 MEQ/ML / methionine 2 MG/ML / phenylalanine 2.8 MG/ML / proline 3.4 MG/ML / serine 2.5 MG/ML / sodium acetate trihydrate 3.4 MG/ML / sodium chloride 0.01 MEQ/ML / threonine 2.1 MG/ML / tryptophan 0.9 MG/ML / tyrosine 0.2 MG/ML / valine 2.9 MG/ML Injectable Solution [Clinimix E 5/15]Tier 3Approval first
- alanine 10.4 MG/ML / arginine 5.75 MG/ML / calcium chloride 0.004 MEQ/ML / dibasic potassium phosphate 2.61 MG/ML / glucose 200 MG/ML / glycine 5.15 MG/ML / histidine 2.4 MG/ML / isoleucine 3 MG/ML / leucine 3.65 MG/ML / lysine 2.9 MG/ML / magnesium chloride 0.01 MEQ/ML / methionine 2 MG/ML / phenylalanine 2.8 MG/ML / proline 3.4 MG/ML / serine 2.5 MG/ML / sodium acetate trihydrate 3.4 MG/ML / sodium chloride 0.01 MEQ/ML / threonine 2.1 MG/ML / tryptophan 0.9 MG/ML / tyrosine 0.2 MG/ML / valine 2.9 MG/ML Injectable Solution [Clinimix E 5/20]Tier 3Approval first
- alanine 5.7 MG/ML / arginine 3.16 MG/ML / calcium chloride 0.004 MEQ/ML / dibasic potassium phosphate 2.61 MG/ML / glucose 50 MG/ML / glycine 2.83 MG/ML / histidine 1.32 MG/ML / isoleucine 1.65 MG/ML / leucine 2.01 MG/ML / lysine 1.59 MG/ML / magnesium chloride 0.01 MEQ/ML / methionine 1.1 MG/ML / phenylalanine 1.54 MG/ML / proline 1.87 MG/ML / serine 1.38 MG/ML / sodium acetate trihydrate 2.17 MG/ML / sodium chloride 0.02 MEQ/ML / threonine 1.16 MG/ML / tryptophan 0.5 MG/ML / tyrosine 0.11 MG/ML / valine 1.6 MG/ML Injectable Solution [Clinimix E 2.75/5]Tier 3Approval first
- alanine 8.8 MG/ML / arginine 4.89 MG/ML / calcium chloride 0.004 MEQ/ML / dibasic potassium phosphate 2.61 MG/ML / glucose 100 MG/ML / glycine 4.38 MG/ML / histidine 2.04 MG/ML / isoleucine 2.55 MG/ML / leucine 3.11 MG/ML / lysine 2.47 MG/ML / magnesium chloride 0.01 MEQ/ML / methionine 1.7 MG/ML / phenylalanine 2.38 MG/ML / proline 2.89 MG/ML / serine 2.13 MG/ML / sodium acetate trihydrate 2.97 MG/ML / sodium chloride 0.013 MEQ/ML / threonine 1.79 MG/ML / tryptophan 0.77 MG/ML / tyrosine 0.17 MG/ML / valine 2.47 MG/ML Injectable Solution [Clinimix E 4.25/10]Tier 3Approval first
- alanine 8.8 MG/ML / arginine 4.89 MG/ML / calcium chloride 0.004 MEQ/ML / dibasic potassium phosphate 2.61 MG/ML / glucose 50 MG/ML / glycine 4.38 MG/ML / histidine 2.04 MG/ML / isoleucine 2.55 MG/ML / leucine 3.11 MG/ML / lysine 2.47 MG/ML / magnesium chloride 0.01 MEQ/ML / methionine 1.7 MG/ML / phenylalanine 2.38 MG/ML / proline 2.89 MG/ML / serine 2.13 MG/ML / sodium acetate trihydrate 2.97 MG/ML / sodium chloride 0.013 MEQ/ML / threonine 1.79 MG/ML / tryptophan 0.77 MG/ML / tyrosine 0.17 MG/ML / valine 2.47 MG/ML Injectable Solution [Clinimix E 4.25/5]Tier 3Approval first