WIC Special Formula Price List (PDF: 125KB/4

WIC Special Formula Price List
- March 2012 -
Company Formula Container Size Containers per Case
Maximum Price
per Container
Abbott Nutrition Calcilo XD 13.2 oz. powder 6 $20.85
Abbott Nutrition Cyclinex 1 14.1 oz. Powder 6 $22.04
Abbott Nutrition Cyclinex 2 14.1 oz. Powder 6 $42.90
Abbott Nutrition Elecare DHA/ARA (infant) 14.1 oz. Powder 6 $43.23
Abbott Nutrition Elecare Jr Unflavored (1 & Up) 14.1 oz. Powder 6 $43.23
Abbott Nutrition Elecare Jr Vanilla (1 & Up) 14.1 oz. Powder 6 $43.23
Abbott Nutrition Ensure 8 oz. RTU 24 $2.21
Abbott Nutrition Ensure Plus 8 oz. RTU 24 $2.44
Abbott Nutrition Ensure Pudding 4 oz. Pudding 4-packs 48 $1.94
Abbott Nutrition Glucerna Shake 8 oz. RTU 24 $2.15
Abbott Nutrition Hominex 1 14.1 oz. powder 6 $39.00
Abbott Nutrition Hominex 2 14.1 oz. powder 6 $78.00
Abbott Nutrition Isomil DF 32 oz. RTF 6 $10.63
Abbott Nutrition I-Valex 1 14.1 oz. powder 6 $39.00
Abbott Nutrition I-Valex 2 14.1 oz. powder 6 $78.00
Abbott Nutrition Jevity 1 Cal 32 oz. RTF 6 $9.32
Abbott Nutrition Jevity 1 Cal 8 oz. RTF 24 $2.57
Abbott Nutrition Jevity 1.2 Cal 8 oz. RTF 24 $3.09
Abbott Nutrition Pediasure 8 oz. RTF 24 $2.68
Abbott Nutrition Pediasure w/Fiber 8 oz. RTF 24 $2.77
Abbott Nutrition Pediasure Enteral 8 oz. RTF 24 $2.77
Abbott Nutrition Pediasure Enteral w/Fiber 8 oz. RTF 24 $2.77
Abbott Nutrition Pediasure Peptide 8 oz. RTF 24 $8.98
Abbott Nutrition PediaSure Sidekicks 8 oz. RTU 16 $2.77
Abbott Nutrition Phenyx 1 14.1 oz. powder 6 $22.25
Abbott Nutrition Phenyx 2 14.1 oz. powder 6 $43.68
Page 1 of 4

Company Formula Container Size Containers per Case
Maximum Price
per Container
Abbott Nutrition Polycose 12.3 oz. powder 6 $8.80
Abbott Nutrition Propimex 1 14.1 oz. powder 6 $39.00
Abbott Nutrition Propimex 2 14.1 oz. powder 6 $78.00
Abbott Nutrition RCF 13 ounce liquid concentrate 12 $6.58
Abbott Nutrition Similac Alimentum 16 oz. Powder 6 $39.48
Abbott Nutrition Similac Alimentum 32 oz. RTF 6 $13.33
Abbott Nutrition Similac Alimentum 8 oz. RTF 6 $3.74
Abbott Nutrition Similac Expert Care for Diarrhea Quart RTF 6 $10.63
Abbott Nutrition Similac Go & Grow – Milk 22 oz. Powder 6 $30.81
Abbott Nutrition Similac Go & Grow – Soy 22 oz. Powder 6 $30.81
Abbott Nutrition Similac Neosure 13.1 oz. Powder 6 $22.14
Abbott Nutrition Similac Neosure 32 oz. RTF 6 $10.99
Abbott Nutrition Similac Neosure 2 oz. RTF 48 $1.17
Abbott Nutrition Similac PM 60/40 14.1 oz. Powder 6 $20.09
Abbott Nutrition Similac Special Care 24 2 oz. RTF 48 $1.87
Abbott Nutrition Similac Special Care 30 2 oz. RTF 48 $1.87
Axcan
Scandipharm
Scandishake 3 oz. Packets 4 $2.52
Mead Johnson EnfaCare 12.8 oz.(or 13.6 oz) Powder 6 $20.87
Mead Johnson EnfaCare 32 oz. RTU 6 $9.52
Mead Johnson EnfaCare Nursette 22 Cal 2 oz. RTU 48 $1.77
Mead Johnson Enfamil LIPIL w/ Iron 24 Cal 2 oz. RTU 48 $1.77
Mead Johnson Enfamil Premature 30 Cal 2 oz RTU 48 $1.77
Mead Johnson Enfamil Premature High Protein 24 Cal 2 oz. RTU 48 $1.77
Mead Johnson Enfamil Premature Low Iron 20 Cal 2 oz. RTU 48 $1.77
Mead Johnson Enfamil Premature w/ Iron 20 Cal 2 oz. RTU 48 $1.77
Mead Johnson Enfamil Premature Low Iron 24 Cal 2 oz. RTU 48 $1.77
Mead Johnson Enfamil Premature w/ Iron 24 Cal 2 oz. RTU 48 $1.77
Mead Johnson Enfaport 8 oz. RTF 24 $3.55
Mead Johnson Nutramigen AA 14.1 oz. Powder 4 $46.94
Page 2 of 4

Company Formula Container Size Containers per Case
Maximum Price
per Container
Mead Johnson Nutramigen 12.6 oz. Powder 6 $31.42
Mead Johnson Nutramigen 32 oz. RTU 6 $12.26
Mead Johnson Nutramigen 13 oz. Concentrate 12 $9.76
Mead Johnson Nutramigen 20 Calorie 2 oz. RTU 48 $1.83
Mead Johnson OA 1 16 oz. Powder 6 $42.90
Mead Johnson PFD 1 16 oz. Powder 6 $21.45
Mead Johnson Phenyl-Free 1 16 oz. Powder 6 $31.45
Mead Johnson Phenyl-Free 2 16 oz. Powder 6 $36.31
Mead Johnson Portagen 16 oz. Powder 6 $23.73
Mead Johnson Pregestimil 16 oz. Powder 6 $40.96
Mead Johnson Pregestimil 20 Calorie 2 oz. RTU 48 $1.83
Mead Johnson Pregestimil 24 Calorie 2 oz. RTU 48 $1.83
Mead Johnson Product 3232A 16 oz. Powder 6 $75.73
Mead Johnson Tyros 2 16 oz. Powder 6 $74.74
Nestle Beneprotein 8 oz powder 6 $12.68
Nestle Boost 8 oz. RTF 27 $2.13
Nestle Boost Plus 8 oz. RTF 27 $2.13
Nestle Boost Kid Essentials 1.0 8 oz. RTF 27 $1.99
Nestle Boost Kid Essentials 1.5 8 oz. RTF 27 $2.16
Nestle Boost Kid Essentials 1.5 with Fiber 8 oz. RTF 27 $2.18
Nestle Breeze 8 oz. RTF 27 $1.46
Nestle Compleat Pediatric 8.45 (250 ml) oz. RTF 24 $3.32
Nestle Dairy Thick 8 oz. RTU 27 $1.04
Nestle MCT Oil 32 oz. RTU 6 $59.58
Nestle Microlipid 3 oz. RTU 48 $3.26
Nestle Nutren 1.0 8.45 oz. RTU 24 $1.07
Nestle Nutren 1.0 with Fiber 8.45 oz. RTF 24 $1.13
Nestle Nutren Jr. 8.45 oz. RTF 24 $1.47
Nestle Nutren Jr. with Fiber 8.45 oz. RTF 24 $1.60
Page 3 of 4

Company Formula Container Size Containers per Case
Maximum Price
per Container
Nestle Nutren Replete 8.45 oz. RTF 24 $1.46
Nestle Peptamen 8.45 oz. RTU 24 $6.20
Nestle Peptamen 1.5 8.45 oz. RTU 24 $9.29
Nestle Peptamen Jr. 8.45 oz. RTU 24 $6.93
Nestle Peptamen Junior 1.5 8.45 oz. RTU 24 $9.70
Nestle Peptamen Jr. w/ Fiber 8.45 oz. RTU 24 $7.10
Nestle Peptamen Jr. with Prebio 8.45 oz. RTU 24 $7.10
Nestle Tolerex 2.82 ounce packets 60 $7.81
Nestle Vivonex Pediatric 1.7 oz.Powder Packets 36 $6.07
Nestle Vivonex T.E.N. 2.84 oz. Powder Packets 60 $8.62
Nutricia Duocal 14 oz. Powder 6 $25.68
Nutricia EO28 Splash 8 oz. RTF 27 $5.00
Nutricia Ketocal 3:1 11 oz. Powder 6 $30.77
Nutricia Ketocal 4:1 11 oz. Powder 6 $31.85
Nutricia Neocate Infant with DHA/ARA 14 oz. Powder 4 $40.00
Nutricia Neocate Junior 14 oz. Powder 4 $39.33
Nutricia Neocate Junior w/ Prebiotics 14 oz. Powder 4 $39.33
Nutricia XMTVI Maxamaid 16 oz. Powder 6 $78.00
Nutricia Xphe Maxamaid 16 oz. Powder 6 $46.80
Nutricia Xphe Maxamum 16 oz. Powder 6 $74.43
Nutricia Xphe,XTyr Maxamaid 16 oz. Powder 6 $78.00
PBM Bright Beginnings 8 oz. RTF 24 $1.63
PBM Bright Beginnings w/ Fiber 8 oz. RTF 24 $1.63
PBM Bright Beginnings Soy 8 oz. RTF 24 $1.63
For any formula not listed above, please contact us at (651) 201-4401 or (651) 201-4417.
Page 4 of 4