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

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

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