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