Pharmacies must list prices for ALL FORMULAS ON THIS PAGE. Powder Ready to Feed (RTF) Liquid Concentrate Case Size (UPC) Price Size (UPC) Size (UPC) Price Size (UPC) Price Boost (any 8 oz. 6-Pack flavor) (041679674000) Boost Kid 8.25 oz. 4-Pack Essentials 1.0 (041679950968) Cal (any flavor) EleCare for 14.1 oz. Infants w/ DHA (070074535111) & ARA Enfamil 12.6 oz. Nutramigen w/ (300871239418) Enflora Enfamil Quart 13 oz. Nutramigen (300870499011) (300870498014) Enfamil 12.8 oz. 8 oz. 6-Pack 2 oz./48/case EnfaCare (300870019448) (300875102985) (300871390010) Ensure (any 8 oz. 6-Pack flavor) (070074407111) Neocate Infant 14.1 oz. w/DHA & ARA (749735025956) Neocate Jr 14.1 oz. (any flavor) (749735017906) Pediasure 8 oz. 6-Pack Grow & Gain (070074620503) (any flavor) Pediasure 8 oz. 6-Pack Grow & Gain (070074582214) w/ (any flavor) Pediasure 1.5 8 oz./24/case Cal (any (070074564098) flavor) Pediasure 8 oz./24/case Peptide 1.0 (070074564111) Cal (any flavor) Similac Expert 12.1 oz. Quart Care (070074647128) (070074575131) Alimentum Similac Expert 16 oz. Quart Care NeoSure (070074574318) (070074574561) This is not a complete list of all special formulas. Please see the complete list at .
Pharmacies must list prices for ALL FORMULAS ON THIS PAGE. Powder Ready to Feed (RTF) Liquid Concentrate Case Size (UPC) Price Size (UPC) Size (UPC) Price Size (UPC) Price Boost (any flavor) 8 oz. 6-Pack (041679674000) Boost Kid Essentials 1.0 Cal (any flavor) 8.25 oz. 4-Pack (041679950968) EleCare for Infants w/ DHA & ARA 14.1 oz. (070074535111) Enfamil Nutramigen w/ Enflora 12.6 oz. (300871239418) Enfamil Nutramigen Quart (300870499011) 13 oz. (300870498014) Enfamil EnfaCare 12.8 oz. (300870019448) 8 oz. 6-Pack (300875102985) 2 oz./48/case (300871390010) Ensure (any flavor) 8 oz. 6-Pack (070074407111) Neocate Infant w/DHA & ARA 14.1 oz. (749735025956) Neocate Jr (any flavor) 14.1 oz. (749735017906) Pediasure Grow & Gain (any flavor) 8 oz. 6-Pack (070074620503) Pediasure Grow & Gain w/ (any flavor) 8 oz. 6-Pack (070074582214) Pediasure 1.5 Cal (any flavor) 8 oz./24/case (070074564098) Pediasure Peptide 1.0 Cal (any flavor) 8 oz./24/case (070074564111) Similac Expert Care Alimentum 12.1 oz. (070074647128) Quart (070074575131) Similac Expert Care NeoSure 16 oz. (070074574318) Quart (070074574561) This is not a complete list of all special formulas. Please see the complete list at .
IN%20WIC%20Pharmacy%20Price%20List%20PPL%20updated%2012.19.2016.docx