Indiana Wic Authorized Formulas

ADVERTISEMENT

INDIANA WIC AUTHORIZED FORMULAS
(Print in COLOR for ease in reading)
Exempt
Product
Unit of Measure
or
Yield/
****Women
(*IFF)
Infant Fully Formula
&
Infant BF Mostly (***IBPm)
Concentrate
WIC
Unit
&
Infant BF some
(**IBPs)
Formula Name
A
B
C
D
Eligible
in
Children
RTU
A
B
C
0 to 1/ 1-3/ 4-5/ 6-11
0-3mo / 4-5mo / 6-11mo
(Fd. Pkg. III)
Nutritio
fluid
Powder
nals
ounces
Contract Formulas
MAX
MAX CONTAINERS
MAX CONTAINERS
CONTAINERS
(Milk Based Formulas)
I
5-9
6-10
5- 7
1
1-4/
1-5/
1-4
90
Gerber Good Start Gentle
12.7 oz powder
Nestle
24.2
I
Gerber Good Start Gentle
17-34
20-37
14-26
5
5-16/
5-19/ 5-13
12.1 oz concentrate
Nestle
I
8.45-oz RTU, 4 pack
13-25
15-27
11-19
4
4-12/
4-14/ 4-10
33.8
Gerber Good Start Gentle
Nestle
I
Gerber Good Start Soothe
5-9
6-10
5- 7
1
1-4/
1-5/
1-4
90
12.4 oz. powder
Nestle
Contract Formulas
(Soy Based Formulas)
Gerber Good Start Soy
12.9 oz powder
5-9
6-10
5- 7
1
1-4/
1-5/
1-4
91
I
Nestle
24.2
I
Gerber Good Start Soy
17-34
20-37
14-26
5
5-16/
5-19/ 5-13
12.1 oz concentrate
Nestle
Gerber Good Start Soy
8.45-oz RTU, 4 pack
13-25
15-27
11-19
4
4-12/
4-14/ 4-10
33.8
I
Nestle
Not Available
1
Revised September 2017

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Medical
Go
Page of 6