WIC Retailer Food and Formula Reference Guide - Missouri

WIC Retailer Food and Formula Reference Guide

Missouri WIC-Approved Infant Formulas, Special Formulas and Missouri WIC-Approved Food Descriptions

Effective April 2024 Missouri Department of Health and Senior Services

WIC and Nutrition Services

An EO/AA employer: Services provided on a nondiscriminatory basis. Individuals who are deaf, hard-of-hearing or have a speech disability can dial 711 or 1-800-735-2966. This institution is an equal opportunity provider.

Revised April 2024

Bolded items below indicate changes to products. The changes can include a new product or a change in a product's name or packaging.

NOTE: The Missouri WIC Approved Product List (APL) transmitted to retailers contains only the UPCs for the individual formula container or pack. No formula case UPCs are currently included in the APL. Please ensure that store systems are set appropriately to allow WIC formula purchases and train cashiers to utilize the appropriate UPC during WIC transactions. Additionally, WIC prohibits the use of a multiplier key during a WIC formula transaction.

PRIMARY CONTRACT INFANT FORMULAS ? See Appendix A of the WIC Retailer Manual for the stocking requirements by Tiered Stocking Group.

Product Name Similac Advance Similac Sensitive Similac Soy Isomil Similac Total Comfort

Manufacturer Abbott Abbott Abbott Abbott

Form PWD PWD PWD PWD

Size and Packaging Size 12.4 oz 12.5 oz 12.4 oz 12.6 oz

NDC 70074-0559-58 70074-0575-41 70074-0559-64 70074-0626-00

Unit UPC 070074559582 070074575414 070074559643 070074626000

Balance Receipt Description Similac Advance12.4ozPWD Similac Sensitive12.5PWD Similac Isomil 12.4ozPWD Sim Ttl Comfort12.6 PWD

Product Name

EnfaCare NeuroPro Enfamil A.R. Extensive HA Nutramigen Nutramigen Nutramigen with Probiotic LGG PurAmino Similac Advance Similac Advance Similac Alimentum Similac Alimentum Similac NeoSure Similac NeoSure Similac Sensitive Similac Soy Isomil Similac Soy Isomil

NON-PRIMARY CONTRACT INFANT FORMULAS

Manufacturer

MJN MJN Nestle MJN MJN MJN MJN Abbott Abbott Abbott Abbott Abbott Abbott Abbott Abbott Abbott

Form

PWD PWD PWD CONC RTU (Bottle) PWD PWD CONC RTF PWD RTU PWD RTF RTF CONC RTF

Size and Packaging Size

13.6 oz 12.9 oz 14.1 oz 13 fl oz 1 qt (32 fl oz) 12.6 oz 14.1 oz 13 fl oz 1 qt (32 fl oz) 12.1 oz 1 qt (32 fl oz) 13.1 oz 1 qt (32 fl oz) 1 qt (32 fl oz) 13 fl oz 1 qt (32 fl oz)

NDC

UPC

Balance Receipt Description

00087512208 00087020142 50000059852 00087049801 00087511564 00087123941 00087510480 70074056974 70074053364 70074064712 70074057513 70074057431 70074057456 70074057534 70074056976 70074055964

300875122082 300870201423 050000598526 300870498014 300875115640 300871239418 300875104804 070074569741 070074533643 070074647128 070074575131 070074574318 070074574561 070074575346 070074569765 070074559681

EnfaCareNeuro 13.6oz PWD Enfamil AR 12.9 oz PWD Gerber ExtensiveHA14.1oz Nutramigen 13 oz CONC Nutramigen 32 oz RTU Nutramigen LGG 12.6ozPWD PurAmino 14.1 oz PWD Similac Advance13oz CONC Similac Advance 32oz RTF Alimentum 12.1 oz PWD Alimentum 32 oz RTU NeoSure 13.1 oz PWD NeoSure 32 oz RTF Similac Sensitive32ozRTF Similac Isomil 13oz CONC Similac Isomil 32 oz RTF

Revised April 2024

Product Name

Boost ? Chocolate Boost ? Strawberry Boost ? Vanilla EleCare For Infants DHA/ARA ? Unflavored Ensure ? Banana Nut Ensure ? Butter Pecan Ensure ? Coffee Latte Ensure ? Dark Chocolate Ensure ? Milk Chocolate Ensure ? Strawberry Ensure ? Vanilla Glucerna Shake ? Butter Pecan Glucerna Shake ? Chocolate Glucerna Shake ? Chocolate Caramel Glucerna Shake ? Strawberry Glucerna Shake ? Vanilla Neocate Infant DHA/ARA PediaSure Grow and Gain ? Banana PediaSure Grow and Gain ? Berry PediaSure Grow and Gain ? Chocolate PediaSure Grow and Gain ? S'mores PediaSure Grow and Gain ? Strawberry PediaSure Grow and Gain ? Vanilla PediaSure Grow and Gain with Fiber ? Chocolate PediaSure Grow and Gain with Fiber ? Strawberry PediaSure Grow and Gain with Fiber ? Vanilla PediaSure SideKicks ? Chocolate PediaSure SideKicks ? Strawberry PediaSure SideKicks ? Vanilla

FORMULAS AND NUTRITIONALS-Available at stores and pharmacies.

Manufacturer

Nestl? Nestl? Nestl? Abbott Abbott Abbott Abbott Abbott Abbott Abbott Abbott Abbott Abbott Abbott Abbott Abbott Nutricia Abbott Abbott Abbott Abbott Abbott Abbott

Abbott

Form

RTU RTU RTU PWD RTU RTU RTU RTU RTU RTU RTU RTU RTU RTU RTU RTU PWD RTU RTU RTU RTU RTU RTU

RTU

Size and Packaging Size 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack)

14.1 oz 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 14.1 oz (400 g) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack)

7.4 fl oz (4 pack)

NDC

41679067566 41679067666 41679067466 70074053511 70074066911 70074051785 70074056016 70074053807 70074040701 70074040705 70074040711 70074057812 70074057806 70074066795 70074057809 70074057803 49735012595 70074058053 70074053819 70074058059 70074066920 70074058056 70074058050

70074068756

UPC

041679675663 041679676660 041679674666 070074535111 070074669113 070074517858 070074560168 070074538075 070074407012 070074407050 070074407111 070074578118 070074578057 070074667959 070074578088 070074578026 749735025956 070074580531 070074538198 070074580593 070074669205 070074580562 070074580500

070074687568

Abbott

RTU 7.4 fl oz (4 pack) 70074068763 070074687636

Abbott

Abbott Abbott Abbott

RTU

RTU RTU RTU

7.4 fl oz (4 pack)

8 fl oz (6 pack) 8 fl oz (6 pack) 8 fl oz (6 pack)

70074068760

70074066640 70074066917 70074066913

070074687605

070074666402 070074669175 070074669137

Balance Receipt Description Boost 6 PK (8 oz) RTU EleCare DHA/ARA 14.1 PWD Ensure 6 PK (8 oz) RTU

Glucerna 6 PK (8 oz) RTU Neocate Infant 14.1 PWD PediaSure 6PK (8 oz) RTU

PediaSure Fiber 4 PK RTU PediSur SideKick 6PK RTU

Revised April 2024

Product Name

Alfamino Infant Alfamino Junior ? Unflavored Alfamino Junior ? Vanilla Boost Kid Essentials ? Chocolate Boost Kid Essentials ? Strawberry Boost Kid Essentials ? Vanilla Boost Kid Essentials 1.5 ? Chocolate Boost Kid Essentials 1.5 ? Strawberry Boost Kid Essentials 1.5 ? Vanilla Boost Kid Essentials 1.5 with Fiber ? Vanilla Calcilo XD Compleat Pediatric Compleat Pediatric Reduced Calorie EleCare Jr. ? Banana EleCare Jr. ? Chocolate EleCare Jr. ? Unflavored EleCare Jr. ? Vanilla Enfamil Premature with Iron (24 Cal) Enfaport Isosource 1.5 Cal with Fiber KetoCal 3:1 KetoCal 4:1 Monogen (with DHA) Neocate Junior without Prebiotics Neocate Junior with Prebiotics ? Chocolate Neocate Junior with Prebiotics ? Strawberry Neocate Junior with Prebiotics ? Tropical Neocate Junior with Prebiotics ? Unflavored Neocate Junior with Prebiotics ? Vanilla

SPECIAL FORMULAS-Available through pharmacies.

Manufacturer

Nestle Nestle Nestle Nestl? Nestl? Nestl? Nestl? Nestl? Nestl? Nestl? Abbott Nestl? Nestl? Abbott Abbott Abbott Abbott MJN MJN Nestl? Nutricia Nutricia Nutricia Nutricia Nutricia Nutricia Nutricia Nutricia Nutricia

Form

PWD PWD PWD RTU RTU RTU RTU RTU RTU RTU PWD RTU RTU PWD PWD PWD PWD RTF RTU RTU PWD PWD PWD PWD PWD PWD PWD PWD PWD

Size and Packaging Size

14.1 oz 14.1 oz 14.1 oz 8 fl oz 8 fl oz 8 fl oz 8 fl oz 8 fl oz 8 fl oz 8 fl oz 13.2 oz 8.45 fl oz 8.45 fl oz 14.1 oz 14.1 oz 14.1 oz 14.1 oz 2 fl oz (6 pack) 6 fl oz (6 pack) 8.45 fl oz 11 oz 11 oz 14.1 oz (400 g) 14.1 oz (400 g) 14.1 oz (400 g) 14.1 oz (400 g) 14.1 oz (400 g) 14.1 oz (400 g) 14.1 oz (400 g)

NDC

13034078821 13034078795 13287010606 43900033520 43900033530 43900033511 43900033588 43900033590 43900033540 43900033500 70074053329 43900014240 43900038074 70074066276 70074066271 70074055254 70074056586 00087511568 00087510525 43900018150 49735016672 49735016670 49735017097 49735011790 49735012690 49735016456 49735012124 49735012912 49735010627

UPC

7613034788214 7613034787958 7613287106063 043900335209 043900335308 043900335117 043900335889 043900335902 043900335407 043900335001 070074533292 043900142401 043900380742 070074662763 070074662718 070074552545 070074565866 300875133880 300875105252 043900181509 749735066720 749735018422 749735060339 749735017906 749735026908 749735064566 749735021248 749735029121 749735006276

Balance Receipt Description Alfamino Infant14.1ozPWD Alfamino Jr 14.1 oz PWD

Boost Kid Essntl 8oz RTU

Bst Kd Esntl1.5 8 oz RTU

Bst Kd Esntl 1.5 Fbr RTU Calcilo XD 13.2 oz PWD Compleat Pediatric RTU Cmplet Pdtrc Rdc Cal RTU

EleCare Jr 14.1 oz PWD

Enfamil Prem 24 6PK RTF Enfaport 6PK (6 oz) RTU Isosource 1.5 8.45oz RTU KetoCal 3:1 11 oz PWD KetoCal 4:1 11 oz PWD Monogen 14.1 oz PWD Neocate Jr 14.1 oz PWD

Neocate Jr Prebio PWD

Revised April 2024

Product Name

Neocate Splash ? Grape Neocate Splash ? Orange-Pineapple Neocate Splash ? Tropical Fruit Neocate Splash ? Unflavored Neocate Splash ? Vanilla Nutren Junior ? Vanilla Nutren Junior Fiber ? Vanilla PediaSure 1.5 Cal ? Vanilla PediaSure 1.5 Cal with Fiber ? Vanilla PediaSure Enteral Formula 1.0 Cal PediaSure Enteral Formula 1.0 Cal with Fiber PediaSure Peptide 1.0 Cal ? Strawberry PediaSure Peptide 1.0 Cal ? Unflavored PediaSure Peptide 1.0 Cal ? Vanilla PediaSure Peptide 1.5 Cal ? Vanilla Peptamen Junior ? Strawberry Peptamen Junior ? Unflavored Peptamen Junior ? Vanilla Peptamen Junior Fiber ? Vanilla Peptamen Junior 1.5 ? Unflavored Peptamen Junior 1.5 ? Vanilla Portagen Pregestimil Pregestimil (20 Cal) Pregestimil (24 Cal) RCF (Ross Carbohydrate Free) Similac PM 60/40 Similac Special Care 24 with Iron Super Soluble Duocal Suplena with Carb Steady ? Vanilla

Tolerex

Manufacturer

Nutricia Nutricia Nutricia Nutricia Nutricia Nestl? Nestl? Abbott Abbott Abbott

Abbott

Abbott Abbott Abbott Abbott Nestl? Nestl? Nestl? Nestl? Nestl? Nestl? MJN MJN MJN MJN Abbott Abbott Abbott Nutricia Abbott

Nestl?

Form

RTU RTU RTU RTU RTU RTU RTU RTU RTU RTU

RTU

RTU RTU RTU RTU RTU RTU RTU RTU RTU RTU PWD PWD RTU RTU CONC PWD RTF PWD RTU

PWD

Size and Packaging Size

8 fl oz 8 fl oz 8 fl oz 8 fl oz 8 fl oz 8.45 fl oz 8.45 fl oz 8 fl oz 8 fl oz 8 fl oz

8 fl oz

8 fl oz 8 fl oz 8 fl oz 8 fl oz 8.45 fl oz 8.45 fl oz 8.45 fl oz 8.45 fl oz 8.45 fl oz 8.45 fl oz 14.46 oz 16 oz 2 fl oz (6 pack) 2 fl oz (6 pack) 13 fl oz 14.1 oz 2 fl oz (4 pack) 14.1 oz (400 g) 8 fl oz 2.82 oz (6 packets /carton)

NDC

49735012435 49735012436 49735012437 49735014451 49735010059 98716006062 98716006063 70074067386 70074067375 70074067402

70074067404

70074067412 70074067414 70074067410 70074067418 98716060140 98716006253 98716006252 98716060200 98716007363 98716070482 00087511728 00087036701 00087143341 00087143441 70074040108 70074060850 70074056270 49735018262 70074062089

43900045806

UPC

749735024355 749735024362 749735024379 749735044513 749735000595 798716060622 798716060639 070074673868 070074673752 070074674025

070074674049

070074674124 070074674148 070074674100 070074674186 798716601405 798716062534 798716062527 798716602006 798716073639 098716704824 300875117286 300870367013 300871433410 300871434417 070074401089 070074608501 070074674476 749735002803 070074620893

043900458069

Balance Receipt Description

Neocate Splash 8 oz RTU

Nutren Jr 8.45 oz RTU Nutren Jr Fbr 8.45oz RTU PediaSure 1.5 8 oz RTU PediaSure1.5 Fbr 8oz RTU PediaSure Enteral 8ozRTU PediSure Enteral Fbr RTU

PediaSure Peptide1.0 RTU

PediaSure Peptide1.5 RTU

Peptamen Jr 8.45 oz RTU

Peptamen Jr Fbr 8.45 RTU Peptamen Jr 1.5 RTU Portagen14.46 oz PWD Pregestimil 16 oz PWD Pregestimil 20 6PK RTU Pregestimil 24 6PK RTU RCF 13 oz CONC Similac PM60/40 14.1 PWD Similac Spec Care 24 RTF Duocal 14.1 oz PWD Suplena 8 oz RTU Tolerex 2.82 oz PWD

Revised April 2024

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