5 - Attach 5_ Updated WIC Nutritionals 110317a.pdf
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- Attached to
- T1057 - WIC Infant Formula Rebate:DOH
- Solicitation number
- 18DPP00157
- Issued by
- New Jersey
About this file
The provided document is an attachment to a state and local contract opportunity for the New Jersey WIC (Women, Infants, and Children) Services program. The attachment lists the authorized exempt infant formulas and WIC-eligible nutritionals that may be issued by the WIC program with appropriate medical documentation. The formulas are provided by various manufacturers in powder, concentrate, and ready-to-use forms.
The related state and local contract opportunity is titled "T1057 - WIC Infant Formula Rebate:DOH" and involves the jurisdiction of Mercer County, New Jersey. The contract likely involves the provision and rebate of infant formulas and nutritionals to the WIC program in Mercer County and potentially other New Jersey jurisdictions. The document does not provide details on the contract term, response dates, or award information.
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*WIC may issue these formulas with Medical Documentation for approved Qualifying Medical Conditions. See WIC-11 New Jersey Medical Documentation Form.
Forms Available - Pwdr = powder; Conc = concentrate; RTU = ready to use Revised January 2017 Supersedes March 2016 version.
Formula (in alphabetical order) Manufacturer Forms Available
Alimentum Abbott Pwdr, RTU
BCAD 1 Mead Johnson Pwdr
BCAD 2 Mead Johnson Pwdr
Boost Nestles RTU
Boost High Protein Nestles RTU
Boost Kids Essential 1.5 Cal Nestles RTU
Boost Kids Essential 1.5 Cal with Fiber
Nestles RTU
Bright Beginnings Soy Pediatric Drink
PBM Products, Inc. RTU
Cyclinex-1 Abbott Pwdr
Cyclinex-2 Abbott Pwdr
Elecare DHA/ARA Abbott Pwdr
Elecare Junior Abbott Pwdr
Enfamil Enfacare Mead Johnson Pwdr
Ensure Abbott Pwdr, RTU
Ensure Plus Abbott RTU
EO28 Splash Nutricia RTU
Gluterex-1 Abbott Pwdr
Gluterex-2 Abbott Pwdr
Good Start Gentle Gerber Pwdr, Conc, RTU
Good Start Soy Gerber Pwdr, Conc, RTU
Hominex-1 Abbott Pwdr
Hominex-2 Abbott Pwdr
I-Valex-1 Abbott Pwdr
I-Valex-2 Abbott Pwdr
Ketocal Nutricia Pwdr
Ketocal 4:1 Liquid Nutricia RTU
Neocate Junior Nutricia Pwdr
Neocate Jr. with Prebiotics Vanilla
Nutricia Pwdr
Neocate with DHA/ARA Nutricia Pwdr
Neosure Abbott Pwdr, RTU
Nutramigen Enflora LGG Mead Johnson Pwdr
Nutramigen Mead Johnson Conc, RTU
Nutren Junior Nestles RTU
Pediasure Abbott RTU
Pediasure with Fiber Abbott RTU
Pediasure Peptide 1.0 cal. Abbott RTU
Pediasure 1.5 Cal. Abbott RTU
Peptamen Nestles RTU
Attachment #5 Updated New Jersey WIC Services
Authorized Exempt Infant Formulas and WIC-Eligible Nutritionals* (As of 11/03/17)
New Jersey WIC Services
Authorized Exempt Infant Formulas and WIC-Eligible Nutritionals*
*WIC may issue these formulas with Medical Documentation for approved Qualifying Medical Conditions. See WIC-11 New Jersey Medical Documentation Form.
Forms Available - Pwdr = powder; Conc = concentrate; RTU = ready to use Revised January 2017 Supersedes March 2016 version.
Peptamen Junior Nestles RTU
PKU Periflex Early Years Nutricia Powder
Formula (in alphabetical order)
Manufacturer Forms Available
PKU Periflex Jr. Plus Nutricia Powder
PFD 1 Mead Johnson Pwdr
PFD 2 Mead Johnson Pwdr
Phenylade 40 Citrus, 25 g Applied Nutrition Pwdr pouches
Phenyl Free 1 Mead Johnson Pwdr
Phenyl Free 2 Mead Johnson Pwdr
Portagen Mead Johnson Pwdr
Product 3232a Mead Johnson Pwdr
Pregestimil DHA/ARA Mead Johnson Pwdr
Propimex-1 Abbott Pwdr
Propimex-2 Abbott Pwdr
RCF Abbott Conc
Similac PM 60/40 Abbott Pwdr
Similac Special Care Advance 24 calorie with Iron
Abbott RTU
Tolerax Nestles Pwdr
TYROS 1 Mead Johnson Pwdr
TYROS 2 Mead Johnson Pwdr
Vivonex Pediatric Nestles Pwdr
Vivonex T.E.N. Nestles Pwdr
This institution is an equal opportunity provider.
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