Attachment E-2 - 11 months non-Rebate Formula redemptions 2021-2022.pdf
PDF 3 MB Posted
- Attached to
- IFB Infant Formula Rebate Program
- Solicitation number
- 22-444DHS-FAMCO-B-28401
- Issued by
- Illinois
About this file
This document is an eWIC Rebate Analysis Summary for the Illinois WIC program, which provides details on the redemption and rebate information for various infant formula and nutritional products over multiple date ranges.
The report includes data on the redeemed quantities, applied benefit units, and settled rebate amounts for over 40 different product subcategories under the Exempt Infant Formula (EXF) and WIC Eligible Nutritional categories. The data is organized by month and provides insights into the usage and rebates for products such as Nutramigen, Pregestimil, Enfamil, Similac, Elecare, PurAmino, Neocate, and Pediasure. This information is likely used by the Illinois WIC program to manage its infant formula and nutritional product inventory, costs, and rebates.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment B - Food Center Addresses.xlsx | XLSX spreadsheet | |
| Attachment D - 2023 Rebate Bid Sheet~1.xlsx | XLSX spreadsheet | |
| Attachment F-2 - FFY21 Rebate Receipts.pdf | ||
| Attachment F-3 - FFY20 Rebate Receipts.pdf | ||
| Attachment H - Active Vendors February 2022.xlsx | XLSX spreadsheet | |
| Attachment I - Food Center WIC Formula Purchases 3-year Trend.xlsx | XLSX spreadsheet | |
| DHS IFB WIC Infant Formula-B-28401.docx | DOCX document | |
| Attachment E-1 - 11 months Rebate Formula redemptions 2021-2022.pdf | ||
| Attachment F-1 - FFY22 Rebate Receipts.pdf | ||
| B-28401 Notice of Award Form v.22.1_41.pdf | ||
| Forms A~44.docx | DOCX document | |
| Attachment C - WIC Food Center Information.docx | DOCX document | |
| Questions and Answers for B-28401~1.pdf | ||
| Attachment A - Federal Participation.docx | DOCX document | |
| Attachment G - Infant Formula Invoices 2021-2022.pdf | ||
| Forms B~60.docx | DOCX document | |
| Notice of Electronic Submission Only v.22.1~39.pdf |
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Text version
Category: 31 Exempt Infant Formula (EXF)
Sub-Category Code Sub-Category Description UPC/PLU UPC/PLU Description UOM Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
004 Nutramigen with Enflora LGG Powder
300871239418 NutramigenEnfl CTR No 9,190.00 9,184.00 $283,601.29
Sub-Category Total : 004 Nutramigen with Enflora LGG Powder
9,190.00 9,184.00 $283,601.29
009 Pregestimil Powder 300870367013 Pregestimil 16 CTR No 34.00 34.00 $923.68
Sub-Category Total : 009 Pregestimil Powder 34.00 34.00 $923.68
011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
300875122082 Enf Enfacare PWD 12.8oz CTR No 3,266.00 3,222.00 $59,043.93
Sub-Category Total : 011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
3,266.00 3,222.00 $59,043.93
030 Similac Neosure Powder 070074574318 Sim Neosure 13. CTR No 9,407.00 9,331.00 $165,243.30
Sub-Category Total : 030 Similac Neosure Powder 9,407.00 9,331.00 $165,243.30
031 Similac NeoSure RTF 070074574561 Similac NeoSure CTR No 2,957.00 2,957.00 $21,143.70
Sub-Category Total : 031 Similac NeoSure RTF 2,957.00 2,957.00 $21,143.70
032 Similac Alimentum RTF 070074575131 Sim Alimentum 3 CTR No 1,337.00 1,337.00 $13,898.45
Sub-Category Total : 032 Similac Alimentum RTF 1,337.00 1,337.00 $13,898.45
036 Similac PM 60/40 Powder 070074608501 Sim PM 60/40 14 CTR No 60.00 60.00 $763.64
Sub-Category Total : 036 Similac PM 60/40 Powder 60.00 60.00 $763.64
042 Elecare DHA/ARA Powder 070074535111 EleCare Infant CTR No 1,300.00 1,296.00 $56,000.63
Sub-Category Total : 042 Elecare DHA/ARA Powder 1,300.00 1,296.00 $56,000.63
069 PurAmino DHA/ARA Powder 300875104804 PurAmino 14.1oz CTR No 192.00 192.00 $8,055.50
Sub-Category Total : 069 PurAmino DHA/ARA Powder 192.00 192.00 $8,055.50
072 Neocate Infant DHA/ARA Powder 749735025956 Neocate Infant CTR No 243.00 243.00 $9,533.69 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 05/01/2021 - 05/31/2021
Account Type: H-Household Report Date/Time: 06/01/2021 02:15:00 PM
Created with EO.Pdf for .NET trial version. http://www.essentialobjects.com.
Attachment E-2
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
Sub-Category Total : 072 Neocate Infant DHA/ARA Powder
243.00 243.00 $9,533.69
073 Elecare Jr. Unflavored Powder 070074552545 EleCareJr unfl CTR No 571.00 571.00 $24,302.54
Sub-Category Total : 073 Elecare Jr. Unflavored Powder
571.00 571.00 $24,302.54
074 EleCare Junior Powder- Any Flavor
070074565866 EleCare Jr van CTR No 415.00 415.00 $14,049.95
074 EleCare Junior Powder- Any Flavor
070074662763 ELECARE JUNIOR POWDER
BANANA 14.1 OZ
CTR No 30.00 30.00 $750.00
Sub-Category Total : 074 EleCare Junior Powder- Any Flavor
445.00 445.00 $14,799.95
081 Similac Alimentum Powder 070074647128 Similac_Similac Alimentu CTR No 4,695.00 4,671.00 $129,633.33
Sub-Category Total : 081 Similac Alimentum Powder 4,695.00 4,671.00 $129,633.33
102 Neocate Syneo Infant Powder 749735014363 NeocateSyn PWD14.1oz CTR No 39.00 39.00 $2,069.30
Sub-Category Total : 102 Neocate Syneo Infant Powder
39.00 39.00 $2,069.30
Category Total : 31 33,736.00 33,582.00 $789,012.93 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 05/01/2021 - 05/31/2021
Account Type: H-Household Report Date/Time: 06/01/2021 02:15:00 PM
Category: 41 WIC Eligible Nutritional
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
036 Pediasure 6pk (any flavor) 070074538198 Pediasure berry PKG No 143.00 143.00 $1,662.04
036 Pediasure 6pk (any flavor) 070074580500 Pediasure van 6 PKG No 2,034.00 2,034.00 $20,010.63
036 Pediasure 6pk (any flavor) 070074580531 Pediasure banan PKG No 476.00 476.00 $5,292.90
036 Pediasure 6pk (any flavor) 070074580562 Pediasure straw PKG No 974.00 974.00 $9,597.07
036 Pediasure 6pk (any flavor) 070074580593 Pediasure choc PKG No 808.00 808.00 $9,975.33
036 Pediasure 6pk (any flavor) 070074669205 Ped GrwGain 6pk 8 oz PKG No 124.00 124.00 $1,432.62
Sub-Category Total : 036 Pediasure 6pk (any flavor) 4,559.00 4,559.00 $47,970.59
038 Pediasure with Fiber 6pk (any flavor)
070074563695 Pediasure Straw PKG No 504.00 504.00 $6,503.60
038 Pediasure with Fiber 6pk (any flavor)
070074580623 Pediasure vanfi PKG No 1,987.00 1,973.00 $20,281.15
Sub-Category Total : 038 Pediasure with Fiber 6pk (any flavor)
2,491.00 2,477.00 $26,784.75
063 Neocate Junior -Any Flavor 749735006276 NeocateJr van p CTR No 54.00 54.00 $2,382.00
063 Neocate Junior -Any Flavor 749735017906 Neocate Jr unfl CTR No 432.00 432.00 $14,999.59
063 Neocate Junior -Any Flavor 749735026908 Neocate Jr choc CTR No 40.00 40.00 $1,272.16
063 Neocate Junior -Any Flavor 749735064566 NeocateJr. Str Prebiotic CTR No 11.00 11.00 $550.84
063 Neocate Junior -Any Flavor 749735106273 NeocateJr van p CTR No 8.00 32.00 $1,735.92
Sub-Category Total : 063 Neocate Junior -Any Flavor 545.00 569.00 $20,940.51
142 Nutren Junior RTF 798716060622 NutrenJr van 8. CTR No 311.00 311.00 $750.22
Sub-Category Total : 142 Nutren Junior RTF 311.00 311.00 $750.22
143 Nutren Junior with Fiber RTF 798716060639 NutrenJr vanfi CTR No 96.00 96.00 $0.00
Sub-Category Total : 143 Nutren Junior with Fiber RTF 96.00 96.00 $0.00
153 Peptamen Junior RTF- Any Flavor 798716062527 Pep Jr 1.0 van CTR No 96.00 96.00 $694.08 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 05/01/2021 - 05/31/2021
Account Type: H-Household Report Date/Time: 06/01/2021 02:17:00 PM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
153 Peptamen Junior RTF- Any Flavor 798716062534 Pep Jr 1.0 unf CTR No 113.00 113.00 $846.37
Sub-Category Total : 153 Peptamen Junior RTF- Any Flavor
209.00 209.00 $1,540.45
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074621203 PedPeptide 1.0 CTR No 125.00 125.00 $1,609.25
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674100 PediaSure Peptide 1.0 Vanilla RTF 8 oz
CTR No 1,909.00 1,909.00 $12,544.60
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674124 PediaSure Peptide 1.0 Strawberry RTF 8 oz
CTR No 452.00 452.00 $6,531.40
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674148 PediaSure Peptide 1.0 Unflavored RTF 8 oz
CTR No 96.00 96.00 $687.36
Sub-Category Total : 228 Pediasure Peptide 1.0 CAL- Any Flavor
2,582.00 2,582.00 $21,372.61
256 PediaSure 1.5 Cal RTF 070074673868 PediaSure 1.5 Cal Vanilla RTF 8 oz CTR No 925.00 925.00 $1,428.82
256 PediaSure 1.5 Cal RTF 070074674186 PediaSure Peptide 1.5 Cal Vanilla RTF 8 oz
CTR No 96.00 96.00 $479.04
Sub-Category Total : 256 PediaSure 1.5 Cal RTF 1,021.00 1,021.00 $1,907.86
257 PediaSure 1.5 Cal with Fiber RTF 8 oz
070074673752 PediaSure 1.5 Cal with Fiber Vanilla RTF 8 oz
CTR No 1,515.00 1,515.00 $2,285.36
Sub-Category Total : 257 PediaSure 1.5 Cal with Fiber RTF 8 oz
1,515.00 1,515.00 $2,285.36
271 Peptamen Junior Fiber 798716602006 Pep Jr vanfi 1. CTR No 226.00 226.00 $2,004.62
Sub-Category Total : 271 Peptamen Junior Fiber 226.00 226.00 $2,004.62
288 Neocate Junior with Prebiotics Unflavored
749735029121 NeocateJr unf p CTR No 14.00 14.00 $762.86
Sub-Category Total : 288 Neocate Junior with Prebiotics Unflavored
14.00 14.00 $762.86 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 05/01/2021 - 05/31/2021
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
336 Neocate Splash- Any Flavor 749735024355 NeoSplsh Grpe RTF8oz CTR No 89.00 89.00 $195.75
336 Neocate Splash- Any Flavor 749735024362 NeocSplsh O/P RTF8oz CTR No 363.00 363.00 $2,991.36
336 Neocate Splash- Any Flavor 749735024379 NeocSplsh TFr RTF8oz CTR No 326.00 326.00 $2,728.71
336 Neocate Splash- Any Flavor 749735044513 Neocate Splash Unflavor CTR No 1,488.00 1,149.00 $18,004.71
Sub-Category Total : 336 Neocate Splash- Any Flavor 2,266.00 1,927.00 $23,920.53
Category Total : 41 15,835.00 15,506.00 $150,240.36 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 05/01/2021 - 05/31/2021
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
004 Nutramigen with Enflora LGG Powder
300871239418 NutramigenEnfl CTR No 8,901.00 8,862.00 $271,225.63
Sub-Category Total : 004 Nutramigen with Enflora LGG Powder
8,901.00 8,862.00 $271,225.63
009 Pregestimil Powder 300870367013 Pregestimil 16 CTR No 67.00 67.00 $1,563.52
Sub-Category Total : 009 Pregestimil Powder 67.00 67.00 $1,563.52
011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
300875122082 Enf Enfacare PWD 12.8oz CTR No 3,289.00 3,225.00 $59,763.98
Sub-Category Total : 011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
3,289.00 3,225.00 $59,763.98
030 Similac Neosure Powder 070074574318 Sim Neosure 13. CTR No 9,305.00 9,190.00 $163,070.72
Sub-Category Total : 030 Similac Neosure Powder 9,305.00 9,190.00 $163,070.72
031 Similac NeoSure RTF 070074574561 Similac NeoSure CTR No 2,917.00 2,834.00 $18,977.09
Sub-Category Total : 031 Similac NeoSure RTF 2,917.00 2,834.00 $18,977.09
032 Similac Alimentum RTF 070074575131 Sim Alimentum 3 CTR No 1,383.00 1,383.00 $14,669.90
Sub-Category Total : 032 Similac Alimentum RTF 1,383.00 1,383.00 $14,669.90
036 Similac PM 60/40 Powder 070074608501 Sim PM 60/40 14 CTR No 88.00 88.00 $979.40
Sub-Category Total : 036 Similac PM 60/40 Powder 88.00 88.00 $979.40
042 Elecare DHA/ARA Powder 070074535111 EleCare Infant CTR No 1,220.00 1,220.00 $52,717.02
Sub-Category Total : 042 Elecare DHA/ARA Powder 1,220.00 1,220.00 $52,717.02
069 PurAmino DHA/ARA Powder 300875104804 PurAmino 14.1oz CTR No 250.00 250.00 $11,314.43
Sub-Category Total : 069 PurAmino DHA/ARA Powder
250.00 250.00 $11,314.43
072 Neocate Infant DHA/ARA Powder 749735025956 Neocate Infant CTR No 280.00 280.00 $11,212.00 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 06/01/2021 - 06/30/2021
Account Type: H-Household Report Date/Time: 07/01/2021 10:04:27 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
Sub-Category Total : 072 Neocate Infant DHA/ARA Powder
280.00 280.00 $11,212.00
073 Elecare Jr. Unflavored Powder 070074552545 EleCareJr unfl CTR No 498.00 498.00 $20,573.26
Sub-Category Total : 073 Elecare Jr. Unflavored Powder
498.00 498.00 $20,573.26
074 EleCare Junior Powder- Any Flavor
070074565866 EleCare Jr van CTR No 380.00 380.00 $15,029.83
074 EleCare Junior Powder- Any Flavor
070074662718 ELECARE JUNIOR CHOCOLATE
POWDER 14.1 OZ
CTR No 17.00 17.00 $773.50
074 EleCare Junior Powder- Any Flavor
070074662763 ELECARE JUNIOR POWDER
BANANA 14.1 OZ
CTR No 26.00 26.00 $227.50
Sub-Category Total : 074 EleCare Junior Powder- Any Flavor
423.00 423.00 $16,030.83
081 Similac Alimentum Powder 070074647128 Similac_Similac Alimentu CTR No 4,534.00 4,523.00 $124,308.63
Sub-Category Total : 081 Similac Alimentum Powder 4,534.00 4,523.00 $124,308.63
102 Neocate Syneo Infant Powder 749735014363 NeocateSyn PWD14.1oz CTR No 71.00 71.00 $2,533.15
Sub-Category Total : 102 Neocate Syneo Infant Powder
71.00 71.00 $2,533.15
Category Total : 31 33,226.00 32,914.00 $768,939.56 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 06/01/2021 - 06/30/2021
Account Type: H-Household Report Date/Time: 07/01/2021 10:04:27 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
005 Ensure 070074407012 Ensure m.choc 6 PKG No 1.00 1.00 $9.09
005 Ensure 070074407050 Ensure straw 6p PKG No 1.00 1.00 $9.09
005 Ensure 070074407111 Ensure van 6 pk PKG No 1.00 1.00 $9.09
005 Ensure 070074517858 Ensure bpecan 6 PKG No 4.00 4.00 $36.36
005 Ensure 070074538075 Ensure dkchoc 6 PKG No 3.00 3.00 $27.27
Sub-Category Total : 005 Ensure 10.00 10.00 $90.90
036 Pediasure 6pk (any flavor) 070074538198 Pediasure berry PKG No 198.00 198.00 $2,255.22
036 Pediasure 6pk (any flavor) 070074580500 Pediasure van 6 PKG No 1,928.00 1,894.00 $19,256.66
036 Pediasure 6pk (any flavor) 070074580531 Pediasure banan PKG No 484.00 484.00 $5,629.47
036 Pediasure 6pk (any flavor) 070074580562 Pediasure straw PKG No 820.00 820.00 $7,863.43
036 Pediasure 6pk (any flavor) 070074580593 Pediasure choc PKG No 876.00 876.00 $10,782.54
036 Pediasure 6pk (any flavor) 070074669205 Ped GrwGain 6pk 8 oz PKG No 94.00 94.00 $1,085.07
Sub-Category Total : 036 Pediasure 6pk (any flavor) 4,400.00 4,366.00 $46,872.39
038 Pediasure with Fiber 6pk (any flavor)
070074563695 Pediasure Straw PKG No 428.00 428.00 $5,323.35
038 Pediasure with Fiber 6pk (any flavor)
070074580623 Pediasure vanfi PKG No 2,057.00 2,057.00 $20,373.16
Sub-Category Total : 038 Pediasure with Fiber 6pk (any flavor)
2,485.00 2,485.00 $25,696.51
063 Neocate Junior -Any Flavor 749735006276 NeocateJr van p CTR No 23.00 23.00 $1,026.86
063 Neocate Junior -Any Flavor 749735017906 Neocate Jr unfl CTR No 577.00 577.00 $21,379.94
063 Neocate Junior -Any Flavor 749735021248 Neocate Jr trop CTR No 4.00 4.00 $184.24
063 Neocate Junior -Any Flavor 749735026908 Neocate Jr choc CTR No 84.00 84.00 $3,946.48
063 Neocate Junior -Any Flavor 749735106273 NeocateJr van p CTR No 3.00 12.00 $650.97 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 06/01/2021 - 06/30/2021
Account Type: H-Household Report Date/Time: 07/01/2021 10:05:48 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
063 Neocate Junior -Any Flavor 749735164563 Neocate Jr. w/Prebiotics Strawberry Powder 14.1 oz
CTR No 3.00 12.00 $516.57
Sub-Category Total : 063 Neocate Junior -Any Flavor
694.00 712.00 $27,705.06
142 Nutren Junior RTF 798716060622 NutrenJr van 8. CTR No 435.00 435.00 $1,022.10
Sub-Category Total : 142 Nutren Junior RTF 435.00 435.00 $1,022.10
143 Nutren Junior with Fiber RTF 798716060639 NutrenJr vanfi CTR No 0.00 0.00 $0.00
Sub-Category Total : 143 Nutren Junior with Fiber
RTF
0.00 0.00 $0.00
153 Peptamen Junior RTF- Any Flavor
798716062527 Pep Jr 1.0 van CTR No 144.00 144.00 $1,041.12
153 Peptamen Junior RTF- Any Flavor
798716062534 Pep Jr 1.0 unf CTR No 113.00 113.00 $846.37
Sub-Category Total : 153 Peptamen Junior RTF- Any Flavor
257.00 257.00 $1,887.49
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074621203 PedPeptide 1.0 CTR No 65.00 65.00 $844.35
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674100 PediaSure Peptide 1.0 Vanilla RTF 8 oz CTR No 1,672.00 1,672.00 $7,921.79
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674124 PediaSure Peptide 1.0 Strawberry RTF 8 oz
CTR No 452.00 452.00 $6,531.40
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674148 PediaSure Peptide 1.0 Unflavored RTF 8 oz
CTR No 168.00 168.00 $1,202.88
Sub-Category Total : 228 Pediasure Peptide 1.0 CAL- Any Flavor
2,357.00 2,357.00 $16,500.42
256 PediaSure 1.5 Cal RTF 070074564104 Pediasure 1.5cal Van 8oz CTR No 339.00 339.00 $1,013.61
256 PediaSure 1.5 Cal RTF 070074673868 PediaSure 1.5 Cal Vanilla RTF 8 oz CTR No 1,039.00 1,039.00 $1,855.06 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 06/01/2021 - 06/30/2021
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
256 PediaSure 1.5 Cal RTF 070074674186 PediaSure Peptide 1.5 Cal Vanilla RTF 8 oz
CTR No 38.00 38.00 $162.64
Sub-Category Total : 256 PediaSure 1.5 Cal RTF 1,416.00 1,416.00 $3,031.31
257 PediaSure 1.5 Cal with Fiber RTF 8 oz
070074673752 PediaSure 1.5 Cal with Fiber Vanilla RTF 8 oz
CTR No 1,734.00 1,734.00 $2,593.47
Sub-Category Total : 257 PediaSure 1.5 Cal with Fiber RTF 8 oz
1,734.00 1,734.00 $2,593.47
271 Peptamen Junior Fiber 798716602006 Pep Jr vanfi 1. CTR No 226.00 226.00 $2,174.12
Sub-Category Total : 271 Peptamen Junior Fiber 226.00 226.00 $2,174.12
336 Neocate Splash- Any Flavor 749735024355 NeoSplsh Grpe RTF8oz CTR No 248.00 248.00 $1,768.62
336 Neocate Splash- Any Flavor 749735024362 NeocSplsh O/P RTF8oz CTR No 295.00 295.00 $3,018.51
336 Neocate Splash- Any Flavor 749735024379 NeocSplsh TFr RTF8oz CTR No 318.00 318.00 $2,608.80
336 Neocate Splash- Any Flavor 749735044513 Neocate Splash Unflavor CTR No 1,067.00 1,067.00 $16,456.67
Sub-Category Total : 336 Neocate Splash- Any Flavor
1,928.00 1,928.00 $23,852.60
Category Total : 41 15,942.00 15,926.00 $151,426.37 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 06/01/2021 - 06/30/2021
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
004 Nutramigen with Enflora LGG Powder
300871239418 NutramigenEnfl CTR No 8,792.00 8,771.00 $272,175.36
Sub-Category Total : 004 Nutramigen with Enflora LGG Powder
8,792.00 8,771.00 $272,175.36
009 Pregestimil Powder 300870367013 Pregestimil 16 CTR No 52.00 52.00 $1,364.08
Sub-Category Total : 009 Pregestimil Powder 52.00 52.00 $1,364.08
011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
300875122082 Enf Enfacare PWD 12.8oz CTR No 3,299.00 3,232.00 $57,661.59
Sub-Category Total : 011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
3,299.00 3,232.00 $57,661.59
030 Similac Neosure Powder 070074574318 Sim Neosure 13. CTR No 9,415.00 9,320.00 $163,763.23
Sub-Category Total : 030 Similac Neosure Powder 9,415.00 9,320.00 $163,763.23
031 Similac NeoSure RTF 070074574561 Similac NeoSure CTR No 2,812.00 2,812.00 $20,147.57
Sub-Category Total : 031 Similac NeoSure RTF 2,812.00 2,812.00 $20,147.57
032 Similac Alimentum RTF 070074575131 Sim Alimentum 3 CTR No 1,468.00 1,468.00 $15,269.11
Sub-Category Total : 032 Similac Alimentum RTF 1,468.00 1,468.00 $15,269.11
036 Similac PM 60/40 Powder 070074608501 Sim PM 60/40 14 CTR No 68.00 68.00 $658.70
Sub-Category Total : 036 Similac PM 60/40 Powder 68.00 68.00 $658.70
042 Elecare DHA/ARA Powder 070074535111 EleCare Infant CTR No 1,125.00 1,121.00 $48,095.50
Sub-Category Total : 042 Elecare DHA/ARA Powder 1,125.00 1,121.00 $48,095.50
069 PurAmino DHA/ARA Powder 300875104804 PurAmino 14.1oz CTR No 316.00 316.00 $13,914.31
Sub-Category Total : 069 PurAmino DHA/ARA Powder
316.00 316.00 $13,914.31
072 Neocate Infant DHA/ARA Powder 749735025956 Neocate Infant CTR No 267.00 267.00 $10,432.65 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 07/01/2021 - 07/31/2021
Account Type: H-Household Report Date/Time: 08/02/2021 10:09:06 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
Sub-Category Total : 072 Neocate Infant DHA/ARA Powder
267.00 267.00 $10,432.65
073 Elecare Jr. Unflavored Powder 070074552545 EleCareJr unfl CTR No 646.00 646.00 $29,540.32
Sub-Category Total : 073 Elecare Jr. Unflavored Powder
646.00 646.00 $29,540.32
074 EleCare Junior Powder- Any Flavor
070074565866 EleCare Jr van CTR No 308.00 308.00 $12,314.39
074 EleCare Junior Powder- Any Flavor
070074662718 ELECARE JUNIOR CHOCOLATE
POWDER 14.1 OZ
CTR No 7.00 7.00 $318.50
074 EleCare Junior Powder- Any Flavor
070074662763 ELECARE JUNIOR POWDER
BANANA 14.1 OZ
CTR No 30.00 30.00 $1,669.65
Sub-Category Total : 074 EleCare Junior Powder- Any Flavor
345.00 345.00 $14,302.54
081 Similac Alimentum Powder 070074647128 Similac_Similac Alimentu CTR No 4,288.00 4,288.00 $118,743.14
Sub-Category Total : 081 Similac Alimentum Powder 4,288.00 4,288.00 $118,743.14
102 Neocate Syneo Infant Powder 749735014363 NeocateSyn PWD14.1oz CTR No 61.00 61.00 $2,256.96
Sub-Category Total : 102 Neocate Syneo Infant Powder
61.00 61.00 $2,256.96
Category Total : 31 32,954.00 32,767.00 $768,325.06 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 07/01/2021 - 07/31/2021
Account Type: H-Household Report Date/Time: 08/02/2021 10:09:06 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
036 Pediasure 6pk (any flavor) 070074538198 Pediasure berry PKG No 152.00 152.00 $1,668.58
036 Pediasure 6pk (any flavor) 070074580500 Pediasure van 6 PKG No 1,905.00 1,905.00 $18,675.00
036 Pediasure 6pk (any flavor) 070074580531 Pediasure banan PKG No 449.00 449.00 $5,125.82
036 Pediasure 6pk (any flavor) 070074580562 Pediasure straw PKG No 928.00 928.00 $8,002.22
036 Pediasure 6pk (any flavor) 070074580593 Pediasure choc PKG No 804.00 804.00 $9,847.71
036 Pediasure 6pk (any flavor) 070074669205 Ped GrwGain 6pk 8 oz PKG No 123.00 123.00 $1,398.89
Sub-Category Total : 036 Pediasure 6pk (any flavor) 4,361.00 4,361.00 $44,718.22
038 Pediasure with Fiber 6pk (any flavor)
070074563695 Pediasure Straw PKG No 427.00 427.00 $5,189.87
038 Pediasure with Fiber 6pk (any flavor)
070074580623 Pediasure vanfi PKG No 2,325.00 2,325.00 $24,617.61
Sub-Category Total : 038 Pediasure with Fiber 6pk (any flavor)
2,752.00 2,752.00 $29,807.48
063 Neocate Junior -Any Flavor 749735006276 NeocateJr van p CTR No 64.00 64.00 $2,296.54
063 Neocate Junior -Any Flavor 749735017906 Neocate Jr unfl CTR No 442.00 442.00 $16,811.30
063 Neocate Junior -Any Flavor 749735021248 Neocate Jr trop CTR No 26.00 26.00 $1,309.74
063 Neocate Junior -Any Flavor 749735026908 Neocate Jr choc CTR No 42.00 42.00 $1,464.54
063 Neocate Junior -Any Flavor 749735064566 NeocateJr. Str Prebiotic CTR No 45.00 45.00 $1,608.02
063 Neocate Junior -Any Flavor 749735106273 NeocateJr van p CTR No 3.00 12.00 $650.97
Sub-Category Total : 063 Neocate Junior -Any Flavor 622.00 631.00 $24,141.11
142 Nutren Junior RTF 798716060622 NutrenJr van 8. CTR No 388.00 388.00 $934.78
Sub-Category Total : 142 Nutren Junior RTF 388.00 388.00 $934.78
143 Nutren Junior with Fiber RTF 798716060639 NutrenJr vanfi CTR No 48.00 48.00 $141.60 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 07/01/2021 - 07/31/2021
Account Type: H-Household Report Date/Time: 08/02/2021 10:13:45 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
Sub-Category Total : 143 Nutren Junior with Fiber
RTF
48.00 48.00 $141.60
153 Peptamen Junior RTF- Any Flavor
798716062527 Pep Jr 1.0 van CTR No 48.00 48.00 $347.04
153 Peptamen Junior RTF- Any Flavor
798716062534 Pep Jr 1.0 unf CTR No 113.00 113.00 $846.37
Sub-Category Total : 153 Peptamen Junior RTF- Any Flavor
161.00 161.00 $1,193.41
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074621203 PedPeptide 1.0 CTR No 113.00 113.00 $1,467.87
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674100 PediaSure Peptide 1.0 Vanilla RTF 8 oz
CTR No 1,444.00 1,444.00 $8,355.21
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674124 PediaSure Peptide 1.0 Strawberry RTF 8 oz
CTR No 452.00 452.00 $6,531.40
228 Pediasure Peptide 1.0 CAL- Any Flavor
070074674148 PediaSure Peptide 1.0 Unflavored RTF 8 oz
CTR No 180.00 180.00 $1,330.44
Sub-Category Total : 228 Pediasure Peptide 1.0 CAL- Any Flavor
2,189.00 2,189.00 $17,684.92
256 PediaSure 1.5 Cal RTF 070074564104 Pediasure 1.5cal Van 8oz CTR No 226.00 226.00 $675.74
256 PediaSure 1.5 Cal RTF 070074673868 PediaSure 1.5 Cal Vanilla RTF 8 oz CTR No 918.00 918.00 $1,467.22
256 PediaSure 1.5 Cal RTF 070074674186 PediaSure Peptide 1.5 Cal Vanilla RTF 8 oz
CTR No 209.00 209.00 $962.68
Sub-Category Total : 256 PediaSure 1.5 Cal RTF 1,353.00 1,353.00 $3,105.64
257 PediaSure 1.5 Cal with Fiber RTF 8 oz
070074673752 PediaSure 1.5 Cal with Fiber Vanilla RTF 8 oz
CTR No 1,727.00 1,727.00 $1,817.60
Sub-Category Total : 257 PediaSure 1.5 Cal with Fiber RTF 8 oz
1,727.00 1,727.00 $1,817.60 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 07/01/2021 - 07/31/2021
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
271 Peptamen Junior Fiber 798716602006 Pep Jr vanfi 1. CTR No 113.00 113.00 $1,173.87
Sub-Category Total : 271 Peptamen Junior Fiber 113.00 113.00 $1,173.87
336 Neocate Splash- Any Flavor 749735024355 NeoSplsh Grpe RTF8oz CTR No 289.00 289.00 $1,036.56
336 Neocate Splash- Any Flavor 749735024362 NeocSplsh O/P RTF8oz CTR No 334.00 334.00 $2,769.36
336 Neocate Splash- Any Flavor 749735024379 NeocSplsh TFr RTF8oz CTR No 351.00 351.00 $2,891.16
336 Neocate Splash- Any Flavor 749735044513 Neocate Splash Unflavor CTR No 796.00 796.00 $11,759.32
Sub-Category Total : 336 Neocate Splash- Any Flavor 1,770.00 1,770.00 $18,456.40
Category Total : 41 15,484.00 15,493.00 $143,175.03 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 07/01/2021 - 07/31/2021
SubCategory Code SubCategory Description UPC/PLU UPC/PLU Description UOM Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
004 Nutramigen with Enflora LGG Powder
300871239418 NutramigenEnfl CTR No 8,449.00 8,445.00 $261,942.38
SubCategory Total : 004 Nutramigen with Enflora LGG Powder
8,449.00 8,445.00 $261,942.38
009 Pregestimil Powder 300870367013 Pregestimil 16 CTR No 80.00 80.00 $2,287.76
SubCategory Total : 009 Pregestimil Powder 80.00 80.00 $2,287.76
011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
300875122082 Enf Enfacare PWD 12.8oz CTR No 3,313.00 3,313.00 $61,724.26
SubCategory Total : 011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
3,313.00 3,313.00 $61,724.26
030 Similac Neosure Powder 070074574318 Sim Neosure 13. CTR No 9,351.00 9,234.00 $160,773.93
SubCategory Total : 030 Similac Neosure Powder 9,351.00 9,234.00 $160,773.93
031 Similac NeoSure RTF 070074574561 Similac NeoSure CTR No 2,857.00 2,848.00 $19,451.47
SubCategory Total : 031 Similac NeoSure RTF 2,857.00 2,848.00 $19,451.47
032 Similac Alimentum RTF 070074575131 Sim Alimentum 3 CTR No 1,499.00 1,499.00 $15,655.02
SubCategory Total : 032 Similac Alimentum RTF 1,499.00 1,499.00 $15,655.02
036 Similac PM 60/40 Powder 070074608501 Sim PM 60/40 14 CTR No 66.00 66.00 $572.42
SubCategory Total : 036 Similac PM 60/40 Powder 66.00 66.00 $572.42
042 Elecare DHA/ARA Powder 070074535111 EleCare Infant CTR No 1,030.00 1,030.00 $44,469.76
SubCategory Total : 042 Elecare DHA/ARA Powder 1,030.00 1,030.00 $44,469.76
069 PurAmino DHA/ARA Powder 300875104804 PurAmino 14.1oz CTR No 245.00 245.00 $10,307.40
SubCategory Total : 069 PurAmino DHA/ARA Powder
245.00 245.00 $10,307.40
072 Neocate Infant DHA/ARA Powder 749735025956 Neocate Infant CTR No 224.00 224.00 $8,725.61 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 08/01/2021 08/31/2021 Account Type: HHousehold Report Date/Time: 09/07/2021 11:55:09 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
SubCategory Total : 072 Neocate Infant DHA/ARA Powder
224.00 224.00 $8,725.61
073 Elecare Jr. Unflavored Powder 070074552545 EleCareJr unfl CTR No 539.00 539.00 $20,773.87
SubCategory Total : 073 Elecare Jr. Unflavored Powder
539.00 539.00 $20,773.87
074 EleCare Junior Powder Any Flavor
070074565866 EleCare Jr van CTR No 436.00 436.00 $15,250.47
074 EleCare Junior Powder Any Flavor
070074662718 ELECARE JUNIOR CHOCOLATE
POWDER 14.1 OZ
CTR No 12.00 12.00 $546.00
074 EleCare Junior Powder Any Flavor
070074662763 ELECARE JUNIOR POWDER
BANANA 14.1 OZ
CTR No 27.00 27.00 $1,092.00
SubCategory Total : 074 EleCare Junior Powder Any Flavor
475.00 475.00 $16,888.47
081 Similac Alimentum Powder 070074647128 Similac_Similac Alimentu CTR No 4,391.00 4,391.00 $121,669.34
SubCategory Total : 081 Similac Alimentum Powder 4,391.00 4,391.00 $121,669.34
102 Neocate Syneo Infant Powder 749735014363 NeocateSyn PWD14.1oz CTR No 45.00 45.00 $1,643.80
SubCategory Total : 102 Neocate Syneo Infant Powder
45.00 45.00 $1,643.80
Category Total : 31 32,564.00 32,434.00 $746,885.49 eWIC Rebate Analysis Summary
Account Type: HHousehold Report Date/Time: 09/07/2021 11:55:09 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
036 Pediasure 6pk (any flavor) 070074538198 Pediasure berry PKG No 224.00 224.00 $2,549.41
036 Pediasure 6pk (any flavor) 070074580500 Pediasure van 6 PKG No 1,810.00 1,810.00 $17,389.38
036 Pediasure 6pk (any flavor) 070074580531 Pediasure banan PKG No 530.00 530.00 $5,988.33
036 Pediasure 6pk (any flavor) 070074580562 Pediasure straw PKG No 898.00 898.00 $8,782.92
036 Pediasure 6pk (any flavor) 070074580593 Pediasure choc PKG No 709.00 709.00 $8,493.09
036 Pediasure 6pk (any flavor) 070074669205 Ped GrwGain 6pk 8 oz PKG No 115.00 115.00 $1,320.18
SubCategory Total : 036 Pediasure 6pk (any flavor) 4,286.00 4,286.00 $44,523.31
038 Pediasure with Fiber 6pk (any flavor)
070074563695 Pediasure Straw PKG No 372.00 372.00 $4,501.90
038 Pediasure with Fiber 6pk (any flavor)
070074580623 Pediasure vanfi PKG No 2,042.00 2,042.00 $19,229.42
SubCategory Total : 038 Pediasure with Fiber 6pk (any flavor)
2,414.00 2,414.00 $23,731.32
063 Neocate Junior Any Flavor 749735006276 NeocateJr van p CTR No 28.00 28.00 $1,068.46
063 Neocate Junior Any Flavor 749735017906 Neocate Jr unfl CTR No 444.00 444.00 $16,315.77
063 Neocate Junior Any Flavor 749735026908 Neocate Jr choc CTR No 78.00 78.00 $3,340.16
SubCategory Total : 063 Neocate Junior Any Flavor 550.00 550.00 $20,724.39
142 Nutren Junior RTF 798716060622 NutrenJr van 8. CTR No 161.00 161.00 $457.39
SubCategory Total : 142 Nutren Junior RTF 161.00 161.00 $457.39
143 Nutren Junior with Fiber RTF 798716060639 NutrenJr vanfi CTR No 252.00 252.00 $188.80
SubCategory Total : 143 Nutren Junior with Fiber
RTF
252.00 252.00 $188.80
153 Peptamen Junior RTF Any Flavor
798716062527 Pep Jr 1.0 van CTR No 96.00 96.00 $694.08 eWIC Rebate Analysis Summary
Account Type: HHousehold Report Date/Time: 09/07/2021 11:56:46 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
153 Peptamen Junior RTF Any Flavor
798716062534 Pep Jr 1.0 unf CTR No 113.00 113.00 $846.37
SubCategory Total : 153 Peptamen Junior RTF Any Flavor
209.00 209.00 $1,540.45
228 Pediasure Peptide 1.0 CAL Any Flavor
070074621203 PedPeptide 1.0 CTR No 65.00 65.00 $844.35
228 Pediasure Peptide 1.0 CAL Any Flavor
070074674100 PediaSure Peptide 1.0 Vanilla RTF 8 oz
CTR No 1,904.00 1,904.00 $11,115.66
228 Pediasure Peptide 1.0 CAL Any Flavor
070074674124 PediaSure Peptide 1.0 Strawberry RTF 8 oz
CTR No 471.00 471.00 $6,664.21
228 Pediasure Peptide 1.0 CAL Any Flavor
070074674148 PediaSure Peptide 1.0 Unflavored RTF 8 oz
CTR No 192.00 192.00 $1,406.40
SubCategory Total : 228 Pediasure Peptide 1.0 CAL Any Flavor
2,632.00 2,632.00 $20,030.62
256 PediaSure 1.5 Cal RTF 070074564104 Pediasure 1.5cal Van 8oz CTR No 452.00 452.00 $1,351.48
256 PediaSure 1.5 Cal RTF 070074673868 PediaSure 1.5 Cal Vanilla RTF 8 oz CTR No 1,076.00 1,076.00 $1,619.33
256 PediaSure 1.5 Cal RTF 070074674186 PediaSure Peptide 1.5 Cal Vanilla RTF 8 oz
CTR No 209.00 209.00 $974.75
SubCategory Total : 256 PediaSure 1.5 Cal RTF 1,737.00 1,737.00 $3,945.56
257 PediaSure 1.5 Cal with Fiber RTF 8 oz
070074673752 PediaSure 1.5 Cal with Fiber Vanilla RTF 8 oz
CTR No 1,584.00 1,584.00 $1,104.23
SubCategory Total : 257 PediaSure 1.5 Cal with Fiber RTF 8 oz
1,584.00 1,584.00 $1,104.23
271 Peptamen Junior Fiber 798716602006 Pep Jr vanfi 1. CTR No 226.00 226.00 $2,267.91
SubCategory Total : 271 Peptamen Junior Fiber 226.00 226.00 $2,267.91
336 Neocate Splash Any Flavor 749735024355 NeoSplsh Grpe RTF8oz CTR No 145.00 145.00 $1,036.56
336 Neocate Splash Any Flavor 749735024362 NeocSplsh O/P RTF8oz CTR No 198.00 198.00 $866.11 eWIC Rebate Analysis Summary
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
336 Neocate Splash Any Flavor 749735024379 NeocSplsh TFr RTF8oz CTR No 64.00 64.00 $713.65
336 Neocate Splash Any Flavor 749735044513 Neocate Splash Unflavor CTR No 1,169.00 943.00 $14,456.88
SubCategory Total : 336 Neocate Splash Any Flavor 1,576.00 1,350.00 $17,073.20
Category Total : 41 15,627.00 15,401.00 $135,587.18 eWIC Rebate Analysis Summary
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
004 Nutramigen with Enflora LGG Powder
300871239418 NutramigenEnfl CTR No 8,039.00 8,027.00 $246,621.39
SubCategory Total : 004 Nutramigen with Enflora LGG Powder
8,039.00 8,027.00 $246,621.39
009 Pregestimil Powder 300870367013 Pregestimil 16 CTR No 42.00 42.00 $596.16
SubCategory Total : 009 Pregestimil Powder 42.00 42.00 $596.16
011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
300875122082 Enf Enfacare PWD 12.8oz CTR No 3,131.00 3,115.00 $57,967.75
SubCategory Total : 011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
3,131.00 3,115.00 $57,967.75
030 Similac Neosure Powder 070074574318 Sim Neosure 13. CTR No 9,199.00 9,127.00 $155,671.86
SubCategory Total : 030 Similac Neosure Powder 9,199.00 9,127.00 $155,671.86
031 Similac NeoSure RTF 070074574561 Similac NeoSure CTR No 2,987.00 2,937.00 $20,606.90
SubCategory Total : 031 Similac NeoSure RTF 2,987.00 2,937.00 $20,606.90
032 Similac Alimentum RTF 070074575131 Sim Alimentum 3 CTR No 1,695.00 1,695.00 $17,937.03
SubCategory Total : 032 Similac Alimentum RTF 1,695.00 1,695.00 $17,937.03
036 Similac PM 60/40 Powder 070074608501 Sim PM 60/40 14 CTR No 88.00 88.00 $512.81
SubCategory Total : 036 Similac PM 60/40 Powder 88.00 88.00 $512.81
042 Elecare DHA/ARA Powder 070074535111 EleCare Infant CTR No 924.00 924.00 $41,180.02
SubCategory Total : 042 Elecare DHA/ARA Powder 924.00 924.00 $41,180.02
069 PurAmino DHA/ARA Powder 300875104804 PurAmino 14.1oz CTR No 254.00 254.00 $11,656.57
SubCategory Total : 069 PurAmino DHA/ARA Powder
254.00 254.00 $11,656.57
072 Neocate Infant DHA/ARA Powder 749735025956 Neocate Infant CTR No 265.00 265.00 $9,363.10 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 09/01/2021 09/30/2021 Account Type: HHousehold Report Date/Time: 10/04/2021 04:59:38 PM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
SubCategory Total : 072 Neocate Infant DHA/ARA Powder
265.00 265.00 $9,363.10
073 Elecare Jr. Unflavored Powder 070074552545 EleCareJr unfl CTR No 670.00 641.00 $24,892.01
SubCategory Total : 073 Elecare Jr. Unflavored Powder
670.00 641.00 $24,892.01
074 EleCare Junior Powder Any Flavor
070074565866 EleCare Jr van CTR No 467.00 467.00 $15,045.56
074 EleCare Junior Powder Any Flavor
070074662718 ELECARE JUNIOR CHOCOLATE
POWDER 14.1 OZ
CTR No 30.00 30.00 $1,511.30
074 EleCare Junior Powder Any Flavor
070074662763 ELECARE JUNIOR POWDER
BANANA 14.1 OZ
CTR No 26.00 26.00 $910.00
SubCategory Total : 074 EleCare Junior Powder Any Flavor
523.00 523.00 $17,466.86
081 Similac Alimentum Powder 070074647128 Similac_Similac Alimentu CTR No 4,003.00 4,003.00 $109,006.99
SubCategory Total : 081 Similac Alimentum Powder 4,003.00 4,003.00 $109,006.99
102 Neocate Syneo Infant Powder 749735014363 NeocateSyn PWD14.1oz CTR No 43.00 43.00 $1,555.18
SubCategory Total : 102 Neocate Syneo Infant Powder
43.00 43.00 $1,555.18
Category Total : 31 31,863.00 31,684.00 $715,034.63 eWIC Rebate Analysis Summary
Account Type: HHousehold Report Date/Time: 10/04/2021 04:59:38 PM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
036 Pediasure 6pk (any flavor) 070074538198 Pediasure berry PKG No 163.00 163.00 $1,866.92
036 Pediasure 6pk (any flavor) 070074580500 Pediasure van 6 PKG No 1,887.00 1,887.00 $18,017.93
036 Pediasure 6pk (any flavor) 070074580531 Pediasure banan PKG No 420.00 420.00 $4,721.92
036 Pediasure 6pk (any flavor) 070074580562 Pediasure straw PKG No 662.00 662.00 $5,640.91
036 Pediasure 6pk (any flavor) 070074580593 Pediasure choc PKG No 633.00 633.00 $7,692.55
036 Pediasure 6pk (any flavor) 070074669205 Ped GrwGain 6pk 8 oz PKG No 133.00 133.00 $1,550.92
SubCategory Total : 036 Pediasure 6pk (any flavor) 3,898.00 3,898.00 $39,491.15
038 Pediasure with Fiber 6pk (any flavor)
070074563695 Pediasure Straw PKG No 380.00 380.00 $4,668.60
038 Pediasure with Fiber 6pk (any flavor)
070074580623 Pediasure vanfi PKG No 2,125.00 2,125.00 $20,569.24
SubCategory Total : 038 Pediasure with Fiber 6pk (any flavor)
2,505.00 2,505.00 $25,237.84
063 Neocate Junior Any Flavor 749735006276 NeocateJr van p CTR No 18.00 18.00 $643.86
063 Neocate Junior Any Flavor 749735017906 Neocate Jr unfl CTR No 560.00 504.00 $18,499.42
063 Neocate Junior Any Flavor 749735021248 Neocate Jr trop CTR No 8.00 8.00 $440.00
063 Neocate Junior Any Flavor 749735026908 Neocate Jr choc CTR No 42.00 42.00 $2,063.04
063 Neocate Junior Any Flavor 749735064566 NeocateJr. Str Prebiotic CTR No 39.00 39.00 $1,058.34
063 Neocate Junior Any Flavor 749735106273 NeocateJr van p CTR No 3.00 12.00 $650.97
SubCategory Total : 063 Neocate Junior Any Flavor 670.00 623.00 $23,355.63
142 Nutren Junior RTF 798716060622 NutrenJr van 8. CTR No 407.00 407.00 $1,044.87
SubCategory Total : 142 Nutren Junior RTF 407.00 407.00 $1,044.87
143 Nutren Junior with Fiber RTF 798716060639 NutrenJr vanfi CTR No 206.00 206.00 $141.60
SubCategory Total : 143 Nutren Junior with Fiber RTF 206.00 206.00 $141.60 eWIC Rebate Analysis Summary
Account Type: HHousehold Report Date/Time: 10/04/2021 05:07:42 PM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
153 Peptamen Junior RTF Any Flavor
798716062527 Pep Jr 1.0 van CTR No 24.00 24.00 $173.52
153 Peptamen Junior RTF Any Flavor
798716062534 Pep Jr 1.0 unf CTR No 113.00 113.00 $846.37
SubCategory Total : 153 Peptamen Junior RTF Any Flavor
137.00 137.00 $1,019.89
228 Pediasure Peptide 1.0 CAL Any Flavor
070074674100 PediaSure Peptide 1.0 Vanilla RTF 8 oz
CTR No 1,752.00 1,752.00 $11,041.21
228 Pediasure Peptide 1.0 CAL Any Flavor
070074674124 PediaSure Peptide 1.0 Strawberry RTF 8 oz
CTR No 581.00 581.00 $7,462.81
SubCategory Total : 228 Pediasure Peptide 1.0 CAL Any Flavor
2,333.00 2,333.00 $18,504.02
256 PediaSure 1.5 Cal RTF 070074564104 Pediasure 1.5cal Van 8oz CTR No 339.00 339.00 $1,053.16
256 PediaSure 1.5 Cal RTF 070074673868 PediaSure 1.5 Cal Vanilla RTF 8 oz CTR No 1,072.00 1,072.00 $1,986.54
256 PediaSure 1.5 Cal RTF 070074674186 PediaSure Peptide 1.5 Cal Vanilla RTF 8 oz
CTR No 234.00 234.00 $1,081.75
SubCategory Total : 256 PediaSure 1.5 Cal RTF 1,645.00 1,645.00 $4,121.45
257 PediaSure 1.5 Cal with Fiber RTF 8 oz
070074673752 PediaSure 1.5 Cal with Fiber Vanilla RTF 8 oz
CTR No 1,750.00 1,750.00 $1,841.84
SubCategory Total : 257 PediaSure 1.5 Cal with Fiber RTF 8 oz
1,750.00 1,750.00 $1,841.84
271 Peptamen Junior Fiber 798716602006 Pep Jr vanfi 1. CTR No 338.00 338.00 $3,084.13
SubCategory Total : 271 Peptamen Junior Fiber 338.00 338.00 $3,084.13
288 Neocate Junior with Prebiotics Unflavored
749735029121 NeocateJr unf p CTR No 14.00 14.00 $923.86
SubCategory Total : 288 Neocate Junior with Prebiotics Unflavored
14.00 14.00 $923.86 eWIC Rebate Analysis Summary
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
336 Neocate Splash Any Flavor 749735024355 NeoSplsh Grpe RTF8oz CTR No 235.00 235.00 $1,232.31
336 Neocate Splash Any Flavor 749735024362 NeocSplsh O/P RTF8oz CTR No 120.00 120.00 $676.65
336 Neocate Splash Any Flavor 749735024379 NeocSplsh TFr RTF8oz CTR No 65.00 65.00 $689.64
336 Neocate Splash Any Flavor 749735044513 Neocate Splash Unflavor CTR No 1,380.00 928.00 $14,435.03
SubCategory Total : 336 Neocate Splash Any Flavor 1,800.00 1,348.00 $17,033.63
Category Total : 41 15,703.00 15,204.00 $135,799.91 eWIC Rebate Analysis Summary
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
004 Nutramigen with Enflora LGG Powder
300871239418 NutramigenEnfl CTR No 8,615.00 8,613.00 $264,699.68
SubCategory Total : 004 Nutramigen with Enflora LGG Powder
8,615.00 8,613.00 $264,699.68
009 Pregestimil Powder 300870367013 Pregestimil 16 CTR No 74.00 74.00 $1,560.00
SubCategory Total : 009 Pregestimil Powder 74.00 74.00 $1,560.00
011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
300875122082 Enf Enfacare PWD 12.8oz CTR No 3,279.00 3,275.00 $61,288.66
SubCategory Total : 011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
3,279.00 3,275.00 $61,288.66
030 Similac Neosure Powder 070074574318 Sim Neosure 13. CTR No 9,371.00 9,210.00 $157,190.77
SubCategory Total : 030 Similac Neosure Powder 9,371.00 9,210.00 $157,190.77
031 Similac NeoSure RTF 070074574561 Similac NeoSure CTR No 3,115.00 3,016.00 $21,223.75
SubCategory Total : 031 Similac NeoSure RTF 3,115.00 3,016.00 $21,223.75
032 Similac Alimentum RTF 070074575131 Sim Alimentum 3 CTR No 1,572.00 1,572.00 $16,337.04
SubCategory Total : 032 Similac Alimentum RTF 1,572.00 1,572.00 $16,337.04
036 Similac PM 60/40 Powder 070074608501 Sim PM 60/40 14 CTR No 49.00 49.00 $468.45
SubCategory Total : 036 Similac PM 60/40 Powder 49.00 49.00 $468.45
042 Elecare DHA/ARA Powder 070074535111 EleCare Infant CTR No 938.00 932.00 $40,377.22
SubCategory Total : 042 Elecare DHA/ARA Powder 938.00 932.00 $40,377.22
069 PurAmino DHA/ARA Powder 300875104804 PurAmino 14.1oz CTR No 204.00 204.00 $9,343.43
SubCategory Total : 069 PurAmino DHA/ARA Powder
204.00 204.00 $9,343.43
072 Neocate Infant DHA/ARA Powder 749735025956 Neocate Infant CTR No 255.00 255.00 $10,599.62 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 10/01/2021 10/31/2021 Account Type: HHousehold Report Date/Time: 11/01/2021 08:44:40 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
SubCategory Total : 072 Neocate Infant DHA/ARA Powder
255.00 255.00 $10,599.62
073 Elecare Jr. Unflavored Powder 070074552545 EleCareJr unfl CTR No 646.00 617.00 $24,447.68
SubCategory Total : 073 Elecare Jr. Unflavored Powder
646.00 617.00 $24,447.68
074 EleCare Junior Powder Any Flavor
070074565866 EleCare Jr van CTR No 451.00 451.00 $18,290.98
074 EleCare Junior Powder Any Flavor
070074662718 ELECARE JUNIOR CHOCOLATE
POWDER 14.1 OZ
CTR No 33.00 33.00 $1,731.07
074 EleCare Junior Powder Any Flavor
070074662763 ELECARE JUNIOR POWDER
BANANA 14.1 OZ
CTR No 86.00 86.00 $3,033.38
SubCategory Total : 074 EleCare Junior Powder Any Flavor
570.00 570.00 $23,055.43
081 Similac Alimentum Powder 070074647128 Similac_Similac Alimentu CTR No 4,461.00 4,433.00 $121,615.70
SubCategory Total : 081 Similac Alimentum Powder 4,461.00 4,433.00 $121,615.70
102 Neocate Syneo Infant Powder 749735014363 NeocateSyn PWD14.1oz CTR No 16.00 16.00 $363.51
SubCategory Total : 102 Neocate Syneo Infant Powder
16.00 16.00 $363.51
Category Total : 31 33,165.00 32,836.00 $752,570.94 eWIC Rebate Analysis Summary
Account Type: HHousehold Report Date/Time: 11/01/2021 08:44:40 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
036 Pediasure 6pk (any flavor) 070074538198 Pediasure berry PKG No 159.00 159.00 $1,908.66
036 Pediasure 6pk (any flavor) 070074580500 Pediasure van 6 PKG No 1,842.00 1,842.00 $17,771.61
036 Pediasure 6pk (any flavor) 070074580531 Pediasure banan PKG No 506.00 506.00 $5,999.57
036 Pediasure 6pk (any flavor) 070074580562 Pediasure straw PKG No 938.00 938.00 $8,531.25
036 Pediasure 6pk (any flavor) 070074580593 Pediasure choc PKG No 866.00 866.00 $10,296.48
036 Pediasure 6pk (any flavor) 070074669205 Ped GrwGain 6pk 8 oz PKG No 123.00 123.00 $1,468.72
SubCategory Total : 036 Pediasure 6pk (any flavor) 4,434.00 4,434.00 $45,976.29
038 Pediasure with Fiber 6pk (any flavor)
070074563695 Pediasure Straw PKG No 433.00 433.00 $5,253.83
038 Pediasure with Fiber 6pk (any flavor)
070074580623 Pediasure vanfi PKG No 2,063.00 2,063.00 $19,347.76
SubCategory Total : 038 Pediasure with Fiber 6pk (any flavor)
2,496.00 2,496.00 $24,601.59
063 Neocate Junior Any Flavor 749735006276 NeocateJr van p CTR No 38.00 38.00 $449.90
063 Neocate Junior Any Flavor 749735017906 Neocate Jr unfl CTR No 352.00 334.00 $13,723.17
063 Neocate Junior Any Flavor 749735021248 Neocate Jr trop CTR No 8.00 8.00 $440.00
063 Neocate Junior Any Flavor 749735026908 Neocate Jr choc CTR No 57.00 57.00 $2,602.92
063 Neocate Junior Any Flavor 749735064566 NeocateJr. Str Prebiotic CTR No 28.00 28.00 $629.86
063 Neocate Junior Any Flavor 749735117903 Neocate Jr unfl CTR No 3.00 12.00 $683.67
SubCategory Total : 063 Neocate Junior Any Flavor 486.00 477.00 $18,529.52
142 Nutren Junior RTF 798716060622 NutrenJr van 8. CTR No 141.00 141.00 $435.69
SubCategory Total : 142 Nutren Junior RTF 141.00 141.00 $435.69
143 Nutren Junior with Fiber RTF 798716060639 NutrenJr vanfi CTR No 140.00 140.00 $191.75
SubCategory Total : 143 Nutren Junior with Fiber RTF 140.00 140.00 $191.75 eWIC Rebate Analysis Summary
Account Type: HHousehold Report Date/Time: 11/01/2021 08:45:58 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
153 Peptamen Junior RTF Any Flavor
798716062527 Pep Jr 1.0 van CTR No 96.00 96.00 $694.08
153 Peptamen Junior RTF Any Flavor
798716062534 Pep Jr 1.0 unf CTR No 113.00 113.00 $846.37
SubCategory Total : 153 Peptamen Junior RTF Any Flavor
209.00 209.00 $1,540.45
228 Pediasure Peptide 1.0 CAL Any Flavor
070074621227 PedPeptide 1.0 CTR No 452.00 452.00 $6,508.80
228 Pediasure Peptide 1.0 CAL Any Flavor
070074674100 PediaSure Peptide 1.0 Vanilla RTF 8 oz
CTR No 1,291.00 1,291.00 $8,480.17
228 Pediasure Peptide 1.0 CAL Any Flavor
070074674148 PediaSure Peptide 1.0 Unflavored RTF 8 oz
CTR No 212.00 212.00 $1,514.52
SubCategory Total : 228 Pediasure Peptide 1.0 CAL Any Flavor
1,955.00 1,955.00 $16,503.49
256 PediaSure 1.5 Cal RTF 070074564104 Pediasure 1.5cal Van 8oz CTR No 113.00 113.00 $377.42
256 PediaSure 1.5 Cal RTF 070074673868 PediaSure 1.5 Cal Vanilla RTF 8 oz CTR No 1,312.00 1,312.00 $1,701.67
256 PediaSure 1.5 Cal RTF 070074674186 PediaSure Peptide 1.5 Cal Vanilla RTF 8 oz
CTR No 96.00 96.00 $479.04
SubCategory Total : 256 PediaSure 1.5 Cal RTF 1,521.00 1,521.00 $2,558.13
257 PediaSure 1.5 Cal with Fiber RTF 8 oz
070074673752 PediaSure 1.5 Cal with Fiber Vanilla RTF 8 oz
CTR No 1,073.00 1,073.00 $1,234.65
SubCategory Total : 257 PediaSure 1.5 Cal with Fiber RTF 8 oz
1,073.00 1,073.00 $1,234.65
271 Peptamen Junior Fiber 798716602006 Pep Jr vanfi 1. CTR No 339.00 339.00 $3,092.33
SubCategory Total : 271 Peptamen Junior Fiber 339.00 339.00 $3,092.33
288 Neocate Junior with Prebiotics Unflavored
749735029121 NeocateJr unf p CTR No 28.00 28.00 $1,749.72 eWIC Rebate Analysis Summary
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
SubCategory Total : 288 Neocate Junior with Prebiotics Unflavored
28.00 28.00 $1,749.72
336 Neocate Splash Any Flavor 749735024355 NeoSplsh Grpe RTF8oz CTR No 288.00 288.00 $1,660.06
336 Neocate Splash Any Flavor 749735024362 NeocSplsh O/P RTF8oz CTR No 387.00 387.00 $1,036.61
336 Neocate Splash Any Flavor 749735024379 NeocSplsh TFr RTF8oz CTR No 97.00 97.00 $1,036.61
336 Neocate Splash Any Flavor 749735044513 Neocate Splash Unflavor CTR No 821.00 595.00 $8,662.29
SubCategory Total : 336 Neocate Splash Any Flavor 1,593.00 1,367.00 $12,395.57
Category Total : 41 14,415.00 14,180.00 $128,809.18 eWIC Rebate Analysis Summary
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
004 Nutramigen with Enflora LGG Powder
300871239418 NutramigenEnfl CTR No 8,622.00 8,622.00 $266,128.93
SubCategory Total : 004 Nutramigen with Enflora LGG Powder
8,622.00 8,622.00 $266,128.93
009 Pregestimil Powder 300870367013 Pregestimil 16 CTR No 78.00 78.00 $863.11
SubCategory Total : 009 Pregestimil Powder 78.00 78.00 $863.11
011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
300875122082 Enf Enfacare PWD 12.8oz CTR No 3,481.00 3,458.00 $64,641.56
SubCategory Total : 011 Enfamil NeuroPro EnfaCare Powder 12.8 oz
3,481.00 3,458.00 $64,641.56
030 Similac Neosure Powder 070074574318 Sim Neosure 13. CTR No 8,912.00 8,777.00 $149,483.30
SubCategory Total : 030 Similac Neosure Powder 8,912.00 8,777.00 $149,483.30
031 Similac NeoSure RTF 070074574561 Similac NeoSure CTR No 2,929.00 2,875.00 $19,984.55
SubCategory Total : 031 Similac NeoSure RTF 2,929.00 2,875.00 $19,984.55
032 Similac Alimentum RTF 070074575131 Sim Alimentum 3 CTR No 1,493.00 1,493.00 $15,587.70
SubCategory Total : 032 Similac Alimentum RTF 1,493.00 1,493.00 $15,587.70
036 Similac PM 60/40 Powder 070074608501 Sim PM 60/40 14 CTR No 58.00 58.00 $348.26
SubCategory Total : 036 Similac PM 60/40 Powder 58.00 58.00 $348.26
042 Elecare DHA/ARA Powder 070074535111 EleCare Infant CTR No 837.00 823.00 $37,057.28
SubCategory Total : 042 Elecare DHA/ARA Powder 837.00 823.00 $37,057.28
069 PurAmino DHA/ARA Powder 300875104804 PurAmino 14.1oz CTR No 263.00 263.00 $12,325.98
SubCategory Total : 069 PurAmino DHA/ARA Powder
263.00 263.00 $12,325.98
072 Neocate Infant DHA/ARA Powder 749735025956 Neocate Infant CTR No 276.00 276.00 $10,960.81 eWIC Rebate Analysis Summary WIC Agency: Illinois WIC Date Range: 11/01/2021 11/30/2021 Account Type: HHousehold Report Date/Time: 12/01/2021 08:36:21 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
SubCategory Total : 072 Neocate Infant DHA/ARA Powder
276.00 276.00 $10,960.81
073 Elecare Jr. Unflavored Powder 070074552545 EleCareJr unfl CTR No 659.00 659.00 $24,824.42
SubCategory Total : 073 Elecare Jr. Unflavored Powder
659.00 659.00 $24,824.42
074 EleCare Junior Powder Any Flavor
070074565866 EleCare Jr van CTR No 324.00 324.00 $11,540.99
074 EleCare Junior Powder Any Flavor
070074662718 ELECARE JUNIOR CHOCOLATE
POWDER 14.1 OZ
CTR No 32.00 32.00 $1,526.70
074 EleCare Junior Powder Any Flavor
070074662763 ELECARE JUNIOR POWDER
BANANA 14.1 OZ
CTR No 44.00 44.00 $1,834.00
SubCategory Total : 074 EleCare Junior Powder Any Flavor
400.00 400.00 $14,901.69
081 Similac Alimentum Powder 070074647128 Similac_Similac Alimentu CTR No 4,063.00 4,049.00 $110,884.08
SubCategory Total : 081 Similac Alimentum Powder 4,063.00 4,049.00 $110,884.08
102 Neocate Syneo Infant Powder 749735014363 NeocateSyn PWD14.1oz CTR No 16.00 16.00 $363.51
SubCategory Total : 102 Neocate Syneo Infant Powder
16.00 16.00 $363.51
Category Total : 31 32,087.00 31,847.00 $728,355.18 eWIC Rebate Analysis Summary
Account Type: HHousehold Report Date/Time: 12/01/2021 08:36:21 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
036 Pediasure 6pk (any flavor) 070074538198 Pediasure berry PKG No 56.00 56.00 $835.84
036 Pediasure 6pk (any flavor) 070074580500 Pediasure van 6 PKG No 2,014.00 2,014.00 $18,458.00
036 Pediasure 6pk (any flavor) 070074580531 Pediasure banan PKG No 525.00 525.00 $6,128.06
036 Pediasure 6pk (any flavor) 070074580562 Pediasure straw PKG No 807.00 807.00 $7,284.07
036 Pediasure 6pk (any flavor) 070074580593 Pediasure choc PKG No 774.00 774.00 $9,176.85
036 Pediasure 6pk (any flavor) 070074669205 Ped GrwGain 6pk 8 oz PKG No 56.00 56.00 $618.94
SubCategory Total : 036 Pediasure 6pk (any flavor) 4,232.00 4,232.00 $42,501.76
038 Pediasure with Fiber 6pk (any flavor)
070074563695 Pediasure Straw PKG No 194.00 194.00 $2,412.40
038 Pediasure with Fiber 6pk (any flavor)
070074580623 Pediasure vanfi PKG No 2,094.00 2,094.00 $20,495.76
SubCategory Total : 038 Pediasure with Fiber 6pk (any flavor)
2,288.00 2,288.00 $22,908.16
063 Neocate Junior Any Flavor 749735006276 NeocateJr van p CTR No 64.00 64.00 $2,714.39
063 Neocate Junior Any Flavor 749735017906 Neocate Jr unfl CTR No 405.00 377.00 $15,148.66
063 Neocate Junior Any Flavor 749735021248 Neocate Jr trop CTR No 27.00 27.00 $1,324.84
063 Neocate Junior Any Flavor 749735026908 Neocate Jr choc CTR No 58.00 58.00 $2,259.52
063 Neocate Junior Any Flavor 749735064566 NeocateJr. Str Prebiotic CTR No 35.00 35.00 $1,216.88
SubCategory Total : 063 Neocate Junior Any Flavor 589.00 561.00 $22,664.29
142 Nutren Junior RTF 798716060622 NutrenJr van 8. CTR No 279.00 279.00 $726.33
SubCategory Total : 142 Nutren Junior RTF 279.00 279.00 $726.33
143 Nutren Junior with Fiber RTF 798716060639 NutrenJr vanfi CTR No 66.00 66.00 $0.00
SubCategory Total : 143 Nutren Junior with Fiber RTF 66.00 66.00 $0.00 eWIC Rebate Analysis Summary
Account Type: HHousehold Report Date/Time: 12/01/2021 08:37:50 AM
Rebate Indicator
Redeemed Quantity
Applied Benefit Units
Settled Amount
153 Peptamen Junior RTF Any Flavor
798716062527 Pep Jr 1.0 van CTR No 120.00 120.00 $867.60
153 Peptamen…
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