ESBD_567618_1791984820491_Exhibit_H-4 -- Choctaw Invoice Examples.pdf
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- Attached to
- WIC Infant Formula Rebate
- Solicitation number
- HHS0016707
- Issued by
- Texas
About this file
This document contains WIC Program Formula Rebate billing invoices and supporting documentation from the Choctaw Nation of Oklahoma for the months of January, February, and March 2026. The invoices represent rebate billings submitted to two primary infant formula suppliers: Abbott Laboratories, Inc. (for Similac Isomil soy-based formulas) and Mead Johnson & Company, LLC (for Enfamil milk-based and specialty formulas). The Choctaw Nation WIC Program utilizes an electronic benefits transfer (EBT) system to track formula redemptions by vendors, with rebate amounts calculated based on units redeemed and negotiated per-unit rebate rates. The documentation includes detailed invoices specifying product types, package sizes, quantities redeemed, and corresponding rebate calculations for each redemption period and month.
The rebate structure demonstrates significant monthly volume and pricing consistency across the three-month period examined. For Abbott formulas, the Similac Isomil Powder 12.4 oz product carried a consistent rebate rate of $20.85 per unit, with total rebates ranging from $729.75 to $4,774.65 per invoice. For Mead Johnson formulas, rebate rates varied by product type, ranging from $5.51 to $25.03 per unit, with total monthly rebates ranging from approximately $17,891 to $123,233. The invoices are submitted by Shelly Rector, Sr. Director of USDA Food & Nutrition for the Choctaw Nation Health Services Administration, and sent to the respective manufacturers' rebate departments. Supporting documentation includes Supplier Rebate Reports generated through the SPIRIT 2001 system, detailing product participation dates, food distribution dollars, unit redemptions, and corresponding rebate calculations for each invoice period.
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Choctaw Nation of Oklahoma
February 6, 2026
Abbott Nutrition Attn: WIC Rebate 3300 Stelzer Road Dept. 106711 , RP2-2 Columbus, Ohio 43219
To Whom It May Concern:
Women, Infants & Children
(580) 9 16-9 140 • Fax (580) 9 16-9 143
Gary Batton Chief
Jack Austin, Jr.
Assistant Chief
Attached you will find the Choctaw Nation WIC Program Formula Rebate Billing for the redemption month of January 2026. Our software system computes the number of cans that were redeemed by our vendors according to the pricing that they reported to us. Also included, please find the documentation of computer tallied formula cans for this billing period for your records.
WIC REBATE INVOICE:
December 2025 EBT redeemed in January 2026
January 2026 EBT redeemed in January 2026
Total
$ 500.40
$4,274.25 $4,774.65
If you have additional questions, please contact me at (539) 316-3855.
Sincerely, Shelly Rector, Sr. Director of USDA Food & Nutrition Choctaw Nation Health Services Administration PO Box 1210 Durant, Ok 74702-1210 539-316-3855 sdrector@cnhsa.com
Attachments:
Rebate Billing Invoices Computer Documentation
WIC Rebate Invoice
FY 26 ABBOTT FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
SOY BASED
Similac lsomil Similac lsomil Similac lsomil
5-Feb-26
Jan-26
Dec-25
Type
RTF 32.0 OZ
PWD 12.4 OZ
CONG 13 OZ
Rebate Units TOTAL REBATE
2.2900 0 0.00
20.8500 24 500.40
4.8000 0 0.00
TOTAL 500.40
FY 26 ABBOTT FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
SOY BASED
Similac lsomil Similac lsomil Similac lsomil
I
5-Feb-26
Jan-26
Jan-26
Type
RTF 32.0 OZ
PWD 12.4 OZ
CONG 13 OZ
Rebate Units TOTAL REBATE
2.2900 0 0.00
20.8500 205 4,274.25
TOTAL 4,274.25
Choctaw Nation Supplier Rebate Report
Redemption Month of January 2026 EBT Only
Supplier: 6 - ABBOTT LABORATORIES, INC
Food Dist Dollars Units Product Participation Date Item Redeemed Redeemed
83 - Similac Soy lsomil Powder 12.4oz
UPC: 70074559643
December 2025 1034 562.32 24
January 2026 1034 4,746.22 205
5,308.54 229
5,308.54 229
Rebate Per Unit
20.85000
20.85000
Run Date: 2/5/2026
SPIRIT _2001
Page: 3
Rebate Dollars
500.40
4,274.25
4,774.65
4,774.65
February 6, 2026
Mead Johnson & Co, LLC
Women, Infants & Children
(580) 9 16-9 140 • Fax (580) 9 16-9 I 43
Attn: WIC Rebate, Cheryl Cook 2400 West Lloyd Expressway Evansville, Indiana 47721-001
To Whom It May Concern:
Gary Batton Chief
Jack Austin, Jr.
Assistant Chief
Attached you will find the Choctaw Nation WIC Program Formula Rebate Billing for the redemption month of January 2026. Our software system computes the number of cans that were redeemed by our vendors according to the pricing that they reported to us. Also included, please find the documentation of computer tallied formula cans for this billing period for your records.
WIC REBATE INVOICE:
December 2025 EBT redeemed in January 2026
January 2026 EBT redeemed in January 2026
Total
If you have additional questions, please contact me at (539) 316-3855.
Sincerely, ~~Vn Shelly Rector, Sr. Director of USDA Food & Nutrition Choctaw Nation Health Services Administration 1803 Chukka Hina Durant, Ok 74701 539-316-3855 sdrector@cnhsa.com
Attachments:
Rebate Billing Invoices Computer Documentation
$ 16,405.18
$101,321.04 $117, 726.22
FY 26 MEAD JOHNSON & COMPANY FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
MILK BASED
Enfamil Infant Enfamil Infant Enfamil Infant
Enfamil AR
Enfamil Gentlease Enfamil Neuropro Gentlease
Enfmail Reguline
6-Feb-26
Jan-26
Dec-25
Type
CONG 13 oz PWD12.5 oz RTF 32 oz
PWD 12.9 oz.
PWD. 12.4 oz.
RTF 32 oz.
PWD 12.4 oz
Rebate
5.5060 20.8120 4.6440
25.0250
22.9450 8.0880
24.5180
Units TOTAL REBATE
0 0.00 274 5,702.49
0 0.00
92 2,302.30
348 7,984.86 15 121 .32
12 294.22
---~- TOTAL~I --~-------1_6,_40_5_.1~81
FY 26 MEAD JOHNSON & COMPANY FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
MILK BASED
Enfamil Infant Enfamil Infant Enfamil Infant
Enfamil AR
Enfamil Gentlease Enfamil Neuropro Gentlease
Enfmail Reguline
6-Feb-26
Jan-26
Jan-26
Type
CONC 13 oz PWD12.5 oz RTF 32 oz
PWD 12.9 oz.
PWD. 12.4 oz.
RTF 32 oz.
PWD 12.4 oz
Rebate
5.5060 20.8120
4.6440
25.0250
22.9450 8.0880
24.5180
Units TOTAL REBATE
0 0.00 1495 31 ,113.94
0 0.00
485 12,137.13
2356 54,058.42 111 897.77
127 3,113.79
----- TOTAL~I _ _ ___. _______ 1_0~1,_32_1_.0_,4I
Choctaw Nation Run Date: 2/5/2026 Supplier Rebate Report SPIRIT 2001
Redemption Month of January 2026 Page: 1
EBT Only
Supplier: 5 - MEAD JOHNSON & COMPANY, LLC
Food Dist Dollars Units Rebate Product Participation Date Item Redeemed Redeemed Per Unit Rebate Dollars
88 - Enfamil Infant Powder 12.5oz
UPC: 300871365421
December 2025 1110 5,948.09 274 20.81200 5,702.49
January 2026 1110 32,228.28 1495 20.81200 31 ,113.94
38,176.37 1,769 36,816.43
89 - Enfamil AR Powder 12.9 oz
UPC: 300870201423
December 2025 1111 2,482.12 92 25.02500 2,302.30
January 2026 1111 13,094.53 485 25.02500 12,137.13
15,576.65 577 14,439.43
90 - Enfamil Gentlease Powder 12.4oz
UPC: 300875100691
December 2025 1112 8,403.70 348 22.94500 7,984.86
January 2026 1112 56,961 .22 2356 22.94500 54,058.42
65,364.92 2,704 62,043.28
Redemption Month of January 2026 EBT Only
Supplier: 5 - MEAD JOHNSON & COMPANY, LLC
Food Dist Dollars Units Product Participation Date Item Redeemed Redeemed
91 - Enfamil Neuropro Gentlease RTF 32oz
UPC: 300875115626
December 2025 1113 192.30 15
January 2026 1113 1,423.02 111
1,615.32 126
92 - Enfamil Reguline Powder 12.4oz
UPC: 300875111321
December 2025 1114 327.40 12
January 2026 1114 3,435.61 127
3,763.01 139
124,496.27 5,315
Rebate Per Unit
8.08800
8.08800
24.51800
24.51800
Run Date: 2/5/2026
SPIRIT 2001
Page: 2
Rebate Dollars
121 .32
897.77
1,019.09
294.22
3,113.79
3,408.00
117,726.22
March 6, 2026
Abbott Nutrition Attn: WIC Rebate 3300 Stelzer Road Dept. 106711 , RP2-2 Columbus, Ohio 43219
To Whom It May Concern:
Women, Infants & Children
(580) 916-9140 • Fax (580) 9 16-9143
Gary Batton Chief
Jack Austin, Jr.
Assistant Chief
Attached you will find the Choctaw Nation WIC Program Formula Rebate Billing for the redemption month of February 2026. Our software system computes the number of cans that were red~emed by our vendors according to the pricing that they reported to us. Also included, please find the documentation of computer tallied formula cans for this billing period for your records.
WIC REBATE INVOICE:
January 2025 EBT redeemed in February 2026
February 2026 EBT redeemed in February 2026
Total
$ 729.75
$4,336.80 $5,066.55
If you have additional questions, please contact me at (539) 316-3855.
Sincerely, Shelly Rector, Sr. Director of USDA Food & Nutrition Choctaw Nation Health Services Administration PO Box 1210 Durant, Ok 74702-1210 539-316-3855 sdrector@cnhsa.com
Attachments:
Rebate Billing Invoices
FY 26 ABBOTT FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
SOY BASED
Similac lsomil Similac lsomil Similac lsomil
I
5-Mar-26
Feb-26
Jan-26
Type
RTF 32.0 OZ
PWD 12.4 OZ
CONG 13 OZ
Rebate Units TOTAL REBATE I
2.2900 0 0.00
20.8500 35 729.75
TOTAL 729.75
FY 26 ABBOTT FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
SOY BASED
Similac lsomil Similac lsomil Similac lsomil
5-Mar-26
Feb-26
Feb-26
Type
RTF 32.0 OZ
PWD 12.4 OZ
CONG 13 OZ
Rebate Units TOTAL REBATE
2.2900 0 0.00
20.8500 208 4,336.80
TOTAL 4,336.80
Redemption Month of February 2026 EBT Only
Supplier: 6 - ABBOTT LABORATORIES, INC
Food Dist Dollars Units Product Participation Date Item Redeemed Redeemed
83 - Similac Soy lsomil Powder 12.4oz
UPC: 70074559643
January 2026 1034 797.25 35
February 2026 1034 4,810.97 208
5,608.22 243
5,608.22 243
Rebate Per Unit
20.85000
20.85000
Run Date: 3/5/2026
SPIRIT _2001
Page:3
Rebate Dollars
729.75
4,336.80
5,066.55
5,066.55
March 6, 2026
Mead Johnson & Co, LLC
Women, Infants & Children
(580) 916-9140 • Fax (580) 9 16-9143
Attn: WIC Rebate, Cheryl Cook 2400 West Lloyd Expressway Evansville, Indiana 47721-001
To Whom It May Concern:
Gary Batton Chief
Jack Austin, Jr.
Assistant Chief
Attached you will find the Choctaw Nation WIC Program Formula Rebate Billing for the redemption mont~ofFebruary 2026. Our software system computes the number of cans that were redeemed by our vendors according to the pricing that they reported to us. Also included, please find the documentation of computer tallied formula cans for this billing period for your records.
WIC REBATE INVOICE:
January 2025 EBT redeemed in February 2026
February 2026 EBT redeemed in February 2026
Total
If you have additional questions, please contact me at (539) 316-3855.
Sincerely, Shelly Rector, Sr. Director of USDA Food & Nutrition Choctaw Nation Health Services Administration 1803 Chukka Hina Durant, Ok 74701 539-316-3855 sdrector@cnhsa.com
Attachments:
Rebate Billing Invoices Computer Documentation
$ 17,891.21
$91,907.93 $109,799.14
FY 26 MEAD JOHNSON & COMPANY FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
MILK BASED
Enfamil Infant Enfamil Infant Enfamil Infant
Enfamil AR
Enfamil Gentlease Enfamil Neuropro Gentlease
Enfmail Reguline
6-Mar-26
Feb-26
Jan-26
Type
CONC 13 oz PWD12.5 oz RTF 32 oz
PWD 12.9 oz.
PWD. 12.4 oz.
RTF 32 oz.
PWD 12.4 oz
Rebate
5.5060 20.8120
4.6440
25.0250
22.9450 8.0880
24.5180
Units TOTAL REBATE
0 0.00 263 5,473.56
0 0.00
98 2,452.45
407 9,338.62 32 258.82
15 367.77
----- TOTAL~I __ ___._ _______ 17_,_89_1_.2__.11
FY 26 MEAD JOHNSON & COMPANY FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
MILK BASED
Enfamil Infant Enfamil Infant Enfamil Infant
Enfamil AR
Enfamil Gentlease Enfamil Neuropro Gentlease
Enfmail Reguline
6-Mar-26
Feb-26
Feb-26
Type
CONC 13 oz PWD12.5 oz RTF 32 oz
PWD 12.9 oz.
PWD. 12.4 oz.
RTF 32 oz.
PWD 12.4 oz
Rebate
5.5060 20.8120 4.6440
25.0250
22.9450 8.0880
24.5180
Units TOTAL REBATE
0 0.00 1288 26,805.86
0 0.00
503 12,587.58
2146 49,239.97 32 258.82
123 3,015.71
_____ TOTAL_! --~-------9_1,_90_7_.9~31
Choctaw Nation Run Date: 3/5/2026 Supplier Rebate Report SPIRIT _2001
Redemption Month of February 2026 Page: 1 EBT Only
Supplier: 5 - MEAD JOHNSON & COMPANY, LLC
Food Dist Dollars Units Rebate Product Participation Date Item Redeemed Redeemed Per Unit Rebate Dollars
88 - Enfamil Infant Powder 12.5oz
UPC: 300871365421
January 2026 1110 5,664.17 263 20.81200 5,473.56
February 2026 111G 27,766.37 1288 20.81200 26,805.86
33,430.54 1,551 32,279.41
89 - Enfamil AR Powder 12.9 oz
UPC: 300870201423
January 2026 1111 2,653.22 98 25.02500 2,452.45
February 2026 11 11 13,573.99 503 25.02500 12,587.58
16,227.21 601 15,040.03
90 - Enfamil Gentlease Powder 12.4oz
UPC: 300875100691
January 2026 1112 9,910.81 407 22.94500 9,338.62
February 2026 1112 51 ,944.28 2146 22.94500 49,239.97
61,855.09 2,553 58,578.59
Redemption Month of February 2026 EBT Only
Supplier: 5 - MEAD JOHNSON & COMPANY, LLC
Food Dist Dollars Units Product Participation Date Item Redeemed Redeemed
91 - Enfamil Neuropro Gentlease RTF 32oz
UPC: 300875115626
January 2026 1112 410.24 32
February 2026 1112 410.24 32
820.48 64
92 - Enfamil Regu line Powder 12.4oz
UPC: 300875111321
January 2026 1114 404.61 15
February 2026 1114 3,330.19 123
3,734.80 138
116,068.12 4,907
Rebate Per Unit
8.08800
8.08800
24.51800
24.51800
Run Date: 3/5/2026
SPIRIT 2001
Page: 2
Rebate Dollars
258.82
258.82
517.63
367.77
3,015.71
3,383.48
109,799.14
March 9, 2026
Abbott Nutrition Attn: WIC Rebate 3300 Stelzer Road Dept. 106711 , RP2-2 Columbus, Ohio 43219
To Whom It May Concern:
Women, Infants & Children
(580) 916-9140 • Fax (580) 916-9143
Gary Batton Chief
Jack Austin, Jr.
Assistant Chief
Attached you will find the Choctaw Nation WIC Program Formula Rebate Billing for the redemption month of March 2026. Our software system computes the number of cans that were redeemed by our vendors according to the pricing that they reported to us. Also included, please find the documentation of computer tallied formula cans for this billing period for your records.
WIC REBATE INVOICE:
February 2026 EBT redeemed in March 2026
March 2026 EBT redeemed in March 2026 $ 959.10
$4,545.30 $5,504.40
If you have additional questions, please contact me at (539) 316-3855.
Sincerely, Shelly Rector, Sr. Director of USDA Food & Nutrition Choctaw Nation Health Services Administration PO Box 1210 Durant, Ok 74702-1210 539-316-3855 sdrector@cnhsa.com
Attachments:
Rebate Bi lling Invoices
FY 26 ABBOTT FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
SOY BASED
Similac lsomil Similac lsomil Similac lsomil
I
9-Mar-26
Mar-26
Feb-26
Type
RTF 32.0 OZ
PWD 12.4 OZ
CONC 13 OZ
Rebate Units TOTAL REBATE
2.2900 0 0.00
20.8500 46 959.10
TOTAL 959.10
FY 26 ABBOTT FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
SOY BASED
Similac lsomil Similac lsomil Similac lsomil
I
9-Mar-26
Mar-26
Mar-26
Type
RTF 32.0 OZ
PWD 12.4 OZ
CONC 13 OZ
Rebate Units TOTAL REBATE
2.2900 0 0.00
20.8500 218 4,545.30
TOTAL 4,545.30
Redemption Month of March 2026 EBT Only
Supplier: 6 - ABBOTT LABORATORIES, INC
Food Dist Dollars Units Product Participation Date Item Redeemed Redeemed
83 - Similac Soy lsomil Powder 12.4oz
UPC: 70074559643
February 2026 1034 1,059.58 46
March 2026 1034 5,117.91 218
6,177.49 264
6,177.49 264
Rebate Per Unit
20.85000
20.85000
Run Date: 4/6/2026
SPIRIT _2001
Page:3
Rebate Dollars
959.10
4,545.30
5,504.40
5,504.40
March 9, 2026
Mead Johnson & Co, LLC
Women, Infants & Children
(580) 916-9140 • Fax (580) 916-9 143
Attn: WIC Rebate, Cheryl Cook 2400 West Lloyd Expressway Evansville, Indiana 47721-001
To Whom It May Cohcern:
Gary Batton Chief
Jack Austin, Jr.
Assistant Chief
Attached you will find the Choctaw Nation WIC Program Formula Rebate Billing for the redemption month of March 2026. Our software system computes the number of cans that were redeemed by our vendors according to the pricing that they reported to us. Also included, please find the documentation of computer tallied formula cans for this billing period for your records.
WIC REBATE INVOICE:
February 2026 EBT redeemed in March 2026
March 2026 EBT redeemed in March 2026
Total
If you have additional questions, please contact me at (539) 316-3855.
Sincerely, ~~cm Shelly Rector, Sr. Director of USDA Food & Nutrition Choctaw Nation Health Services Administration 1803 Chukka Hina Durant, Ok 74701 539-316-3855 sdrector@cnhsa.com
Attachments:
Rebate Billing Invoices Computer Documentation
$ 24,964.57
$98,268.38 $123,232.96
FY 26 MEAD JOHNSON & COMPANY FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
MILK BASED
Enfamil Infant Enfamil Infant Enfamil Infant
Enfamil AR
Enfamil Gentlease Enfamil Neuropro Gentlease
Enfmail ReQuline
9-Mar-26
Mar-26
Feb-26
Type
CONG 13 oz PWD12.5 oz RTF 32 oz
PWD 12.9 oz.
PWD. 12.4 oz.
RTF 32 oz.
PWD 12.4 oz
Rebate
5.5060 20.8120 4.6440
25.0250
22.9450 8.0880
24.5180
Units TOTAL REBATE
0 0.00 314 6,534.97
0 0.00
128 3,203.20
632 14,501 .24 26 210.29
21 514.88
~---- TOTAL-I --~-------2_4,_96_4_.5_.71
FY 26 MEAD JOHNSON & COMPANY FORMULA CONTRACT INVOICE
Invoice Date:
Redeemed Date:
Issued Date:
Brand
MILK BASED
Enfamil Infant Enfamil Infant Enfamil Infant
Enfamil AR
Enfamil Gentlease Enfamil Neuropro Gentlease
Enfmail Reguline
9-Mar-26
Mar-26
Mar-26
Type
CONC 13 oz PWD12.5 oz RTF 32 oz
PWD 12.9 oz.
PWD. 12.4 oz.
RTF 32 oz.
PWD 12.4 oz
Rebate Units TOTAL REBATE
5.5060 0 0.00
20.8120 1385 28,824.62
4.6440 0 0.00
25.0250 512 12,812 .80
22.9450 2326 53,370.07
8.0880 0 0.00
24.5180 133 3,260.89
TOTAL~I __ __._ _______ 98_;_,2_6_8_.3_,81
Choctaw Nation Run Date: 4/6/2026 Supplier Rebate Report SPIRIT _2001
Redemption Month of March 2026 Page: 1
EBT Only
Supplier: 5 - MEAD JOHNSON & COMPANY, LLC
Food Dist Dollars Units Rebate Product Participation Date Item Redeemed Redeemed Per Unit Rebate Dollars
88 - Enfamil Infant Powder 12.5oz
UPC: 300871365421
February 2026 111 0 6,826.31 314 20.81200 6,534.97
March 2026 1110 29,889.95 1385 20.81200 28,824.62
36,716.26 1,699 35,359.59
89 - Enfamil AR Powder 12.9 oz
UPC: 300870201423
February 2026 111 1 3,473.33 128 25.02500 3,203.20
March 2026 111 1 13,919.34 512 25.02500 12,812.80
17,392.67 640 16,016.00
90 - Enfamil Gentlease Powder 12.4oz
UPC: 300875100691
February 2026 1112 15,350.66 632 22.94500 14,501 .24
March 2026 111 2 56,364.96 2326 22.94500 53,370.07
71,715.62 2,958 67,871 .31
Redemption Month of March 2026 EBT Only
Supplier: 5 - MEAD JOHNSON & COMPANY, LLC
Food Dist Dollars Units Product Participation Date Item Redeemed Redeemed
91 - Enfamil Neuropro Gentlease RTF 32oz
UPC: 300875115626
February 2026 1113 333.32 26
333.32 26
92 - Enfamil Reguline Powder 12.4oz
UPC: 300875111321
February 2026 1114 571.47 21
March 2026 1114 3,601.42 133
4,172.89 154
130,330.76 5,477
Rebate Per Unit
8.08800
24.51800
24.51800
Run Date: 4/6/2026
SPIRIT 2001
Page: 2
Rebate Dollars
210.29
210.29
514.88
3,260.89
3,775.77
123,232.96
| Abbott Jan 26 Rebate Request |
| MJ Jan 26 Rebate Request |
| Abbott- Feb 26 |
| Mead Johnson Feb 26 |
| Abbott March Rebate |
| March Mead Johnson |
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