Indiana wic formulary

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August undefined, 2024

WebThe list of exempt infant formulas and WIC-Eligible Nutritionals allowable can be found here . WIC Medical Documentation is required to provide any products on this list. WIC Medical Documentation can be given to the patient to bring to the WIC office or faxed to 336-641-4617 (Greensboro) 336-641-6961 (High Point). WebREQUIRED MEDICAL DOCUMENTATION FOR WIC FORMULA AND APPROVED WIC FOODS - INFANTS (BIRTH UP TO 12 MONTHS) State Form 55322 (8-14) Indiana State Department of Health Indiana Women, Infants, & Children Program (WIC) Patient’s Name: Birthdate (mm/dd/yyyy): Patient’s Parent/Guardian/Caretaker Name: PLEASE …

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WebTEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE February 2024 Formula Name Category Description Qualifying Conditions Staff Instructions - May issue for 1 cert period unless otherwise indicated Manufacturer Benecalorie Modular 220 cal/oz; 330 cal per 1.5 oz ctnr; lactose and cholesterol-free; 7 g of milk protein as calcium caseinate per WebTEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE February 2024. Formula Name Category Description. Qualifying Conditions. Staff Instructions - May issue for 1 cert period unless otherwise indicated Manufacturer. Alfamino Infant Elemental. 20 cal/oz when mixed 1 scoop to 1 oz huron valley ambulance headquarters

INDIANA WIC AUTHORIZED FORMULAS (Print in COLOR for ease …

Web1 nov. 2024 · State WIC Contact Information Indiana WIC 2 North Meridian Street Indianapolis, IN 46204 Toll Free: 800-522-0874, Option 2 Access the WIC Approved Food Card, Vendor Manual, Vendor Notices, Vendor Application and more at: www.wic.in.gov Vendor Manager Tori Harvey 317-233-1386 [email protected] Vendor Consultants … WebWIC FACTS FNS provides funds through Federal grants to WIC State agencies to pay for WIC foods, nutrition education, breastfeeding promotion and support, and administrative costs. 90 WIC State agencies administer the program through local agencies and clinic sites including: •The 50 States and District of Columbia WebWIC is a nutrition program that provides nutrition and health education, breastfeeding support, healthy food, and referrals to other services free of charge to Indiana families who qualify. WIC stands for the Special Supplemental … mary grace latimer

WIC Food & Formula Texas Health and Human Services

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Web2 feb. 2024 · WIC state agencies may add these formulas to their state approved lists if the state agency has: opted into the imported formula enforcement discretion nationwide waiver, appropriate contract modifications or written agreements in place with their contracted infant formula manufacturer. WebINDIANA WIC AUTHORIZED FORMULAS (Print in COLOR for ease in reading) in 16-oz powdered 6 huron vacation packagesWeb11 apr. 2024 · Nebraska WIC Program - Approved Formulas *This list is subject to periodic updates Formula Name Manufacturer Maximum Number of Cans Per Month by Age 0-3 months 4-5 months 6-11 months Children or Women Contract Infant Formulas Similac Advance 12.4 oz powder Abbott 9 10 7 10 mary grace legaspi

"WebTEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE February 2024; Formula Name Category Description; Qualifying Conditions; Staff Instructions - May issue for 1 cert period unless otherwise indicated Manufacturer: Calcilo XD Special Medical Conditions 20 cal/oz, lactose and vitamin D-free, low-calcium; nutritionally complete " - Indiana wic formulary

Indiana wic formulary

WebWIC does not permit the issuance of RTU/RTF formulas when more than one type of a formula is available (i.e., if available in Powder or Concentrate) unless there are concerns regarding safe preparation of the formula. *Participants receiving Nutramigen with Enflora LGG can also access private label (store brand) WebIndiana WIC Approved Foods. Below is the list of Indiana WIC eligible foods based off of federal requirements. This state must use these requirements when creating the Indiana WIC food list. The following foods must comply with the FDA standards of identity: Infant formula. Exempt infant formula.

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WebRequest form WIC offers over 45 special formulas for participants with special medical needs. To request a special formula, you will need to complete the Massachusetts WIC Nutrition Program Request for Special Formula and Food and instructions for completion (PDF) (DOCX) to document the diagnosis warranting a medical need for the formula. Web1 aug. 2024 · Texas WIC Formulary – October 2024 (PDF) Nutrition Assessment Requirements Guide – October 2024 (PDF) TXIN Maximum Formula Quantity Table (Women & Children) – October 2024 (PDF) TXIN Maximum Formula Quantity Table (Infant) – October 2024 (PDF) Formula Forms and Aids. Texas WIC Medical Request for …

Web11 apr. 2024 · WIC Eligible Nutritionals** Alfamino Junior Powder 14.1 oz. Nestle 14 Boost Breeze Ready To Feed 8 oz. • Orange, Peach, Wild Berry Nestle 113 Boost Kid Essentials 1.5 8 oz. • Vanilla, Chocolate, Strawberry Nestle 113 Boost Kid Essentials 1.5 with fiber 8 oz. Vanilla Nestle 113 Boost Kid Essentials 1.0 8 oz. WebWic Approved Food Card (AFC) Indiana WIC Infant Formula Brand, type, and size specified on benefits balance. No substitutions. Return to top Infant Food Fruits & Vegetables 4 oz. jar, 4 oz. tub 2 pack, or 2 oz. tub 2 pack Includes single ingredient or combination of fruits and/or vegetables (e.g., apple-banana, sweet potato-apple).

WebIndiana WIC Formulary. Medical Documentation Form. WIC Approved Food - 2024 - English. WIC Approved Food - 2024 - Spanish. WIC Approved Food - 2024 - Burmese. WIC Approved Food - 2024 Arabic. WIC Approved Food - 2024 Hakha Chin. WIC Approved Food - 2024 Haitian Creole. WebTEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE October 2024. Formula Name Formula Code Description Qualifying Conditions. Staff Guidance Manufacturer/ Packaging* Alfamino Infant 593. Elemental: 20 cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based. 43% of fat is MCT

WebINDIANA WIC AUTHORIZED FORMULAS (Print in COLOR for ease in reading) 0-3mo / 4-5mo / 6-11mo 0 to 1/ 1-3/ 4-5/ 6-11 & WIC , .

WebTo participate in the WIC program a person must meet the following conditions: Live within the State of preferred participation; Meet income guidelines; Have a nutrition or medical risk; INCOME ELIGIBILITY FOR THE WIC PROGRAM: For more on income guidelines, visit www.fns.usda.gov/wic Effective July 1, 2024 Based on H.H.S. Poverty Income Guidelines huron valley bank milford miWebThe Indiana WIC Program serves an average of 145,000 women, infants, and children each month through a statewide network of 140 WIC clinics. Indiana WIC supports $105 million in food sales at more than 600 Indiana WIC-authorized grocery stores and pharmacies. WIC Provides: Nutrition and health screening and assessment; Nutrition education and ... huron valley community chorusWebWIC (Women, Infants & Children) Breastfeeding Information and Support Formulas Offered Formulas Offered Standard Formula Gerber Good Start Gentle Gerber Good Start … mary grace larson