Food Price List (FPL) Updated 10/01/2017
Food Price List (FPL) Updated 10/01/2017
Store Name / Phone Number / Email / CountyStore Address / City / State / Zip Code
WIC Vendor Number (if known) / Name of Person Completing this FPL
Instructions:
- Complete all sections of the Food Price List (FPL) for all relevant WIC authorized foods in the following pages.
- If you have questions, explanations, or comments, please provide these in the space on the last page.
- If you are an existing vendor, save this document to your computer using the file name “County#####FPL.” For example, a store in Marion County with WIC vendor number 01234 would save the file as Marion01234FPL.
- Email the completed FPL document and Vendor Application to .
Minimum Inventory of WIC Approved Foods (Refer to the Vendor Food Card for more information.):
Milk: 12 gallons total: 3-whole, 2-2%, 1-1% or skim / Infant Formula:Cheese: 2 kinds, 3 lbs. in 8 or 16 oz. sizes / 6-12.1 oz. Gerber Good Start Gentle concentrate
Eggs: 3 dozen large or extra large white eggs, one-dozen / 20-12.7 oz. Gerber Good Start Gentle powder
Dry Beans: 2 kinds of dry beans for a total of 3 lbs. in 1 lb. bags / 10-12.4 oz. Gerber Good Start Soothe powder
5-12.9 oz. Gerber Good Start Soy powder
Canned Beans: 128 oz. of canned beans in 15-64 oz. size / Infant Cereal: 2 kinds for a total of 64 oz. in 8 or 16 oz. containers
Cereal: 6 kinds of dry and 1 kind of cooked, 20 boxes total, at least 1 whole grain cereal / Fruits and Vegetables Infant Food: 192 oz. in 4 oz. jars or 8 oz. 2-packs
Juice: 15 containers of 64 oz., 3 kinds with 100% juice and 120% Vitamin C or more / Meat Baby Food: 16 containers of 2.5 oz. glass jars
Juice Concentrate: 5 cans of 11.5 or 12 oz. concentrate or 46-48 oz. juice, 2 kinds / Bread: 5 loaves of WIC approved whole grain bread in 16 oz. packages
Peanut Butter: 5 jars, 16-18 oz. / Fruits and Vegetables: $30 worth with 2 different fruits and 2 different vegetables
Does your store have all of the required WIC food listed above in stock?☐ Yes☐ No
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A. MILK: Least expensive brand only. No organic.
PriceWhole / gallon
2% / gallon
1% / gallon
Skim / gallon
Whole / ½ gallon
2% / ½ gallon
1% / ½ gallon
Skim / ½ gallon
Lactose-Free / ½ gallon
Lactose-Free / quart
Silk Original Soy Milk / ½ gallon
8th Continent Soy Milk / ½ gallon
Evaporated / 12 oz.
Powdered Dry / 9.6 oz.
Powdered Dry / 25.6 oz.
UHT / quart
B. CHEESE: Highest price. No organic.
8 oz. / 16 oz.American
Cheddar
Colby
Colby-Jack
Monterey-Jack
Mozzarella
Provolone
Swiss
Blend
C. YOGURT: Highest price.32 oz. plain or flavored. Container can be quart or multipacks. No Greek or light yogurt. No organic.
Price / Brand / Container TypeNonfat or Low Fat
Whole Fat
D. EGGS: Least expensive brand only. Cage- free allowed. No organic.
PriceExtra Large White
Large White
E. CANNED BEANS: Highest price. No organic.
PriceBlack / 15-16 oz.
Garbanzo / 15-16 oz.
Great Northern / 15-16 oz.
Kidney / 15-16 oz.
Navy / 15-16 oz.
Pinto / 15-16 oz.
Lima / 15-16 oz.
Fat Free Refried / 15-16 oz.
Black-Eye Peas / 15-16 oz.
F. DRY BEANS: Highest price.No organic.
Type / Price1 lb. (16 oz.)
1 lb. (16 oz.)
1 lb. (16 oz.)
G. FISH: Highest price. Packed in water, oil, or vegetable broth. No premium or organic.
Chunk Light Tuna / Pink Salmon5 oz. / 5 oz.
12 oz. / 6 oz.
7.5 oz.
14.75 oz.
H. PEANUT BUTTER: 16-18 oz. jars only. Creamy or crunchy. No spreads or organic.
PriceStore Brand
Other
Highest Price
I. GRAINS: Highest price. No organic.
16 oz. Whole Wheat Bread / PriceAunt Millie’s
Best Choice
Bimbo
Bunny
Butternut
Family Choice
Holsum
IGA
Kroger
Meijer
Nature’s Own
Pepperidge Farms Stone Ground
Pepperidge Farms Cinnamon and Raisin Swirl
16 oz. Whole Wheat Bread / Price
Sara Lee
Schnucks
Schwebel
Sunbeam
Village Hearth
Wonder
16 oz. Whole Wheat or Corn Tortilla / Price
Best Choice
Chi-Chi’s
Don Pancho
Essential Everyday
Food Club
Great Value
IGA
Kroger
La Banderita
Meijer
Mi Casa
Mission
Ortega
Schnucks
Spartan
Tio Santi
Price
Brown Rice: 14-16 oz.
Whole Wheat Pasta: 16 oz.
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J. CEREAL: 18 oz. minimum size. List the price of all the approved cereals that you stock. Vendors must stock at least one hot and one whole grain cereal.
*Indicates a whole grain cereal.
General Mills / Price / Size / Price / Size / Price / Size*Cheerios Regular / 12 oz. / 18 oz. / 36 oz.
*Multi-Grain Cheerios / 12 oz. / 18 oz. / 36 oz.
Cinnamon Chex / 12 oz.
Corn Chex / 12 oz. / 18 oz.
Rice Chex / 12 oz. / 18 oz.
*Kix / 12 oz. / 18 oz.
Berry Berry Kix / 12 oz.
Honey Kix / 12 oz.
Dora the Explorer / 18 oz.
Kellogg / Price / Size / Price / Size / Price / Size
Crispix / 12 oz. / 18 oz.
Corn Flakes / 12 oz. / 18 oz. / 36 oz.
*Frosted Mini Wheats Original / 18 oz. / 36 oz.
*All-Bran Wheat Flakes / 18 oz.
Rice Krispies / 12 oz. / 18 oz.
*Special K Original / 12 oz. / 18 oz.
Post / Price / Size / Price / Size / Price / Size
Alpha-Bits* / 12 oz.
*Grape Nut Flakes / 18 oz. / 36 oz.
Honey Bunches of Oats
Honey Roasted / 18 oz. / 36 oz.
Almonds / 18 oz. / 36 oz.
Cinnamon Bunches / 18 oz.
*Vanilla Bunches / 18 oz.
*Honey Crunch / 18 oz.
*Almond Crunch / 18 oz.
Malt-O-Meal / Price / Size / Price / Size / Price / Size
*Frosted Mini Spooners / 18 oz. / 36 oz.
*Strawberry Cream Mini Spooners / 18 oz. / 36 oz.
*Blueberry Mini Spooners / 18 oz. / 36 oz.
Crispy Rice / 12 oz. / 18 oz. / 36 oz.
Quaker / Price / Size
*Life Original / 18 oz.
Hot Cereals / Price / Size / Price / Size / Price / Size
Malt-O-Meal Original / 18 oz. / 36 oz.
Malt-O-Meal Chocolate / 36 oz.
Cream of Rice / 12 oz.
*Cream of Wheat Whole Grain / 18 oz.
*Quaker Instant Oatmeal Original / 11.8 oz. / 23.7 oz.
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K. 64 OZ JUICE: Highest price.Can be shelf stable or refrigerated. Must be 100% juice and a minimum of 120% Vitamin C. No organic.
Brand / PriceOrange / 64 oz.
Apple / 64 oz.
Grape / 64 oz.
Grapefruit / 64 oz.
Pineapple / 64 oz.
Tomato / 64 oz.
Vegetable / 64 oz.
Blends / Juicy Juice / 64 oz.
Old Orchard / 64 oz.
L. 46-48 OZ JUICE: Highest price.Can be shelf stable or refrigerated. Must be 100% juice and a minimum of 120% Vitamin C. No organic.
Brand / PriceOrange / 46-48 oz.
Apple / 46-48 oz.
Grape / 46-48 oz.
Grapefruit / 46-48 oz.
Pineapple / 46-48 oz.
Tomato / 46-48 oz.
Vegetable / 46-48 oz.
Blends / Juicy Juice / 46-48 oz.
M. JUICE CONCENTRATE: Highest price.Frozen or shelf stable. 11.5 or 12 oz. containers only. No organic.
Brand / PriceOrange
Apple
Grape
Grapefruit
Pineapple
Other / Welch’s with yellow tab
Old Orchard with green tab
Dole (any flavor)
Welch’s shelf stable (any flavor)
N. INFANT CEREAL: Highest price. 8 or 16 oz. containers. No added fruit or quinoa. No organic.
Brand / PriceOatmeal
Rice
Multigrain
Barley
Other
O. INFANT FOOD: Highest price. No organic.
Brand / Price4 oz. Jar of Fruit and/or Veggie
8 oz. 2-Pack of Fruit and/or Veggie
2.5 oz. Jar of Meat
P. INFANT FORMULA:
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*Indicates required formulas for all stores, even those without pharmacies.
Is your store also a pharmacy? ☐ Yes☐ No
If yes, pharmacies must provide prices for all formulas listed on this page and the next page or this application will not be approved. If your store does not have a pharmacy, then please provide prices of the formulas that are regularly stocked.
Can you obtain any of the items on the WIC formulary list page 1-3 located at within 2 working days?
Who is the WIC contact for special order formula at your store?
Name / Title / Phone Number / EmailPowder / Price / Ready to Feed (RTF) / Price / Liquid Concentrate / Price
Gerber Good Start Gentle / *12.7 oz. / 8.45 oz. 4-Pack / *12.1 oz.
Gerber Good Start Soothe / *12.4 oz.
Gerber Good Start Soy / *12.9 oz. / 8.45 oz. 4-Pack / 12.1 oz.
Q. SPECIAL FORMULA
Reminder: Stores with pharmacies must list prices for ALL FORMULAS ON THIS PAGE.
Powder / Ready to Feed (RTF) / Liquid Concentrate / CaseSize (UPC) / Price / Size (UPC) / Price / Size (UPC) / Price / Size (UPC) / Price
Boost (any flavor) / 8 oz. 6-Pack (041679674000)
Boost Kid Essentials 1.0 Cal (any flavor) / 8.25 oz. 4-Pack (041679950968)
EleCare for Infants w/ DHA & ARA / 14.1 oz. (070074535111)
Enfamil Nutramigen w/ Enflora / 12.6 oz. (300871239418)
Enfamil Nutramigen / Quart (300870499011) / 13 oz. (300870498014)
Enfamil EnfaCare / 12.8 oz. (300870019448) / 8 oz. 6-Pack (300875102985) / 2 oz./48/case (300871390010)
Ensure (any flavor) / 8 oz. 6-Pack (070074407111)
Neocate Infant w/DHA & ARA / 14.1 oz. (749735025956)
Neocate Jr (any flavor) / 14.1 oz. (749735017906)
Pediasure Grow & Gain (any flavor) / 8 oz. 6-Pack (070074620503)
Pediasure Grow & Gain w/ Fiber (any flavor) / 8 oz. 6-Pack (070074582214)
Pediasure 1.5 Cal (any flavor) / 8 oz./24/case (070074564098)
Pediasure Peptide 1.0 Cal (any flavor) / 8 oz./24/case (070074564111)
Similac Expert Care Alimentum / 12.1 oz. (070074647128) / Quart (070074575131)
Similac Expert Care NeoSure / 16 oz. (070074574318) / Quart (070074574561)
This is not a complete list of all special formulas. Please see the complete list at wic.in.gov.
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:
-1 mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410;
-2 fax: (202) 690-7442; or
-3 email: .
USDA is an equal opportunity provider and employer.
Explanations and comments:
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