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State Plan Checklist - FOOD FUNDS MANAGEMENT 8/14/2026 Page 4
Product/Unit Size Manufac turer Rebate/ Unit Net pric e/Unit % WS Di scount Milk-Based Liquid Concentrate Soy-based* Liquid Concentrate Milk-based Powder Soy-based* Powder Milk-Based Ready to Feed Soy-based* Ready to Feed Exempt Formula (if applicable) 3. Infant Formula Issuance.
a. Does the State agency issue the Primary Contract Infant Formula as the first choice of issuance (by physical form), with all other infant formulas issued as an alternative? (Section 246. 16a(c)(8) 246. 10(e)(1)(iii))
Yes No