Composition |
Formula Brand Name, Manufacturer |
Features |
HCPCS Code |
Specifics |
Milk based/Whey protein |
Advantage Infant Formula®, Up and Up (Target) |
DHA, Lutein, Vitamin E; 20 kcal/oz |
|
Contains soy |
|
Enfamil® EnspireTM, Mead Johnson |
DHA, lactoferrin, 20 cal/oz, non-GMO |
B4158 |
Contains soy |
|
Enfamil NeuroPro Infant®, Mead Johnson |
DHA, 20 cal/oz, non-GMO, whey/casein 60/40 |
B4158 |
Contains soy |
|
Enfamil Premium Newborn®, Mead Johnson |
DHA, 20 cal/oz, non-GMO, whey/casein 80/20 |
B4158 |
|
|
Enfamil® Infant, Mead Johnson |
DHA, 20 cal/oz, whey/casein 60/40 |
B4158 |
Contains soy |
|
Infant Non-GMO Formula®, Up and Up (Target) |
20 cal/oz, prebiotics, non-GMO |
|
Contains soy |
|
Natura Stage 1 Organic Infant Formula®, Gerber |
DHA, 20 cal/oz, prebiotics, non-GMO |
|
Contains soy |
|
Natura Stage 2 Organic Infant Formula®, Gerber |
DHA, 20 cal/oz, prebiotics, non-GMO |
|
Contains soy |
|
Organic Dairy Infant Formula®, Earth's Best |
DHA, lutein, prebiotics, non-GMO |
|
Contains soy |
|
Organic Dairy Infant Formula - Non DHA®, Earth's Best |
Lutein, 20 cal/oz, non-GMO |
|
Contains soy |
|
Pure Bliss by Similac®, Abbott |
Lutein, DHA and Vitamin E, 19 cal/oz, Non-GMO |
|
Contains soy |
|
Similac Pro Advance®, Abbott |
Lutein, DHA and Vitamin E, Human milk oligosaccharides; 19 cal/oz |
|
Contains soy |
|
Similac Advance®, Abbott |
Lutein, DHA and Vitamin E, Nucleotides; 19 cal/oz |
|
Contains soy |
|
Similac Advance 20®, Abbott |
Lutein, DHA and Vitamin E, Human milk oligosaccharides; 20 cal/oz |
|
Contains soy |
|
Similac Organic®, Abbott |
Lutein, DHA and Vitamin E, Human milk oligosaccharides; 19 cal/oz |
|
Contains soy |
|
Similac for Supplementation Non GMO®, Abbott |
Lutein, DHA and Vitamin E, Human milk oligosaccharides; 19 cal/oz |
|
Contains soy |
|
Similac Advance for Neuro Support®, Abbott |
Lutein, DHA and Vitamin E, Nucleotides; 19 cal/oz |
|
Contains soy |
|
Similac® with Iron 24, Abbott |
DHA; 24 cal/oz |
|
Contains soy |
Milk based/whey and casein |
Added Rice Starch Infant Formula with Iron, Up and Up (Target) |
20 cal/oz, prebiotics, DHA, added rice starch, |
|
Contains soy |
|
Holle Stage 1 Organic (Bio) Infant Milk Formula, Organic Start |
20 cal/oz, non-GMO |
|
|
|
Holle Stage Pre Organic (Bio) Infant Milk Formula, Organic Start |
20 cal oz, no maltodextrin, reduced vegetable oil, whole milk fat, non-GMO |
|
|
|
Organic Premium Infant Formula With Iron, The Honest Company |
DHA, 20 cal/oz, FOS, non-GMO |
|
Contains soy |
|
Organic Premium Infant Formula with Iron, Plum® Organics |
DHA, 20 cal/oz, non-GMO |
|
Contains soy |
|
Organic Sensitivity® Infant Formula, Earth's Best |
DHA, lutein, 20 cal/oz, reduced lactose |
|
Contains soy |
|
Organic Sensitive Infant Formula with Iron, The Honest Company |
DHA, 20 cal/oz, FOS, non-GMO, reduced lactose |
|
Contains soy |
|
Similac® PM 60/40, Abbott |
Whey/casein 60/40; 20 cal/oz; low mineral content |
|
Contains soy |
Milk based/milk protein isolate |
Enfamil NeuroPro™ Sensitive |
DHA, 20 cal/oz, non-GMO |
|
|
| Sensitivity® Infant Formula, Up and Up (Target)
| DHA, lutein, prebiotics, non-GMO, reduced lactose | | Contains soy |
|
Similac Pro Sensitive®, Abbott |
Lutein, DHA and Vitamin E, Human milk oligosaccharides; 19 cal/oz |
|
|
|
Similac Sensitive®, Abbott |
Lutein, DHA and Vitamin E, 19 cal/oz, Non-GMO |
|
Contains soy |
|
Similac Sensitive for Neuro Support®, Abbott |
Lutein, DHA and Vitamin E, 19 cal/oz, Non-GMO |
|
Contains soy |
Milk based/milk protein isolate with rice starch |
Enfamil A.R.®, Mead Johnson |
DHA, 20 cal/oz, whey/casein 20:80 |
B4158 |
Contains soy |
|
Similac for Spit Up®, Abbott |
Lutein, DHA and Vitamin E, 19 cal/oz |
|
Contains soy |
|
Similac for Spit Up-Non GMO®, Abbott |
Lutein, DHA and Vitamin E, 19 cal/oz, Non-GMO |
|
Contains soy |
Soy protein isolate |
Enfamil® ProSobee®, Mead Johnson |
DHA, 20 cal/oz |
B4158 |
contains soy |
|
Non-GMO Plant Based Formula®, Earth's Best |
DHA, 20 cal/oz |
|
Contains soy |
|
Similac® Soy Isomil, Abbott |
Lutein, DHA and Vitamin E, Nucleotides; 19 cal/oz |
|
Contains soy |
|
Similac® Soy Isomil 20, Abbott |
Lutein, DHA and Vitamin E, 20 cal/oz |
|
Contains soy |
|
Similac® for Diarrhea, Abbott |
Soy fiber; 20 cal/oz |
|
Contains soy |
Goat milk |
Holle Goat Stage 1 Organic Bio Infant Milk Formula®, Organic Start |
19.5 cal/oz |
|
|