> Any health plan issued or renewed after December 31, 2015, must cover medically necessary elemental formula for eosinophilic gastrointestinal associated disorders, with any cost sharing applied to the out-of-pocket maximum set forth in the plan.

Vitamins (ascorbic acid, biotin, calcium d-pantothenate, choline chloride, dl- α -tocopheryl acetate, folic acid, inositol, niacinamide, pyridoxine hydrochloride, riboflavin, thiamine hydrochloride, vitamin A palmitate, vitamin B12, vitamin D3 and vitamin K1). Minerals (calcium citrate, calcium hydroxide, calcium phosphate, cupric sulfate, ferrous sulfate, magnesium oxide, manganese sulfate, potassium chloride, potassium citrate, sodium citrate, sodium iodide, sodium selenite and zinc sulfate). Ingredients (Nursette®Bottle):Water, Corn syrup solids, Extensively hydrolyzed casein§ (from milk), Modified corn starch, Palm olein oil, Soy oil, Coconut oil, High oleic sunflower oil, Carrageenan, Citric acid, Mortierella alpina oil, L- cystine, Crypthecodinium cohnii oil#, L-tyrosine, L-tryptophan, Taurine, L-carnitine, Ascorbyl palmitate, Mixed tocopherols, (may contain potassium hydroxide) § Modified to be better tolerated in milk allergic babies

Minerals (calcium citrate, calcium hydroxide, calcium phosphate, cupric sulfate, ferrous sulfate, magnesium oxide, manganese sulfate, potassium chloride, potassium citrate, sodium citrate, sodium iodide, sodium selenite and zinc sulfate. Ingredients (Powder): Corn syrup solids, Hydrolyzed casein§ (from milk), Palm olein oil, Modified corn starch, Soy oil, Coconut oil, High oleic sunflower oil, Mortierella alpina oil, L- cystine, Crypthecodinium cohnii oil#, L-tyrosine, L-tryptophan, Taurine, L-carnitine, Ascorbyl palmitate, Mixed tocopherols, (may contain potassium hydroxide) PWD Source: Palm olein oil (44%), soy oil (19.5%), coconut oil (19.5%), high oleic sunflower oil (14.5%), ARA & DHA single cell oil blend (2.5%) Nursette Source: Palm olein oil (44%), soy oil (19.5%), coconut oil (19.5%), high oleic sunflower oil (14.5%), ARA & DHA single cell oil blend (2.5%) Source (Nursette® Bottle): Corn syrup solids, modified starch. Source (Powder): Corn syrup solids, modified corn starch. Source: Casein hydrolyzed, amino acid premix

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