Pump Order Guide MN WIC 2015 - Ameda
Contents
1. amp Supplies insert Adapts to all Ameda breastpumps and kits Note that some of these parts amp supplies ee are not part of the Breastpump valves Replacement parts for Ameda HygieniKit contract pricing but Milk Collection System and One Hand Manual Breastpump are added here for your convenience in ordering Silicone Diaphrams Replacement parts for Ameda HygieniKit Milk Collection System amp One hand Manual 3 10 NA Breastpump Retail 2 pack 17148P Cavicide 240z spray Ameda 617657 ask Se eC ae ae Personal Use Personal Use Electric Double Breast Pump Includes Purely Electric Double Yours Breast Pump Ameda Dual Hygienikit Milk Collection Breastpump System with 28 5mm and 30 5mm inserts One Hand Manual NA Requires prior written Breast Pump Handle Assembly and Microfiber Tote Bag With approval Adjustable Shoulder Strap Multi user Electric AMeda Elite Electric Breastpump Multi User Electric Breastpump for Double Breast Pump with cord 305 00 305 00 use in WIC agency not for loan a Feary z Requires prior written Reconditioned Ameda Elite Electric Breastpump approval Multi User Electric Double Breast Pump with cord 199 00 199 00 1 Use this item number to obtain correct pricing 2 Most must be purchased in case quantities If you do not need a full case contact the State WIC Breastfeeding Coordinator We maintain a small stock of a few types of pumps to meet the needs of smaller agenc2. Pump Order Guide MN WIC 2015 Ameda Order Guide 2015 MN WIC Breast Pumps Eligible for Reimbursement Exhibit 61 We will reimburse ONLY for breastpumps listed on this guide unless you have made a request for another product to the State WIC Breastfeeding Coordinator and received written approval to purchase that item This is not a complete list of pumps and supplies available through the CPV If you identify a need for a product that is not on this list contact the State WIC Breastfeeding Coordinator This is not an order form and is not to be sent with your order See Exhibit H for instructions on purchasing through the CPV Type of Pump BE DESCTIDtUON Case Product Price per Price per supply p p Quantity 1 pump 2 3 4 case 2 3 4 Evenflo Ameda One Hand Manual Breastpump non sterile with CustomFit breast flanges 25 mm and 30 5 mm flanges 245 00 plus 22 5 mm and 28 5 mm reducing inserts Manual Breastpump Ameda Dual HygieniKit Milk Collection System Includes 1 Tubing Adapter 2 Silicone Tubings 2 Adapter Caps 2 Double Personal Silicone Diaphragms 2 30 5 mm Breast Flanges 2 28 5 Pump Kit mm Inserts 2 25 0 mm Breast Flanges 4 White Valves 2 330 00 4 oz Bottles with Lock Tight Sealing Lids One Hand Breast Pump Adapter Extra Large Specialty Flanges XXL XL 36 00 mm flange with 32 5 mm insert Adapts to all Ameda breastpumps and kits Large Specialty Flanges Lg Med 30 5 mm flange with 28 5 Parts
3. ies 3 Minnesota WIC Agencies see guidelines in MOM 6 11 on pumps in Minnesota WIC http www health state mn us divs fh wic localagency program mom chsctns ch6 sctn6_11 pdf 4 Please make sure that the order includes the information that you are a MN WIC agency and purchasing through the State of Minnesota WSCA Contract 01910 If you are charged a higher price than listed on this form please contact the manufacturer before paying for the order 5 State WIC Breastfeeding Coordinator contact mary b johnson state mn us 6 Cavicide or Envirocide are used to clean the PedalPump and the case for electric pumps Cavicide is listed here for your convenience but can not be claimed on the pump claim form They can be treated as a regular WIC expense Rev March 2015
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