MULTISTIX 10 SG (MULTIPLE) TEST STRIP (8727) VA PRODUCT (50.68)

Name	Value
NAME	MULTISTIX 10 SG (MULTIPLE) TEST STRIP
VA GENERIC NAME	BILIRUBIN/BLOOD/GLUCOSE/KETONE/LEUKOCYTES/NITRITE/pH/PROTEIN/SPE
DOSAGE FORM	TEST STRIP
ACTIVE INGREDIENTS	GLUCOSE TEST PROTEIN TEST pH TEST KETONE TEST BLOOD TEST BILIRUBIN TEST LEUKOCYTES TEST NITRITE TEST SPECIFIC GRAVITY UROBILINOGEN TEST
CS FEDERAL SCHEDULE	Unscheduled
DSS NUMBER	1
NATIONAL FORMULARY NAME	BILIRUBIN/BLOOD/GLUCOSE/KETONE/LEUKOCYTES/NITRITE/PH/PROTEIN/SPE TEST STRIP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 0 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	MULTISTIX 10 SG MULTIPLE TEST STRIP
VA PRODUCT IDENTIFIER	M0118
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	STRIP
MASTER ENTRY FOR VUID	YES
VUID	4009184
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE