MULTISTIX SG (FOR CLINI-TEK) TEST STRIP (8739) VA PRODUCT (50.68)

Name	Value
NAME	MULTISTIX SG (FOR CLINI-TEK) TEST STRIP
VA GENERIC NAME	BILIRUBIN/BLOOD/GLUCOSE/KETONE/pH/PROTEIN/SPECIFIC GRAVITY/UROBI
DOSAGE FORM	TEST STRIP
ACTIVE INGREDIENTS	GLUCOSE TEST PROTEIN TEST pH TEST KETONE TEST BLOOD TEST BILIRUBIN TEST SPECIFIC GRAVITY TEST UROBILINOGEN TEST
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-20 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	BILIRUBIN/BLOOD/GLUCOSE/KETONE/PH/PROTEIN/SPECIFIC GRAVITY/UROBI 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 SG FOR CLINI-TEK TEST STRIP
VA PRODUCT IDENTIFIER	M0125
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	STRIP
MASTER ENTRY FOR VUID	YES
VUID	4009196
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-20 00:00:00 STATUS: INACTIVE