Urinalysis Test Strip System

The CLIAwaived Inc. Urinalysis Test Strip System is a semi- automated analyzer for urine chemistry analysis. This device has been manufactured and developed with advanced scientific technology of modern microprocessors, optics and electronics.

BENEFITS: . Compact, convenient and easy to use . Computer Interface capability . Test speed: 60 strips per hour . Automatic self-calibration

. Test for ten parameters including: Glucose (GLU), Urobilinogen (URO), Bilirubin (BIL), Ketone (KET), Specific Gravity (SG), Occult Blood (BLD), pH, Protein (PRO), Nitrite (NIT), Leukocytes (LEU) . FDA-Cleared / CLIA Waived

Ordering Information: Product Description Catalog # CLIAwaivedTM Inc. Urine Test Strip System (Includes 5 FREE bottles of CLIA test strips) CLIA-101

Clinistrip - 1 Parameter Urinalysis Test Strip (for the detection of Blood in Urine) CLIA-1B

Clinistrip - 1 Parameter Urinalysis Test Strip (for detection of Glucose in Urine) CLIA-1G

Clinistrip - 1 Parameter Urinalysis Test Strip (for the detection of Ketones in Urine) CLIA-1K

Clinistrip - 2 Parameter Urinalysis Test Strip (for the Detection of Glucose and Protein in Urine) CLIA-2P

Clinistrip - 3 Parameter Urinalysis Test Strip (for the detection of pH, Glucose and Protein in Urine) CLIA-3P

Clinistrip - 5 Parameter Urinalysis Test Strip (for the detection of Ketone, Blood, pH, Glucose and Protein in Urine) CLIA-5K

Clinistrip - 6 Parameter Urinalysis Test Strip (for the detection of Glucose, pH, Protein, Nitrites, Blood, and Leukocytes) CLIA-6L

Clinistrip - 10 Parameter Urinalysis Test Strip (for the detection of of Leukocytes, Blood, Specific Gravity, Urobilinogen, CLIA-10 Ketone, Glucose, Protein, Bilirubin, Nitrite and pH)

Clinistrip - 11 Parameter Urinalysis Test Strip (for the detection of Leukocytes, Blood, Specific Gravity, Urobilinogen, CLIA-11 Ketone, Glucose, Protein, Bilirubin, Nitrite, pH and Ascorbic Acid) Reimbursement Information: CPT Code # National Limit Amount 81002QW (Reagent Urinalysis Dipstick Test Strips Visual) $3.00

DISCLAIMER – The CPT information contained in this document is provided as representative examples of reimbursement in this category. It is intended to assist providers in accurately obtaining reimbursement for health care services. It is not intended to increase or maximize reimbursement by any payor. Providers should consult their payor organizations with regard to local reimbursement policies. The information provided in this document is for information purposes only and represents no statement, promise or guarantee by CLIAwaivedTM Inc. All CPT codes are supplied for information purposes only and represent no statement; promise or guarantee by CLIAwaivedTM Inc. that these codes will be appropriate or that reimbursement will be made. CPT codes and descriptions are copyrights of the American Medical Associations. CPT does not include fee schedules, relative values or related ratings. The source for this information is the Center for Medicare and Medicaid Services. The content provided by the Center for Medicare and Medicaid Services is updated frequently. It is the responsibility of the service provider to confirm the appropriate coding required by their local Medicare carriers, fiscal intermediaries and commercial payors. All product information and prices are subject to change without notice at any time. Please call our office before ordering to verify current prices. Rev. 03.15.10

. 11578 Sorrento Valley Road, Suite 25/26, San Diego, CA 92121 . tel (858) 481-5031 . fax (801) 720-7568 toll free (888) 882-7739 . e-mail: [email protected]