Invoice: 11759
Voucher Codes:
WXQE
OMT6
9827
B4Q2
9OYB
G2ZC
NIOI
RW7N
6XIW
2QXA
U69D
KC83
6KDD
W33E
LEKF
59LO
MYDA
B9AK
WXQE
OMT6
9827
B4Q2
9OYB
G2ZC
NIOI
RW7N
6XIW
2QXA
U69D
KC83
6KDD
W33E
LEKF
59LO
MYDA
B9AK
Invoice: 11759
Invoice Date: April 30, 2026
Service Dates: 4/1/2026 – 4/30/2026
TO:
Wyoming Department of Health
Communicable Disease Unit
122 West 25th Street, 3rd Floor West
Cheyenne, Wy, 82002
Phone (307) 777-3562 | Fax 307-777-8547
FROM:
Northwest Wyoming Family Planning
P.O. Box 941Cody, wyoming 82414
Total Vouchers: 18
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 16 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 16 | Rapid HIV test provided by CDU | $15.00 | $240.00 |
| 11 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $154.00 |
| 8 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $112.00 |
| 10 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $140.00 |
| 3 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| Invoice Total | $688.00 | ||