Invoice: 3701
Voucher Codes:
XSB5
MF2A
ID:3464 (sin título)
FQ2A
ID:3424 (sin título)
828Q
34G3
ID:3407 (sin título)
2LWY
YRU8
NN32
ETT2
XSB5
MF2A
ID:3464 (sin título)
FQ2A
ID:3424 (sin título)
828Q
34G3
ID:3407 (sin título)
2LWY
YRU8
NN32
ETT2
Invoice: 3701
Invoice Date: February 28, 2025
Service Dates: 2/1/2025 – 2/28/2025
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: 12
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 11 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 11 | Rapid HIV test provided by CDU | $15.00 | $165.00 |
| 7 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $98.00 |
| 4 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 8 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $112.00 |
| 1 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| Invoice Total | $445.00 | ||