Invoice: 9183
Voucher Codes:
JHGM
FEGN
SS4X
GFQZ
X622
407N
JHGM
FEGN
SS4X
GFQZ
X622
407N
Invoice: 9183
Invoice Date: November 30, 2025
Service Dates: 11/1/2025 – 11/30/2025
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:
Lincoln County Public Health - Afton
421 Jefferson Street Suite #401
Afton, Wyoming 83110
Total Vouchers: 6
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 4 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 5 | Rapid HIV test provided by CDU | $15.00 | $75.00 |
| 5 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $70.00 |
| 3 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 4 | Syphilis blood draw | $0.00 | $0.00 |
| 3 | Hepatitis B panel (hepatitis B surface antibody, surface antigen, core IgM) | $45.00 | $135.00 |
| 1 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| 3 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| Invoice Total | $378.00 | ||