Invoice: 1351
Invoice: 1351
Invoice Date: September 30, 2024
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: 14
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 10 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 11 | Rapid HIV test provided by CDU | $15.00 | $165.00 |
| 3 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 4 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 4 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 1 | HIV antibody/antigen blood draw, NO RAPID DONE OR CONTROLS FAILED | $45.00 | $45.00 |
| Invoice Total | $364.00 | ||