Invoice: 5550
Voucher Codes:
ID:5380 (sin título)
9MMO
5T8X
ID:5377 (sin título)
OFU5
ID:5266 (sin título)
TRJ2
ESB7
F3F2
O48W
S1A3
HI4J
ID:5380 (sin título)
9MMO
5T8X
ID:5377 (sin título)
OFU5
ID:5266 (sin título)
TRJ2
ESB7
F3F2
O48W
S1A3
HI4J
Invoice: 5550
Invoice Date: June 30, 2025
Service Dates: 6/1/2025 – 6/30/2025
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:
Northwest Wyoming Family Planning
P.O. Box 941Cody, wyoming 82414
Total Vouchers: 12
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 12 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 12 | Rapid HIV test provided by CDU | $15.00 | $180.00 |
| 9 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $126.00 |
| 1 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| 8 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $112.00 |
| 2 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $28.00 |
| Invoice Total | $460.00 | ||