Invoice: 9624
Voucher Codes:
XSYM
KM08
4A2G
XXWL
IIRL
P3PA
QTAJ
OIO4
XUJJ
GOBP
017Y
Y1QO
G2MN
O8NF
PFOU
FX6M
XNBE
XSYM
KM08
4A2G
XXWL
IIRL
P3PA
QTAJ
OIO4
XUJJ
GOBP
017Y
Y1QO
G2MN
O8NF
PFOU
FX6M
XNBE
Invoice: 9624
Invoice Date: December 31, 2025
Service Dates: 12/1/2025 – 12/31/2025
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: 17
| 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 |
| 16 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $224.00 |
| 7 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $98.00 |
| 9 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $126.00 |
| 2 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $28.00 |
| Invoice Total | $641.00 | ||