Invoice: 1858
Voucher Codes:
ID:1734 (sin título)
36AX
ID:1655 (sin título)
YP53
6U2T
4I7O
A5HT
ID:1476 (sin título)
0TDT
KJM3
EB0L
XL08
V86A
7QDR
KMH8
TK9H
ID:1734 (sin título)
36AX
ID:1655 (sin título)
YP53
6U2T
4I7O
A5HT
ID:1476 (sin título)
0TDT
KJM3
EB0L
XL08
V86A
7QDR
KMH8
TK9H
Invoice: 1858
Invoice Date: October 31, 2024
Service Dates: 10/1/2024 – 10/31/2024
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: 16
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 13 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 12 | Rapid HIV test provided by CDU | $15.00 | $180.00 |
| 5 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $70.00 |
| 3 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 9 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $126.00 |
| 1 | HIV antibody/antigen blood draw, NO RAPID DONE OR CONTROLS FAILED | $45.00 | $45.00 |
| Invoice Total | $463.00 | ||