Invoice: 2408
Voucher Codes:
62AN
8R1Y
702M
4UAO
ID:2289 (sin título)
ID:2226 (sin título)
ID:2070 (sin título)
O7R0
A59X
6GFL
1ZD3
CT8X
ACGZ
ID:2006 (sin título)
62AN
8R1Y
702M
4UAO
ID:2289 (sin título)
ID:2226 (sin título)
ID:2070 (sin título)
O7R0
A59X
6GFL
1ZD3
CT8X
ACGZ
ID:2006 (sin título)
Invoice: 2408
Invoice Date: November 30, 2024
Service Dates: 11/1/2024 – 11/30/2024
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 |
|---|---|---|---|
| 5 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $70.00 |
| 13 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 13 | Rapid HIV test provided by CDU | $15.00 | $195.00 |
| 9 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $126.00 |
| 2 | Syphilis blood draw | $0.00 | $0.00 |
| 3 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 7 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $98.00 |
| Invoice Total | $531.00 | ||