Invoice: 4139
Voucher Codes:
4223
ID:4078 (sin título)
ID:4077 (sin título)
SH7R
4OF6
ID:3963 (sin título)
0TN0
MZK1
ID:3919 (sin título)
4GX0
1VNL
3BBG
ID:3913 (sin título)
O8JJ
T1ZV
DS5P
S2OA
L18P
3OB9
O0P3
4223
ID:4078 (sin título)
ID:4077 (sin título)
SH7R
4OF6
ID:3963 (sin título)
0TN0
MZK1
ID:3919 (sin título)
4GX0
1VNL
3BBG
ID:3913 (sin título)
O8JJ
T1ZV
DS5P
S2OA
L18P
3OB9
O0P3
Invoice: 4139
Invoice Date: March 31, 2025
Service Dates: 3/1/2025 – 3/31/2025
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: 20
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 15 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $210.00 |
| 16 | Rapid HIV test provided by CDU | $15.00 | $240.00 |
| 16 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 14 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $196.00 |
| 4 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 1 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| Invoice Total | $716.00 | ||