Invoice: 4692
Voucher Codes:
WYIA
ID:4464 (sin título)
UZ29
2QBW
7INR
ID:4242 (sin título)
70SX
WYIA
ID:4464 (sin título)
UZ29
2QBW
7INR
ID:4242 (sin título)
70SX
Invoice: 4692
Invoice Date: April 30, 2025
Service Dates: 4/1/2025 – 4/30/2025
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: 7
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 4 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 5 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 5 | Rapid HIV test provided by CDU | $15.00 | $75.00 |
| 3 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 3 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 1 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| Invoice Total | $229.00 | ||