Invoice: 4130
Voucher Codes:
55L1
ID:3778 (sin título)
0534
GH47
ID:3734 (sin título)
55L1
ID:3778 (sin título)
0534
GH47
ID:3734 (sin título)
Invoice: 4130
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:
Sublette County Treasurer
P.O. Box 250Pinedale, wyoming 82941
Total Vouchers: 5
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 5 | Rapid HIV test provided by CDU | $15.00 | $75.00 |
| 5 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $70.00 |
| 2 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $28.00 |
| 4 | Syphilis blood draw | $0.00 | $0.00 |
| 3 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 2 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 1 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| Invoice Total | $229.00 | ||