Invoice: 5699
Voucher Codes:
ID:994 (sin título)
ID:917 (sin título)
ID:856 (sin título)
ID:994 (sin título)
ID:917 (sin título)
ID:856 (sin título)
Invoice: 5699
Invoice Date: June 30, 2025
Service Dates: 6/1/2025 – 6/30/2025
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:
Sublette County Treasurer
P.O. Box 250Pinedale, wyoming 82941
Total Vouchers: 3
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 1 | Hepatitis B panel (hepatitis B surface antibody, surface antigen, core IgM) | $45.00 | $45.00 |
| 3 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 3 | Rapid HIV test provided by CDU | $15.00 | $45.00 |
| 3 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 2 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $28.00 |
| 2 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $28.00 |
| 3 | Syphilis blood draw | $0.00 | $0.00 |
| 1 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| Invoice Total | $202.00 | ||