Invoice: 1339
Voucher Codes:
525J
ID:994 (sin título)
ID:917 (sin título)
ID:856 (sin título)
XPM8
525J
ID:994 (sin título)
ID:917 (sin título)
ID:856 (sin título)
XPM8
Invoice: 1339
Invoice Date: September 30, 2024
Service Dates: 9/1/2024 – 9/30/2024
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:
Sublette County Treasurer
P.O. Box 250Pinedale, wyoming 82941
Total Vouchers: 5
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 5 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 5 | Rapid HIV test provided by CDU | $15.00 | $75.00 |
| 5 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $70.00 |
| 4 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 5 | Syphilis blood draw | $0.00 | $0.00 |
| 1 | Hepatitis B panel (hepatitis B surface antibody, surface antigen, core IgM) | $45.00 | $45.00 |
| 2 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $28.00 |
| 1 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| Invoice Total | $288.00 | ||