| Service Date(s) | Service Provider | Status | Submitted Ch | Paid by Plan | Member Responsibility | |
| 08/15/2008 | GREEN MD RALPH MICHAEL | PAID | $204.00 | $102.49 | $20.00 | |
| 06/19/2008 | RAO MD RAMESH K | PAID | $84.00 | $61.39 | $0.00 | |
| 06/19/2008 | BAPTIST HSP OF E TN | DENIED | $91.00 | $0.00 | $0.00 | |
| 06/02/2008 | COFER MD KENNETH F | PAID | $125.00 | $68.04 | $30.00 | |
| 06/02/2008 | BOPPANA MD SRINIVAS | PAID | $82.00 | $52.00 | $30.00 | |
| 05/20/2008 | GREEN MD RALPH MICHAEL | PAID | $43.00 | $21.32 | $20.00 | |
| 05/19/2008 | CLAIBORNE CNTY HSP | PAID | $204.00 | $112.80 | $30.00 | |
| 04/29/2008 | BOPPANA MD SRINIVAS | PAID | $10,055.00 | $10,055.00 | $0.00 | |
| 04/22/2008 - 04/29/2008 | BOPPANA MD SRINIVAS | PAID | $32,185.00 | $32,185.00 | $0.00 | |
| 04/15/2008 | CLAIBORNE CNTY HSP | PROCESSED | $112.00 | $0.00 | $0.00 | |
| 04/01/2008 - 04/14/2008 | BAPTIST HSP OF E TN | PAID | $6,071.00 | $3,672.95 | $0.00 | |
| 03/17/2008 - 03/31/2008 | BAPTIST HSP OF E TN | PAID | $6,378.00 | $3,858.68 | $0.00 | |
| 03/06/2008 - 03/14/2008 | BAPTIST HSP OF E TN | PAID | $10,779.75 | $4,456.35 | $0.00 | |
| 03/04/2008 | EBENEZER MD ALBERT C S | PAID | $164.00 | $56.68 | $30.00 | |
| 03/04/2008 | BOPPANA MD SRINIVAS | PAID | $398.00 | $398.00 | $0.00 | |
| 03/04/2008 | BOPPANA MD SRINIVAS | DENIED | $398.00 | $0.00 | $0.00 | |
| 02/28/2008 | COFER MD KENNETH F | PAID | $75.00 | $30.39 | $30.00 | |
| 02/26/2008 - 04/14/2008 | RAO MD RAMESH K | PAID | $4,711.00 | $2,891.40 | $0.00 | |
| 02/25/2008 | RAO MD RAMESH K | PAID | $171.00 | $160.70 | $0.00 | |
| 02/25/2008 | BAPTIST HSP OF E TN | DENIED | $91.00 | $0.00 | $0.00 | |
| 02/06/2008 | KRISNAMOORTHY CRNA MICHE | PAID | $1,966.50 | $1,671.53 | $0.00 | |
| 02/06/2008 | COFER MD KENNETH F | PAID | $2,800.00 | $2,133.93 | $0.00 | |
| 02/06/2008 - 02/07/2008 | ST MARYS MED CTR | PAID | $19,653.31 | $2,209.91 | $50.00 | |
| 01/29/2008 | CUMBERLAND MED LABORATO | PAID | $85.00 | $85.00 | $0.00 | |
| 01/24/2008 | COFER MD KENNETH F | PAID | $300.00 | $229.02 | $30.00 | |
| 01/09/2008 | RICHARDSON CRNA CHRIS | PAID | $724.50 | $615.83 | $0.00 | |
| 01/09/2008 | VICK II MD GEORGE W | PAID | $900.00 | $298.77 | $0.00 | |
| 01/08/2008 | QUEST DIAG CLINICAL LAB | PAID | $181.20 | $20.77 | $0.00 | |
| 01/08/2008 - 01/09/2008 | ST MARYS MED CTR | PAID | $5,009.89 | $949.44 | $50.00 | |
| 01/07/2008 | GREEN MD RALPH MICHAEL | PAID | $60.00 | $37.71 | $20.00 | |
| 01/02/2008 | APPLC | PAID | $94.00 | $36.96 | $0.00 | |
| $104,196.15 | $66,472.06 | $340.00 | ||||