                                        Your Practice Name                   (56M)
                          VSS Medical Office System
  Printed: 01/11/06     ELECTRONIC SUBMISSION REPORT         Page: 1
                         Selects E & T Options Only

ACCOUNT  INVOICE HOW CARRIER BATCH     DATE     DR    CHARGES RePRINT UserID
------------------------------------------------------------------------------------
       1     264 T     1          85  04/21/03         100.00 N
       1     264 E     MC          9  08/07/03 1       100.00         nancy
       1     264 T     1          30  08/13/03         100.00 N
       1     264 E     MC         76  09/15/03 1       100.00         nancy
       1     264 T     1          66  09/15/03         100.00 N
       1     264 T     1          71  09/16/03         100.00 N
       1     264 E     MC         76  09/17/03 1       100.00         nancy
       1     264 E     MC         76  09/18/03 1       100.00         nancy
       1     264 T     1          79  09/18/03         100.00 N
       1     264 E     MC         77  10/02/03 1       125.00         nancy
       1     264 E     MC         80  10/02/03 1       122.40         nancy
       1     264 E     MC         80  10/03/03 1       124.40 Y       nancy
-------------------------------------------------------------------------------------

       5     223 T     1          86  04/22/03         200.00 N
-------------------------------------------------------------------------------------

      11     268 T     1          86  04/22/03         100.00 N
      11     268 E     MC          9  07/24/03 1       100.00         nancy
      11     268 E     MC          9  07/24/03 1       100.00         nancy
      11     268 E     MC          9  07/28/03 1       100.00         nancy
      11     268 T     1          26  07/28/03         100.00 N
      11     268 E     MC          9  08/07/03 1       100.00         nancy
      11     268 E     MC          9  08/11/03 1       100.00         nancy
      11     268 E     MC          9  08/11/03 1       100.00         nancy
      11     268 E     MC          9  08/13/03 1       100.00         nancy
-------------------------------------------------------------------------------------

      13     280 E     MC         76  09/15/03 1        35.00         nancy
      13     280 T     1          66  09/15/03          35.00 N
      13     280 T     1          71  09/16/03          35.00 N
      13     280 E     MC         76  09/17/03 1        35.00         nancy
      13     280 E     MC         76  09/17/03 1        35.00         nancy
      13     280 E     MC         76  09/17/03 1        35.00         nancy
      13     280 E     MC         76  09/18/03 1        35.00         nancy
      13     280 E     MC         76  09/18/03 1        35.00         nancy
      13     280 E     MC         76  09/18/03 1        35.00         nancy
      13     280 T     1          79  09/18/03          35.00 N
      13     280 E     MC         82  10/03/03 1        30.00         nancy
-------------------------------------------------------------------------------------

      20     152 E     BS         69  08/13/03 1        16.40         nancy
      20     152 T     5          31  08/13/03         100.00 N
-------------------------------------------------------------------------------------

      21     275 E     MD         76  09/15/03 1       135.00         nancy
      21     275 T     3          67  09/15/03         135.00 N
      21     275 T     3          69  09/16/03         135.00 N
      21     275 E     MD         76  09/17/03 1       135.00         nancy
      21     275 E     MD         76  09/17/03 1       135.00         nancy
      21     275 E     MD         76  09/17/03 1       135.00         nancy
      21     275 E     MD         76  09/18/03 1       135.00         nancy
      21     275 E     MD         76  09/18/03 1       135.00         nancy






                                        Your Practice Name                   (56M)
                          VSS Medical Office System
  Printed: 01/11/06     ELECTRONIC SUBMISSION REPORT         Page: 2
                         Selects E & T Options Only

ACCOUNT  INVOICE HOW CARRIER BATCH     DATE     DR    CHARGES RePRINT UserID
------------------------------------------------------------------------------------
      21     275 E     MD         76  09/18/03 1       135.00         nancy
      21     275 T     3          81  09/18/03         135.00 N
-------------------------------------------------------------------------------------

      24      30 E     MD         76  09/15/03 1        65.00         nancy
      24      30 T     3          67  09/15/03          65.00 N
      24      30 T     3          69  09/16/03          65.00 N
      24      30 E     MD         76  09/17/03 1        65.00         nancy
      24      30 E     MD         76  09/17/03 1        65.00         nancy
      24      30 E     MD         76  09/17/03 1        65.00         nancy
      24      30 E     MD         76  09/18/03 1        65.00         nancy
      24      30 E     MD         76  09/18/03 1        65.00         nancy
      24      30 E     MD         76  09/18/03 1        65.00         nancy
-------------------------------------------------------------------------------------
      24     198 E     MC         76  09/15/03 1        20.00         nancy
      24     198 T     1          66  09/15/03          20.00 N
      24     198 T     1          71  09/16/03          20.00 N
      24     198 E     MC         76  09/17/03 1        20.00         nancy
      24     198 E     MC         76  09/17/03 1        20.00         nancy
      24     198 E     MC         76  09/17/03 1        20.00         nancy
      24     198 E     MC         76  09/18/03 1        20.00         nancy
      24     198 E     MC         76  09/18/03 1        20.00         nancy
      24     198 E     MC         76  09/18/03 1        20.00         nancy
      24     198 T     1          79  09/18/03          20.00 N
-------------------------------------------------------------------------------------

      25      70 E     MC         64  08/13/03 1        55.00         nancy
      25      70 T     1          30  08/13/03          55.00 N
      25      70 E     MC         64  08/21/03 1        55.00         nancy
      25      70 E     MC         64  08/22/03 1        55.00         nancy
      25      70 E     MC         64  08/22/03 1        55.00         nancy
      25      70 E     MC         64  08/22/03 1        55.00         nancy
      25      70 E     MC         64  09/08/03 1        55.00         nancy
      25      70 T     1          48  09/08/03          55.00 N
      25      70 T     1          66  09/15/03          55.00 N
      25      70 T     1          71  09/16/03          55.00 N
-------------------------------------------------------------------------------------

      28      34 T     1          30  08/13/03          55.10 N
-------------------------------------------------------------------------------------

      31      65 E     MC         64  08/13/03 1        50.00         nancy
      31      65 T     1          30  08/13/03          50.00 N
      31      65 E     MC         64  08/21/03 1        50.00         nancy
      31      65 E     MC         64  08/22/03 1        50.00         nancy
      31      65 E     MC         76  09/15/03 1        50.00         nancy
      31      65 T     1          66  09/15/03          50.00 N
      31      65 T     1          71  09/16/03          50.00 N
      31      65 E     MC         76  09/17/03 1        50.00         nancy
      31      65 E     MC         76  09/17/03 1        50.00         nancy
      31      65 E     MC         76  09/17/03 1        50.00         nancy
      31      65 E     MC         76  09/18/03 1        50.00         nancy
      31      65 E     MC         76  09/18/03 1        50.00         nancy






                                        Your Practice Name                   (56M)
                          VSS Medical Office System
  Printed: 01/11/06     ELECTRONIC SUBMISSION REPORT         Page: 3
                         Selects E & T Options Only

ACCOUNT  INVOICE HOW CARRIER BATCH     DATE     DR    CHARGES RePRINT UserID
------------------------------------------------------------------------------------
      31      65 E     MC         76  09/18/03 1        50.00         nancy
      31      65 T     1          79  09/18/03          50.00 N
-------------------------------------------------------------------------------------

      46      71 E     MC         64  08/13/03 1        55.00         nancy
      46      71 T     1          30  08/13/03          55.00 N
      46      71 E     MC         64  08/21/03 1        55.00         nancy
      46      71 E     MC         64  08/22/03 1        55.00         nancy
      46      71 E     MC         76  09/15/03 1        55.00         nancy
      46      71 T     1          66  09/15/03          55.00 N
      46      71 T     1          71  09/16/03          55.00 N
      46      71 E     MC         76  09/17/03 1        55.00         nancy
      46      71 E     MC         76  09/17/03 1        55.00         nancy
      46      71 E     MC         76  09/17/03 1        55.00         nancy
      46      71 E     MC         76  09/18/03 1        55.00         nancy
      46      71 E     MC         76  09/18/03 1        55.00         nancy
      46      71 E     MC         76  09/18/03 1        55.00         nancy
      46      71 T     1          79  09/18/03          55.00 N
-------------------------------------------------------------------------------------

      47      55 E     MC         64  08/13/03 1        55.00         nancy
      47      55 T     1          30  08/13/03          55.00 N
      47      55 E     MC         64  08/21/03 1        55.00         nancy
      47      55 E     MC         64  08/22/03 1        55.00         nancy
      47      55 E     MC         76  09/15/03 1        55.00         nancy
      47      55 T     1          66  09/15/03          55.00 N
      47      55 T     1          71  09/16/03          55.00 N
      47      55 E     MC         76  09/17/03 1        55.00         nancy
      47      55 E     MC         76  09/17/03 1        55.00         nancy
      47      55 E     MC         76  09/17/03 1        55.00         nancy
      47      55 E     MC         76  09/18/03 1        55.00         nancy
      47      55 E     MC         76  09/18/03 1        55.00         nancy
      47      55 E     MC         76  09/18/03 1        55.00         nancy
      47      55 T     1          79  09/18/03          55.00 N
-------------------------------------------------------------------------------------

      48      54 E     MC         64  08/13/03 1        55.00         nancy
      48      54 T     1          30  08/13/03          55.00 N
      48      54 E     MC         64  08/21/03 1        55.00         nancy
      48      54 E     MC         64  08/22/03 1        55.00         nancy
      48      54 E     MC         64  08/22/03 1        55.00         nancy
      48      54 E     MC         64  08/22/03 1        55.00         nancy
      48      54 E     MC         64  09/08/03 1        55.00         nancy
      48      54 T     1          48  09/08/03          55.00 N
      48      54 T     1          66  09/15/03          55.00 N
      48      54 T     1          71  09/16/03          55.00 N
-------------------------------------------------------------------------------------












