| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| MARIE STOPES INTERNATIONAL CAMBODIA | CHC/PPI/C-1020 |
Full Payment | CL/CHC/PPI/20650 | CL/CHC/PPI/20650-02 |
IN-PATIENT | Leang Theary | 368.60 |
| Account Code | Account Name | Debit | Credit |
|---|---|---|---|
111013 |
Claim Paid-Medical Exp. | 368.60 | 0.00 |
660020 |
Amount due from/(TO)Reinsuranc | 110.58 | 0.00 |
115513 |
Claim Rec.Cam.Re- Medical Exp | 0.00 | 110.58 |
113413 |
Claim Rec.Out FAC-Medical | 0.00 | 0.00 |
114013 |
Claim Rec.Q.T Share-Medical | 0.00 | 0.00 |
660215 |
FTB-Claims Acc. | 0.00 | 368.60 |