| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| XIANG YANG | PA/PPI/C-48854 |
Full Payment | CL/PA/PPI/3957 | CL/PA/PPI/3957-01 |
ACCIDENTAL MEDICAL EXPENSE | LINGXIONG ZENG | 293.00 |