| 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/3958 | CL/PA/PPI/3958-01 |
ACCIDENTAL MEDICAL EXPENSE | KANG BIN | 375.00 |