| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| APLUS CONSULTING CO., LTD. | CHC/PPI/C-1056 |
Full Payment | CL/CHC/PPI/21151 | CL/CHC/PPI/21151-01 |
IN-PATIENT | CHAO VANNY | 265.50 |