| 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/21126 | CL/CHC/PPI/21126-01 |
OUT-PATIENT | CHAO VANNY | 39.75 |