| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| MENGLY J. QUACH EDUCATION PLC. | PA/PPI/C-48472 |
Full Payment | CL/PA/PPI/3990 | CL/PA/PPI/3990-01 |
ACCIDENTAL MEDICAL EXPENSE | MOEUN RAKSA | 47.00 |
| Account Code | Account Name | Debit | Credit |
|---|---|---|---|
111006 |
Claim Paid - PA | 47.00 | 0.00 |
660020 |
Amount due from/(TO)Reinsuranc | 37.60 | 0.00 |
115506 |
Claim Rec.Cam.Re- P.A | 0.00 | 9.40 |
114006 |
Claim Rec.Q.T Share- P.A | 0.00 | 28.20 |
660216 |
ABA - Collection Acct | 0.00 | 47.00 |