| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| RESEARCH TRIANGLE INSTITUTE | CHC/PPI/C-0930 |
Full Payment | CL/CHC/PPI/17466 | CL/CHC/PPI/17466-04 |
IN-PATIENT | Leang Theary | 665.60 |
| Account Code | Account Name | Debit | Credit |
|---|---|---|---|
111013 |
Claim Paid-Medical Exp. | 665.60 | 0.00 |
660020 |
Amount due from/(TO)Reinsuranc | 133.12 | 0.00 |
115513 |
Claim Rec.Cam.Re- Medical Exp | 0.00 | 133.12 |
113413 |
Claim Rec.Out FAC-Medical | 0.00 | 0.00 |
114013 |
Claim Rec.Q.T Share-Medical | 0.00 | 0.00 |
660215 |
FTB-Claims Acc. | 0.00 | 665.60 |