| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| ASIA-PACIFIC DEVELOPMENT BANK PLC. | CHC/PPI/CR1-1034 |
Partial Payment | CL/CHC/PPI/21184 | CL/CHC/PPI/21184-01 |
IN-PATIENT | PHAT LINDA | 37.50 |
| Account Code | Account Name | Debit | Credit |
|---|---|---|---|
111013 |
Claim Paid-Medical Exp. | 37.50 | 0.00 |
660020 |
Amount due from/(TO)Reinsuranc | 11.25 | 0.00 |
115513 |
Claim Rec.Cam.Re- Medical Exp | 0.00 | 11.25 |
113413 |
Claim Rec.Out FAC-Medical | 0.00 | 0.00 |
114013 |
Claim Rec.Q.T Share-Medical | 0.00 | 0.00 |
660216 |
ABA - Collection Acct | 0.00 | 37.50 |