Y_GM_00345474 EFTA_002 1 8 1 66 EFTA01317036 Adjustilia FAX TO Tracking No/Aid:WI No. Reason Code Explanation Invoice Number: Invote Date: Account Nuntee. Page: Af.g 16.200.1 I I f1f1-2081-6 2 o1.1 piFFCME you FAx Please include detailed explanation for each adjustment request. Remember to inclu