""RRA Rebill Recipient Include Race""

EFTA01315865Dataset 10

6p1,314w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Party's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD. please call 1.800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01315865.pdf

EFTA01316751Dataset 10

4p1,510w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rabin Sender RTA Rabin Third Parry include Third Party's Account No. Name Date SUR incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01316751.pdf

EFTA01317712Dataset 10

4p1,392w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Parry's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1 visit…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01317712.pdf

EFTA01317550Dataset 10

5p1,167w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Party's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01317550.pdf

EFTA01318014Dataset 10

4p1,419w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rabin Third Party Include Third Party's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01318014.pdf

EFTA01258889Dataset 9

14p4,289w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Parry' Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1 visit our…

https://www.justice.gov/epstein/files/DataSet%209/EFTA01258889.pdf

EFTA01258847Dataset 9

3p474w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rabin Sender RTA Rabin Third Party include Third Parry's Account No. Name Date SUR incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%209/EFTA01258847.pdf

EFTA01313364Dataset 10

5p1,103w

…Sent account number if applicable. RATE incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebel Sender RTA Rebel Third Party include Third Party's Account No. Name Date SUR incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01313364.pdf

EFTA01317900Dataset 10

8p1,892w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Party's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD. please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01317900.pdf

EFTA01319657Dataset 10

4p590w

…Sent account number if applicable. RATE incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebid Third Party include Third Pay's Account No. Name Date SUR incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01319657.pdf

EFTA01315583Dataset 10

4p850w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:dents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Parry's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1.800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01315583.pdf

EFTA01315558Dataset 10

3p584w

…Sent account number it applicable. RATE incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Party's Account No. Name Date SUR incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures of lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1 visit…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01315558.pdf

EFTA01318199Dataset 10

10p2,407w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:QM% Account No. From: RSA Rabin Sender RTA Rebill Third Party Include Third Parry' Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD. please call I-800-622…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01318199.pdf

EFTA01314422Dataset 10

7p2,173w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rabin Third Party Include Third Party's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD. please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01314422.pdf

EFTA01312568Dataset 10

5p1,529w

…Sent account number if applicable. RATE incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rabin Third Parry include Third Pany's Account No. Name Date SUR incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01312568.pdf

EFTA01316715Dataset 10

4p1,237w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Party's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01316715.pdf

EFTA01317646Dataset 10

12p3,274w

…Sent mecum number if applicable. RATE incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Pays Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800-622…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01317646.pdf

EFTA01317970Dataset 10

9p2,473w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rabin Third Parly Include Third Party's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01317970.pdf

EFTA01314400Dataset 10

6p1,349w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Party's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD. please call I-800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01314400.pdf

EFTA01317803Dataset 10

11p3,658w

…Sent account number if applicable. RATE Incorrect Rates or Pieces RRA Rebill Recipient Include Race:cents Account No. From: RSA Rebill Sender RTA Rebill Third Party Include Third Parry's Account No. Name Date SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain Business Phone Business Fax This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD. To request adjustments for Service Failures or lack of a POD, please call 1.800…

https://www.justice.gov/epstein/files/DataSet%2010/EFTA01317803.pdf