Dispute Amount Adjusted

Used in select letters when the dispute amount is being adjusted.

Date	Description	Amount	Original Dispute Amount	New Dispute Amount
<Date>	<Descriptor>	<Amount>	<Disputed Amount>	<Amount>

We have determined that the amount of the dispute was incorrect and have adjusted it as shown above.

Date	Description	Amount	Original Dispute Amount	New Dispute Amount
06/25/2024	http://WWW.CAREMARK.COM 888-892-7227 IL	$397.00	$397.00	$597.00

We have determined that the amount of the dispute was incorrect and have adjusted it as shown above.

Rule

N/A