Raw X12 — CIN SR56787R

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260726*1640*|*00501*084014662*1*P*:~GS*HS*00ND*EMEDNYREL*20260726*1640*014662*X*005010X279A1~ST*270*4662*005010X279A1~BHT*0022*13*202607261640000001*20260726*1640~HL*1**20*1~NM1*PR*2*NYSDOH*****PI*EMEDNY~HL*2*1*21*1~NM1*1P*2*MEDICAID PLANNING GROUP CORP*****SV*08046628~PRV*PE*PXC*251B00000X~HL*3*2*22*0~TRN*1*202607261640000001*00000000ND~NM1*IL*1******MI*SR56787R~EQ*30~DTP*291*D8*20260726~SE*13*4662~GE*1*014662~IEA*1*084014662~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260726*1240*^*00501*324580941*0*P*|~GS*FA*EMEDNYREL*00ND*20260726*1240*324580941*X*005010X231A1~ST*999*324580941*005010X231A1~AK1*HS*014662*005010X279A1~AK9*R*1*1*0*6~SE*4*324580941~GE*1*324580941~IEA*1*324580941~