Eligibility Response Detail

CIN: SA11753N

Date of Service: Aug. 6, 2026

Submitted: Aug. 9, 2026 3:50 PM

Payload ID: cbd58ab3-eb84-4a36-b066-6fe00422ceaf

Response Type: X12 999

Response Status: Member Not Found

Member Found: No

Coverage: — — —

Plan: —

MCO: —

Received: Aug. 9, 2026 3:50 PM

Parser Version: 1.0

Raw 270 Request

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260809*1950*|*00501*305003564*1*P*:~GS*HS*00ND*EMEDNYREL*20260809*1950*003564*X*005010X279A1~ST*270*3564*005010X279A1~BHT*0022*13*202608091950000001*20260809*1950~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*202608091950000001*00000000ND~NM1*IL*1******MI*SA11753N~EQ*30~DTP*291*D8*20260806~SE*13*3564~GE*1*003564~IEA*1*305003564~

Raw 271 Response

Full screen

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260809*1550*^*00501*300696472*0*P*|~GS*FA*EMEDNYREL*00ND*20260809*1550*300696472*X*005010X231A1~ST*999*300696472*005010X231A1~AK1*HS*003564*005010X279A1~AK9*R*1*1*0*6~SE*4*300696472~GE*1*300696472~IEA*1*300696472~