← Back
Raw X12 — CIN SB37395G
270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260809*1950*|*00501*305032552*1*P*:~GS*HS*00ND*EMEDNYREL*20260809*1950*032552*X*005010X279A1~ST*270*2552*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*SB37395G~EQ*30~DTP*291*D8*20260806~SE*13*2552~GE*1*032552~IEA*1*305032552~
271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260809*1550*^*00501*363010841*0*P*|~GS*FA*EMEDNYREL*00ND*20260809*1550*363010841*X*005010X231A1~ST*999*363010841*005010X231A1~AK1*HS*032552*005010X279A1~AK9*R*1*1*0*6~SE*4*363010841~GE*1*363010841~IEA*1*363010841~