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271 Response
Eligibility Response Detail
CIN: NQ34064X
Date of Service: Aug. 6, 2026
Submitted: Aug. 9, 2026 3:52 PM
Payload ID: e1c39447-3523-477c-bbce-c5c28582c329
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: HEALTH FIRST PHSP INC
Received: Aug. 9, 2026 3:52 PM
Parser Version: 1.0
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 88 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260809*1952*|*00501*305129656*1*P*:~GS*HS*00ND*EMEDNYREL*20260809*1952*129656*X*005010X279A1~ST*270*9656*005010X279A1~BHT*0022*13*202608091952000001*20260809*1952~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*202608091952000001*00000000ND~NM1*IL*1******MI*NQ34064X~EQ*30~DTP*291*D8*20260806~SE*13*9656~GE*1*129656~IEA*1*305129656~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260809*1552*^*00501*314950830*0*P*|~GS*HB*EMEDNYREL*00ND*20260809*155205*314950830*X*005010X279A1~ST*271*314950830*005010X279A1~BHT*0022*11*202608091952000001*20260809*155205~HL*1**20*1~NM1*PR*2*NYSDOH*****FI*141797357~PER*IC*EMEDNY PROVIDER SERVICES*TE*8003439000*UR*www.emedny.org~HL*2*1*21*1~NM1*1P*2*MEDICAID PLANNING GROUP CORP*****SV*08046628~HL*3*2*22*0~TRN*2*202608091952000001*00000000ND~NM1*IL*1*MARTE*EMMANUEL*N***MI*NQ34064X~N3*3424 FULTON ST 2ND FL~N4*BROOKLYN*NY*11208~DMG*D8*20120317*M~DTP*472*D8*20260809~DTP*346*D8*20260801~DTP*102*D8*20251101~EB*U*IND*30**ELIGIBLE PCP~MSG*CNTY CD=66 500~LS*2120~NM1*Y2*2*HEALTH FIRST PHSP INC*****PI*SF~N3*100 CHURCH ST FL 18~N4*NEW YORK*NY*100072601~PER*IC*PROVIDER SERVICES*TE*8888011660~LE*2120~EB*B*IND*30***29*0~EB*1*IND*88~SE*27*314950830~GE*1*314950830~IEA*1*314950830~