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271 Response
Eligibility Response Detail
CIN: RQ69964K
Date of Service: Aug. 6, 2026
Submitted: Aug. 9, 2026 3:52 PM
Payload ID: c5544002-6701-49e2-a16e-edbd56e5f8ac
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: VNS CHOICE PLUS M/M MAP
Received: Aug. 9, 2026 3:52 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| Recertification | RECERT | 2026-08-31 | MSG | Recertification required by this date |
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260809*1952*|*00501*305131842*1*P*:~GS*HS*00ND*EMEDNYREL*20260809*1952*131842*X*005010X279A1~ST*270*1842*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*RQ69964K~EQ*30~DTP*291*D8*20260806~SE*13*1842~GE*1*131842~IEA*1*305131842~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260809*1552*^*00501*314952630*0*P*|~GS*HB*EMEDNYREL*00ND*20260809*155207*314952630*X*005010X279A1~ST*271*314952630*005010X279A1~BHT*0022*11*202608091952000001*20260809*155207~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*MARTIN*NICHOLAS*L***MI*RQ69964K~N3*2903 FARRAGUT RD 2 FL~N4*BROOKLYN*NY*11210~DMG*D8*19470205*M~DTP*472*D8*20260809~DTP*346*D8*20260801~DTP*102*D8*20260201~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=08~LS*2120~NM1*Y2*2*VNS CHOICE PLUS M/M MAP*****PI*YN~N3*220 E 42ND ST FL 6~N4*NEW YORK*NY*100175831~PER*IC*PROVIDER SERVICES*TE*8669867691~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*R*IND*30~REF*6P*H5549~LS*2120~NM1*P4*2*VNS CHOICE MEDICARE*****PI*H5549~N3*1250 BROADWAY 3RD FLOOR~N4*NEW YORK*NY*10001~PER*IC*PROVIDER SERVICES*TE*8665976674~LE*2120~EB*R*IND*30~REF*18*5W34K97WR65~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*42*314952630~GE*1*314952630~IEA*1*314952630~