Import ›
271 Response
Eligibility Response Detail
CIN: UW03720G
Date of Service: Aug. 6, 2026
Submitted: Aug. 9, 2026 4:05 PM
Payload ID: 4187aa24-09ac-45cd-a341-8db6ea947f50
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: COMMUNITY CARE MANAGEMENT PARTNERS
Received: Aug. 9, 2026 4:05 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| Recertification | RECERT | 2026-12-31 | MSG | Recertification required by this date |
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| W | CQ | — | — | — | |
| W | CQ | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260809*2005*|*00501*305940665*1*P*:~GS*HS*00ND*EMEDNYREL*20260809*2005*940665*X*005010X279A1~ST*270*0665*005010X279A1~BHT*0022*13*202608092005000001*20260809*2005~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*202608092005000001*00000000ND~NM1*IL*1******MI*UW03720G~EQ*30~DTP*291*D8*20260806~SE*13*0665~GE*1*940665~IEA*1*305940665~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260809*1605*^*00501*316648930*0*P*|~GS*HB*EMEDNYREL*00ND*20260809*160536*316648930*X*005010X279A1~ST*271*316648930*005010X279A1~BHT*0022*11*202608092005000001*20260809*160536~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*202608092005000001*00000000ND~NM1*IL*1*KING*YRIS****MI*UW03720G~N3*165 NICHOLS AVENUE 3R~N4*BROOKLYN*NY*11208~DMG*D8*19780818*F~DTP*472*D8*20260809~DTP*346*D8*20260801~DTP*102*D8*20260401~EB*U*IND*30**ELIGIBLE PCP~MSG*A1~MSG*A2~MSG*H9~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=12~LS*2120~NM1*Y2*2*HEALTHFIRST HEALTH PLAN, INC*****PI*MH~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*82~EB*W*IND*CQ~LS*2120~NM1*Y2*2*CHDFS INC*****XX*1467872804~LE*2120~EB*W*IND*CQ~LS*2120~NM1*Y2*2*COMMUNITY CARE MANAGEMENT PARTNERS*****XX*1366780850~LE*2120~EB*R*IND*30~REF*6P*H3359~LS*2120~NM1*P4*2*HEALTHFIRST MEDICARE PLAN*****PI*H3359~N3*HEALTHFIRST MEDICARE PLAN PO BOX 5165~N4*NEW YORK*NY*10274~PER*IC*PROVIDER SERVICES*TE*8882601010~LE*2120~EB*R*IND*30~REF*18*4JF2MJ1XM21~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*52*316648930~GE*1*316648930~IEA*1*316648930~