Raw X12 — CIN MW59619W

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260810*1030*|*00501*357856051*1*P*:~GS*HS*00ND*EMEDNYREL*20260810*1030*856051*X*005010X279A1~ST*270*6051*005010X279A1~BHT*0022*13*202608101030000001*20260810*1030~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*202608101030000001*00000000ND~NM1*IL*1******MI*MW59619W~EQ*30~DTP*291*D8*20260806~SE*13*6051~GE*1*856051~IEA*1*357856051~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260810*0630*^*00501*238019430*0*P*|~GS*HB*EMEDNYREL*00ND*20260810*063051*238019430*X*005010X279A1~ST*271*238019430*005010X279A1~BHT*0022*11*202608101030000001*20260810*063051~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*202608101030000001*00000000ND~NM1*IL*1******MI*MW59619W~DTP*472*D8*20260810~EB*6*IND*30~SE*13*238019430~GE*1*238019430~IEA*1*238019430~