Import ›
271 Response
Eligibility Response Detail
CIN: PZ00131S
Date of Service: Aug. 6, 2026
Submitted: Aug. 10, 2026 6:31 AM
Payload ID: 34135731-5ccc-4a18-8474-b5773c493c28
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: HEALTH FIRST PHSP INC
Received: Aug. 10, 2026 6:31 AM
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 *260810*1031*|*00501*357894321*1*P*:~GS*HS*00ND*EMEDNYREL*20260810*1031*894321*X*005010X279A1~ST*270*4321*005010X279A1~BHT*0022*13*202608101031000001*20260810*1031~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*202608101031000001*00000000ND~NM1*IL*1******MI*PZ00131S~EQ*30~DTP*291*D8*20260806~SE*13*4321~GE*1*894321~IEA*1*357894321~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260810*0631*^*00501*238075230*0*P*|~GS*HB*EMEDNYREL*00ND*20260810*063130*238075230*X*005010X279A1~ST*271*238075230*005010X279A1~BHT*0022*11*202608101031000001*20260810*063130~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*202608101031000001*00000000ND~NM1*IL*1*POLANCO*ARIANNA*M***MI*PZ00131S~N3*12202 GRAYSON ST FL 1~N4*SPRINGFIELD GAR*NY*11413~DMG*D8*20081027*F~DTP*472*D8*20260810~DTP*346*D8*20260801~DTP*102*D8*20251001~EB*U*IND*30**ELIGIBLE PCP~MSG*PD~MSG*95~MSG*CNTY CD=66 5C8~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*29*238075230~GE*1*238075230~IEA*1*238075230~