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271 Response
Eligibility Response Detail
CIN: NP53479Q
Date of Service: Aug. 6, 2026
Submitted: Aug. 10, 2026 6:32 AM
Payload ID: c4dbff49-228c-41b3-92fb-fe6eda138e1c
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 6:32 AM
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 | — | $40.50 | — | |
| B | 88 | — | $3.00 | — | |
| B | 91 | — | $3.00 | — | |
| B | 92 | — | $1.00 | — | |
| 1 | 88 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260810*1032*|*00501*357978207*1*P*:~GS*HS*00ND*EMEDNYREL*20260810*1032*978207*X*005010X279A1~ST*270*8207*005010X279A1~BHT*0022*13*202608101032000001*20260810*1032~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*202608101032000001*00000000ND~NM1*IL*1******MI*NP53479Q~EQ*30~DTP*291*D8*20260806~SE*13*8207~GE*1*978207~IEA*1*357978207~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260810*0632*^*00501*238185830*0*P*|~GS*HB*EMEDNYREL*00ND*20260810*063253*238185830*X*005010X279A1~ST*271*238185830*005010X279A1~BHT*0022*11*202608101032000001*20260810*063253~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*202608101032000001*00000000ND~NM1*IL*1*SANCHEZPENA*ANGELA****MI*NP53479Q~N3*890 SCHENCK AVE 5F~N4*BROOKLYN*NY*11207~DMG*D8*19360104*F~DTP*472*D8*20260810~DTP*346*D8*20260801~DTP*102*D8*20251201~EB*U*IND*30**ELIGIBLE PCP~MSG*PD~MSG*CNTY CD=66 066~MSG*RECERT MONTH=12~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*40.50~EB*B*IND*88****3~EB*B*IND*91****3~EB*B*IND*92****1~EB*1*IND*88~SE*32*238185830~GE*1*238185830~IEA*1*238185830~