← Back

Raw X12 — CIN WR52915W

270 Request
ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260810*1034*|*00501*358062293*1*P*:~GS*HS*00ND*EMEDNYREL*20260810*1034*062293*X*005010X279A1~ST*270*2293*005010X279A1~BHT*0022*13*202608101034000001*20260810*1034~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*202608101034000001*00000000ND~NM1*IL*1******MI*WR52915W~EQ*30~DTP*291*D8*20260806~SE*13*2293~GE*1*062293~IEA*1*358062293~
271 Response
ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260810*0634*^*00501*754255725*0*P*|~GS*FA*EMEDNYREL*00ND*20260810*0634*754255725*X*005010X231A1~ST*999*754255725*005010X231A1~AK1*HS*062293*005010X279A1~AK9*R*1*1*0*6~SE*4*754255725~GE*1*754255725~IEA*1*754255725~