Raw X12 — CIN PR78717J

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260810*1034*|*00501*358093322*1*P*:~GS*HS*00ND*EMEDNYREL*20260810*1034*093322*X*005010X279A1~ST*270*3322*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*PR78717J~EQ*30~DTP*291*D8*20260806~SE*13*3322~GE*1*093322~IEA*1*358093322~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260810*0634*^*00501*415251909*0*P*|~GS*FA*EMEDNYREL*00ND*20260810*0634*415251909*X*005010X231A1~ST*999*415251909*005010X231A1~AK1*HS*093322*005010X279A1~AK9*R*1*1*0*6~SE*4*415251909~GE*1*415251909~IEA*1*415251909~