Import › 271 Response

Eligibility Response Detail

CIN: RQ69964K
Date of Service: Aug. 12, 2026
Submitted: Aug. 12, 2026 3:12 AM
Payload ID: b65aa547-5cc4-4c0f-a51e-407d440be963
Response Type: X12 271
Response Status: Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: VNS CHOICE PLUS M/M MAP
Received: Aug. 12, 2026 3:12 AM
Parser Version: 1.0

Eligibility Indicators

Type Code Value Segment Element Description
Recertification RECERT 2026-08-31 MSG Recertification required by this date

Benefit Records (EB)

EB01 Service Type Description Amount Period Message
U 30 ELIGIBLE PCP — —
B 30 — — —
1 82 — — —
R 30 — — —
R 30 — — —

Raw 270 Request

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260812*0712*|*00501*518765735*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*0712*765735*X*005010X279A1~ST*270*5735*005010X279A1~BHT*0022*13*202608120712000001*20260812*0712~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*202608120712000001*00000000ND~NM1*IL*1******MI*RQ69964K~EQ*30~DTP*291*D8*20260812~SE*13*5735~GE*1*765735~IEA*1*518765735~

Raw 271 Response

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260812*0312*^*00501*172036330*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*031241*172036330*X*005010X279A1~ST*271*172036330*005010X279A1~BHT*0022*11*202608120712000001*20260812*031241~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*202608120712000001*00000000ND~NM1*IL*1*MARTIN*NICHOLAS*L***MI*RQ69964K~N3*2903     FARRAGUT RD          2 FL~N4*BROOKLYN*NY*11210~DMG*D8*19470205*M~DTP*472*D8*20260812~DTP*346*D8*20260801~DTP*102*D8*20260201~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=08~LS*2120~NM1*Y2*2*VNS CHOICE PLUS M/M MAP*****PI*YN~N3*220 E 42ND ST FL 6~N4*NEW YORK*NY*100175831~PER*IC*PROVIDER SERVICES*TE*8669867691~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*R*IND*30~REF*6P*H5549~LS*2120~NM1*P4*2*VNS CHOICE MEDICARE*****PI*H5549~N3*1250 BROADWAY  3RD FLOOR~N4*NEW YORK*NY*10001~PER*IC*PROVIDER SERVICES*TE*8665976674~LE*2120~EB*R*IND*30~REF*18*5W34K97WR65~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*42*172036330~GE*1*172036330~IEA*1*172036330~