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271 Response
Eligibility Response Detail
CIN: WP92760C
Date of Service: Aug. 12, 2026
Submitted: Aug. 12, 2026 3:12 AM
Payload ID: 40fa7bd8-eeda-41fd-9594-b4893f5aa3b2
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: VNS CHOICE PARTIAL LTC
Received: Aug. 12, 2026 3:12 AM
Parser Version: 1.0
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| 1 | 88 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260812*0712*|*00501*518769734*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*0712*769734*X*005010X279A1~ST*270*9734*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*WP92760C~EQ*30~DTP*291*D8*20260812~SE*13*9734~GE*1*769734~IEA*1*518769734~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260812*0312*^*00501*172155530*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*031245*172155530*X*005010X279A1~ST*271*172155530*005010X279A1~BHT*0022*11*202608120712000001*20260812*031245~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*MARYASINA*YEVA****MI*WP92760C~N3*675 AVENUE Z 4B~N4*BROOKLYN*NY*11223~DMG*D8*19390813*F~DTP*472*D8*20260812~DTP*346*D8*20260801~DTP*102*D8*20250901~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*CNTY CD=66 5H9~LS*2120~NM1*Y2*2*VNS CHOICE PARTIAL LTC*****PI*VC~N3*220 E 42ND ST FL 6~N4*NEW YORK*NY*100175831~PER*IC*PROVIDER SERVICES*TE*8667830222~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~EB*R*IND*30~REF*18*00000013299~REF*6P*ICA001~LS*2120~NM1*P4*2*DAVIS VISION*****PI*90~N3*PO BOX 1501~N4*LATHAM*NY*121108001~PER*IC*PROVIDER SERVICES*TE*8009995431~LE*2120~EB*R*IND*30~REF*18*3T13G93CG15~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*43*172155530~GE*1*172155530~IEA*1*172155530~