Raw X12 — CIN MW59619W

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260812*0714*|*00501*518840831*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*0714*840831*X*005010X279A1~ST*270*0831*005010X279A1~BHT*0022*13*202608120714000001*20260812*0714~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*202608120714000001*00000000ND~NM1*IL*1******MI*MW59619W~EQ*30~DTP*291*D8*20260812~SE*13*0831~GE*1*840831~IEA*1*518840831~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260812*0313*^*00501*174409130*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*031356*174409130*X*005010X279A1~ST*271*174409130*005010X279A1~BHT*0022*11*202608120714000001*20260812*031356~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*202608120714000001*00000000ND~NM1*IL*1******MI*MW59619W~DTP*472*D8*20260812~EB*6*IND*30~SE*13*174409130~GE*1*174409130~IEA*1*174409130~