Raw X12 — CIN XJ39473U

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260812*0717*|*00501*519042055*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*0717*042055*X*005010X279A1~ST*270*2055*005010X279A1~BHT*0022*13*202608120717000001*20260812*0717~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*202608120717000001*00000000ND~NM1*IL*1******MI*XJ39473U~EQ*30~DTP*291*D8*20260812~SE*13*2055~GE*1*042055~IEA*1*519042055~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260812*0317*^*00501*611987347*0*P*|~GS*FA*EMEDNYREL*00ND*20260812*0317*611987347*X*005010X231A1~ST*999*611987347*005010X231A1~AK1*HS*042055*005010X279A1~AK9*R*1*1*0*6~SE*4*611987347~GE*1*611987347~IEA*1*611987347~