Raw X12 — CIN UB76219S

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260812*0717*|*00501*519071313*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*0717*071313*X*005010X279A1~ST*270*1313*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*UB76219S~EQ*30~DTP*291*D8*20260812~SE*13*1313~GE*1*071313~IEA*1*519071313~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260812*0317*^*00501*266661297*0*P*|~GS*FA*EMEDNYREL*00ND*20260812*0317*266661297*X*005010X231A1~ST*999*266661297*005010X231A1~AK1*HS*071313*005010X279A1~AK9*R*1*1*0*6~SE*4*266661297~GE*1*266661297~IEA*1*266661297~