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271 Response
Eligibility Response Detail
CIN: UX77448Z
Date of Service: Aug. 12, 2026
Submitted: Aug. 12, 2026 3:19 AM
Payload ID: 00bfc02e-fc5e-42ff-8e4c-7ef989adb54b
Response Type: X12 271
Response Status:
Ineligible
Member Found: Yes
Coverage: — — —
Plan: —
MCO: —
Received: Aug. 12, 2026 3:19 AM
Parser Version: 1.0
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| 6 | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260812*0719*|*00501*519171217*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*0719*171217*X*005010X279A1~ST*270*1217*005010X279A1~BHT*0022*13*202608120719000001*20260812*0719~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*202608120719000001*00000000ND~NM1*IL*1******MI*UX77448Z~EQ*30~DTP*291*D8*20260812~SE*13*1217~GE*1*171217~IEA*1*519171217~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260812*0319*^*00501*176435830*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*031926*176435830*X*005010X279A1~ST*271*176435830*005010X279A1~BHT*0022*11*202608120719000001*20260812*031926~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*202608120719000001*00000000ND~NM1*IL*1******MI*UX77448Z~DTP*472*D8*20260812~EB*6*IND*30~SE*13*176435830~GE*1*176435830~IEA*1*176435830~