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271 Response
Eligibility Response Detail
CIN: ZU38542P
Date of Service: Aug. 13, 2026
Submitted: Aug. 12, 2026 3:56 PM
Payload ID: 77917c4b-0b07-4fc2-9ca3-a761ad51413b
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ELDERPLAN INC HOMEFIRST PARTIAL LTC
Received: Aug. 12, 2026 3:56 PM
Parser Version: 1.0
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| 1 | 88 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260812*1956*|*00501*564562129*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*1956*562129*X*005010X279A1~ST*270*2129*005010X279A1~BHT*0022*13*202608121956000001*20260812*1956~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*202608121956000001*00000000ND~NM1*IL*1******MI*ZU38542P~EQ*30~DTP*291*D8*20260813~SE*13*2129~GE*1*562129~IEA*1*564562129~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260812*1555*^*00501*529894130*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*155557*529894130*X*005010X279A1~ST*271*529894130*005010X279A1~BHT*0022*11*202608121956000001*20260812*155557~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*202608121956000001*00000000ND~NM1*IL*1*FLETCHER*TYRONE*M***MI*ZU38542P~N3*1660 FULTON ST 4KK~N4*BROOKLYN*NY*11213~DMG*D8*19751207*M~DTP*472*D8*20260812~DTP*346*D8*20260801~DTP*102*D8*20250901~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*PD~MSG*CNTY CD=66 5H9~LS*2120~NM1*Y2*2*ELDERPLAN INC HOMEFIRST PARTIAL LTC*****PI*ED~N3*55 WATER ST FL 46~N4*NEW YORK*NY*100413211~PER*IC*PROVIDER SERVICES*TE*8777711119~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~SE*30*529894130~GE*1*529894130~IEA*1*529894130~