Raw X12 — CIN ZM14013U

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260812*1958*|*00501*564707306*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*1958*707306*X*005010X279A1~ST*270*7306*005010X279A1~BHT*0022*13*202608121958000001*20260812*1958~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*202608121958000001*00000000ND~NM1*IL*1******MI*ZM14013U~EQ*30~DTP*291*D8*20260813~SE*13*7306~GE*1*707306~IEA*1*564707306~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260812*1558*^*00501*530439030*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*155822*530439030*X*005010X279A1~ST*271*530439030*005010X279A1~BHT*0022*11*202608121958000001*20260812*155822~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*202608121958000001*00000000ND~NM1*IL*1******MI*ZM14013U~DTP*472*D8*20260812~EB*6*IND*30~SE*13*530439030~GE*1*530439030~IEA*1*530439030~