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271 Response
Eligibility Response Detail
CIN: YK77219M
Date of Service: Aug. 13, 2026
Submitted: Aug. 12, 2026 3:59 PM
Payload ID: ea5af882-2cd0-4854-8684-67ad05ff459e
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ANTHEM HP LLC PARTIAL MLTC
Received: Aug. 12, 2026 3:59 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| S1 | S1 | S1 | MSG | MSG01 | S1 exemption code found in MSG segment |
| Recertification | RECERT | 2027-06-30 | MSG | Recertification required by this date |
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| 1 | 88 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260812*1959*|*00501*564744349*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*1959*744349*X*005010X279A1~ST*270*4349*005010X279A1~BHT*0022*13*202608121959000001*20260812*1959~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*202608121959000001*00000000ND~NM1*IL*1******MI*YK77219M~EQ*30~DTP*291*D8*20260813~SE*13*4349~GE*1*744349~IEA*1*564744349~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260812*1559*^*00501*530574930*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*155900*530574930*X*005010X279A1~ST*271*530574930*005010X279A1~BHT*0022*11*202608121959000001*20260812*155900~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*202608121959000001*00000000ND~NM1*IL*1*LOCASCIO*CIRO****MI*YK77219M~N3*6705 17TH AVE~N4*BROOKLYN*NY*11204~DMG*D8*19351225*M~DTP*472*D8*20260812~DTP*346*D8*20260801~DTP*102*D8*20260601~EB*U*IND*30**ELIGIBLE PCP~MSG*PD~MSG*S1~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=06~LS*2120~NM1*Y2*2*ANTHEM HP LLC PARTIAL MLTC*****PI*KX~N3*ONE PENN PLZ FL 35~N4*NEW YORK*NY*101190000~PER*IC*PROVIDER SERVICES*TE*2125635570~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~EB*R*IND*30~REF*18*U0168641701~REF*6P*2443694~LS*2120~NM1*P4*2*CIGNA*****PI*C4~N3*P O BOX 3598~N4*SCRANTON*PA*185050598~PER*IC*PROVIDER SERVICES*TE*8002446224~LE*2120~EB*R*IND*30~REF*18*W183957725~REF*6P*030725301400006~LS*2120~NM1*P4*2*AETNA (DENTAL)*****PI*ACD~N3*PO BOX 14094~N4*LEXINGTON*KY*405124094~PER*IC*PROVIDER SERVICES*TE*8772386200~LE*2120~EB*R*IND*30~REF*18*11840601701~REF*6P*RX1417~LS*2120~NM1*P4*2*CAREMARK (CVS)*****PI*DV~N3*POST OFFICE BOX 52057~N4*PHOENIX*AZ*850722057~PER*IC*PROVIDER SERVICES*TE*8006245060~LE*2120~EB*R*IND*30~REF*18*6MA4PR5FD61~LS*2120~NM1*P4*2*MEDICARE AB~LE*2120~SE*63*530574930~GE*1*530574930~IEA*1*530574930~