Raw X12 — CIN VT04755K

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260812*2003*|*00501*565006813*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*2003*006813*X*005010X279A1~ST*270*6813*005010X279A1~BHT*0022*13*202608122003000001*20260812*2003~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*202608122003000001*00000000ND~NM1*IL*1******MI*VT04755K~EQ*30~DTP*291*D8*20260813~SE*13*6813~GE*1*006813~IEA*1*565006813~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260812*1603*^*00501*571255107*0*P*|~GS*FA*EMEDNYREL*00ND*20260812*1603*571255107*X*005010X231A1~ST*999*571255107*005010X231A1~AK1*HS*006813*005010X279A1~AK9*R*1*1*0*6~SE*4*571255107~GE*1*571255107~IEA*1*571255107~