Raw X12 — CIN SM63259P

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260812*2003*|*00501*565010867*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*2003*010867*X*005010X279A1~ST*270*0867*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*SM63259P~EQ*30~DTP*291*D8*20260813~SE*13*0867~GE*1*010867~IEA*1*565010867~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260812*1603*^*00501*643745265*0*P*|~GS*FA*EMEDNYREL*00ND*20260812*1603*643745265*X*005010X231A1~ST*999*643745265*005010X231A1~AK1*HS*010867*005010X279A1~AK9*R*1*1*0*6~SE*4*643745265~GE*1*643745265~IEA*1*643745265~