← Back
Raw X12 — CIN NC12745N
270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260812*2004*|*00501*565056691*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*2004*056691*X*005010X279A1~ST*270*6691*005010X279A1~BHT*0022*13*202608122004000001*20260812*2004~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*202608122004000001*00000000ND~NM1*IL*1******MI*NC12745N~EQ*30~DTP*291*D8*20260813~SE*13*6691~GE*1*056691~IEA*1*565056691~
271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260812*1604*^*00501*561564151*0*P*|~GS*FA*EMEDNYREL*00ND*20260812*1604*561564151*X*005010X231A1~ST*999*561564151*005010X231A1~AK1*HS*056691*005010X279A1~AK9*R*1*1*0*6~SE*4*561564151~GE*1*561564151~IEA*1*561564151~