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271 Response
Eligibility Response Detail
CIN: UB81084S
Date of Service: Aug. 13, 2026
Submitted: Aug. 12, 2026 4:05 PM
Payload ID: 1f456d98-118c-4309-b555-741cbe2b1ab4
Response Type: X12 271
Response Status:
Ineligible
Member Found: Yes
Coverage: — — —
Plan: —
MCO: —
Received: Aug. 12, 2026 4:05 PM
Parser Version: 1.0
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| 6 | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260812*2005*|*00501*565114974*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*2005*114974*X*005010X279A1~ST*270*4974*005010X279A1~BHT*0022*13*202608122005000001*20260812*2005~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*202608122005000001*00000000ND~NM1*IL*1******MI*UB81084S~EQ*30~DTP*291*D8*20260813~SE*13*4974~GE*1*114974~IEA*1*565114974~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260812*1605*^*00501*533892530*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*160510*533892530*X*005010X279A1~ST*271*533892530*005010X279A1~BHT*0022*11*202608122005000001*20260812*160510~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*202608122005000001*00000000ND~NM1*IL*1******MI*UB81084S~DTP*472*D8*20260812~EB*6*IND*30~SE*13*533892530~GE*1*533892530~IEA*1*533892530~