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271 Response
Eligibility Response Detail
CIN: TD08989J
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:11 PM
Payload ID: 08215742-a4e1-466e-96c2-48c690949d90
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: —
Received: Aug. 13, 2026 3:11 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| Code 60 | 60 | 60 | MSG | MSG01 | Code 60 found in MSG segment |
| S1 | S1 | S1 | MSG | MSG01 | S1 exemption code found in MSG segment |
| Recertification | RECERT | 2026-10-31 | MSG | Recertification required by this date |
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260813*1911*|*00501*648278905*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1911*278905*X*005010X279A1~ST*270*8905*005010X279A1~BHT*0022*13*202608131911000001*20260813*1911~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*202608131911000001*00000000ND~NM1*IL*1******MI*TD08989J~EQ*30~DTP*291*D8*20260814~SE*13*8905~GE*1*278905~IEA*1*648278905~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1511*^*00501*536143230*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*151114*536143230*X*005010X279A1~ST*271*536143230*005010X279A1~BHT*0022*11*202608131911000001*20260813*151114~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*202608131911000001*00000000ND~NM1*IL*1*LEVY*YACOB****MI*TD08989J~N3*2224 EAST 63 RD STREET~N4*BROOKLYN*NY*11234~DMG*D8*19500321*M~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20251101~EB*U*IND*30**ELIGIBLE PCP~MSG*60~MSG*S1~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=10~EB*B*IND*30***29*0~EB*R*IND*30~REF*6P*H3312~LS*2120~NM1*P4*2*AETNA MEDICARE*****PI*H3312~N3*151 FARMINGTON AVENUE~N4*HARTFORD*CT*06156~PER*IC*PROVIDER SERVICES*TE*8002825366~LE*2120~EB*R*IND*30~REF*18*3FT5R17UE85~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*36*536143230~GE*1*536143230~IEA*1*536143230~