Raw X12 — CIN UN84166Q

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260813*1918*|*00501*648712398*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1918*712398*X*005010X279A1~ST*270*2398*005010X279A1~BHT*0022*13*202608131918000001*20260813*1918~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*202608131918000001*00000000ND~NM1*IL*1******MI*UN84166Q~EQ*30~DTP*291*D8*20260814~SE*13*2398~GE*1*712398~IEA*1*648712398~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260813*1518*^*00501*537960430*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*151827*537960430*X*005010X279A1~ST*271*537960430*005010X279A1~BHT*0022*11*202608131918000001*20260813*151827~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*202608131918000001*00000000ND~NM1*IL*1******MI*UN84166Q~DTP*472*D8*20260813~EB*6*IND*30~SE*13*537960430~GE*1*537960430~IEA*1*537960430~