Raw X12 — CIN WK61908Z

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260813*1919*|*00501*648792376*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1919*792376*X*005010X279A1~ST*270*2376*005010X279A1~BHT*0022*13*202608131919000001*20260813*1919~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*202608131919000001*00000000ND~NM1*IL*1******MI*WK61908Z~EQ*30~DTP*291*D8*20260814~SE*13*2376~GE*1*792376~IEA*1*648792376~

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260813*1519*^*00501*538331630*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*151947*538331630*X*005010X279A1~ST*271*538331630*005010X279A1~BHT*0022*11*202608131919000001*20260813*151947~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*202608131919000001*00000000ND~NM1*IL*1******MI*WK61908Z~DTP*472*D8*20260813~EB*6*IND*30~SE*13*538331630~GE*1*538331630~IEA*1*538331630~