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271 Response
Eligibility Response Detail
CIN: YR12712F
Date of Service: June 12, 2026
Submitted: July 28, 2026 11:00 AM
Payload ID: 2841e576-a25b-4256-8b86-01117389eb9b
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: July 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ANTHEM HP LLC PARTIAL MLTC
Received: July 28, 2026 11:00 AM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| Recertification | RECERT | 2026-12-31 | MSG | Recertification required by this date |
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| 1 | 88 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260728*1500*|*00501*250823657*1*P*:~GS*HS*00ND*EMEDNYREL*20260728*1500*823657*X*005010X279A1~ST*270*3657*005010X279A1~BHT*0022*13*202607281500000001*20260728*1500~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*202607281500000001*00000000ND~NM1*IL*1******MI*YR12712F~EQ*30~DTP*291*D8*20260612~SE*13*3657~GE*1*823657~IEA*1*250823657~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260728*1100*^*00501*364534130*0*P*|~GS*HB*EMEDNYREL*00ND*20260728*110020*364534130*X*005010X279A1~ST*271*364534130*005010X279A1~BHT*0022*11*202607281500000001*20260728*110020~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*202607281500000001*00000000ND~NM1*IL*1*FUENTES*MARIA****MI*YR12712F~N3*916 E 179TH ST 1C~N4*BRONX*NY*10460~DMG*D8*19740813*F~DTP*472*D8*20260728~DTP*346*D8*20260701~DTP*102*D8*20250901~EB*U*IND*30**ELIGIBLE PCP~MSG*PD~MSG*CNTY CD=66 038~MSG*RECERT MONTH=12~LS*2120~NM1*Y2*2*ANTHEM HP LLC PARTIAL MLTC*****PI*KX~N3*ONE PENN PLZ FL 35~N4*NEW YORK*NY*101190000~PER*IC*PROVIDER SERVICES*TE*2125635570~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~SE*30*364534130~GE*1*364534130~IEA*1*364534130~