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271 Response
Eligibility Response Detail
CIN: QK44450R
Date of Service: June 12, 2026
Submitted: July 28, 2026 11:00 AM
Payload ID: 7c41d2c6-a83a-42c5-800b-4f5d3c0d5cec
Response Type: X12 271
Response Status:
Ineligible
Member Found: Yes
Coverage: — — —
Plan: —
MCO: —
Received: July 28, 2026 11:00 AM
Parser Version: 1.0
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| 6 | 30 | No Coverage - Excess Income, Resources Verified | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260728*1500*|*00501*250849690*1*P*:~GS*HS*00ND*EMEDNYREL*20260728*1500*849690*X*005010X279A1~ST*270*9690*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*QK44450R~EQ*30~DTP*291*D8*20260612~SE*13*9690~GE*1*849690~IEA*1*250849690~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260728*1100*^*00501*364695830*0*P*|~GS*HB*EMEDNYREL*00ND*20260728*110046*364695830*X*005010X279A1~ST*271*364695830*005010X279A1~BHT*0022*11*202607281500000001*20260728*110046~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******MI*QK44450R~DTP*472*D8*20260728~EB*6*IND*30**No Coverage - Excess Income, Resources Verified~SE*13*364695830~GE*1*364695830~IEA*1*364695830~