ISA*00*          *00*          *ZZ*EMEDNYBAT      *ZZ*ETIN           *100101*1000*^*00501*006000600*0*T*:~GS*HP*EMEDNYBAT*ETIN*20100101*1050*6000600*X*005010X221A1~ST*835*1740~BPR*H*0*C*NON************20100101~TRN*1*10100000000*1000000000~REF*EV*ETIN~DTM*405*20100101~N1*PR*NYSDOH~N3*OFFICE OF HEALTH INSURANCE PROGRAMS*CORNING TOWER, EMPIRE STATE PLAZA~N4*ALBANY*NY*122370080~PER*BL*PROVIDER SERVICES*TE*8003439000*UR*www.emedny.org~N1*PE*MAJOR MEDICAL PROVIDER*XX*9999999995~REF*TJ*000000000~LX*1~CLP*PATIENT ACCOUNT NUMBER*2*34*0**MC*1000220000000030*11~NM1*QC*1*SUBMITTED LAST*SUBMITTED FIRST****MI*LL88888L~NM1*74*1*CORRECTED LAST*CORRECTED FIRST~REF*EA*PATIENT ACCOUNT NUMBER~DTM*232*20100101~DTM*233*20100101~SVC*HC:V2020*12*0**0~DTM*472*20100101~CAS*CO*29*12~SVC*HC:V2103*22*0**0~DTM*472*20100101~CAS*CO*29*22~SE*25*1740~GE*1*6000600~IEA*1*006000600~