Import Eligibility Patient Detail

JUSTIN FERNANDEZ

CIN: VT25777K

Active
Date of Birth: Aug. 22, 1993
Gender: Male
Created: July 28, 2026
Address: 340 S 3RD ST E1 , BROOKLYN, NY 11211
Last Updated: July 28, 2026 11:00 AM

Latest Eligibility Snapshot

Date of Service: June 12, 2026
Medicaid Eligible: Yes
Coverage: July 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ANTHEM HP LLC MAINSTREAM
Recertification: No
Code 60: No
S1: No

Eligibility History

Date of Service Status Recert Code 60 S1 Import 271
June 12, 2026 Eligible Expert Census Referrals - CIN_50_Import.csv View