Import Eligibility Patient Detail

HERMAN GOMEZ

CIN: YM58376R

Active
Date of Birth: May 12, 1950
Gender: Male
Created: July 28, 2026
Address: 162 15 HIGHLAND AVENUE 2O , QUEENS, NY 11432
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 PARTIAL MLTC
Recertification: Yes — March 31, 2027
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