Import Eligibility Patient Detail

MOUNIS KHAKIMOV

CIN: UW77138Z

Active
Date of Birth: May 23, 1973
Gender: Male
Created: July 28, 2026
Address: 155 BEACH 19 STREET 15A , FAR ROCKAWAY, NY 11691
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: MA Eligible
MCO:
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