Import Eligibility Patient Detail

JUSTIN FERNANDEZ

CIN: VT25777K

Active
Date of Birth: Aug. 22, 1993
Gender: Male
Created: July 26, 2026
Address: 340 S 3RD ST E1 , BROOKLYN, NY 11211
Last Updated: July 26, 2026 10:06 AM

Latest Eligibility Snapshot

Date of Service: July 26, 2026
Medicaid Eligible: Yes
Coverage: July 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ANTHEM HP LLC MAINSTREAM
Recertification: No
NHTD: No
Code 60: No
Surplus: Yes

Eligibility History

Date of Service Status Recert NHTD Code 60 Surplus Import 271
July 26, 2026 Eligible Expert Census Referrals - CIN_IMPORT.csv View