Import Eligibility Patient Detail

HERMAN GOMEZ

CIN: YM58376R

Active
Date of Birth: May 12, 1950
Gender: Male
Created: July 26, 2026
Address: 162 15 HIGHLAND AVENUE 2O , QUEENS, NY 11432
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 PARTIAL MLTC
Recertification: Yes — March 31, 2027
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