Import Eligibility Patient Detail

DORA HERNANDEZ

CIN: ZK93187E

Active
Date of Birth: Jan. 22, 1944
Gender: Female
Created: July 26, 2026
Address: 609 METROPOLITAN AVENUE 4C , 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 PARTIAL MLTC
Recertification: Yes — Nov. 30, 2026
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