AVTANDIL BOLOTAEV
CIN: PH60259S
Date of Birth: June 3, 1956
Gender: Male
Created: Aug. 9, 2026
Address:
1735 E 13TH ST 4B
, BROOKLYN, NY 11229
Last Updated: Aug. 9, 2026 3:45 PM
Latest Eligibility Snapshot
Date of Service: Aug. 12, 2026
Medicaid Eligible:
Yes
Coverage: Aug. 1, 2026 — —
Plan: Community Coverage No LTC
MCO: —
Recertification:
Yes — Feb. 28, 2027
Code 60:
No
S1:
No
Eligibility History
| Date of Service | Status | Recert | Code 60 | S1 | Import | 271 |
|---|---|---|---|---|---|---|
| Aug. 12, 2026 | Eligible | ✓ | — | — | Just care Census ( Prem) - Just_Care_Census_CIN.csv | View |
| Aug. 6, 2026 | Eligible | ✓ | — | — | Just care Census ( Prem) - Just_Care_Census_CIN.csv | View |
| Aug. 6, 2026 | Eligible | ✓ | — | — | Just care Census ( Prem) - Just_Care_Census_CIN.csv | View |