Import Eligibility Patient Detail

IVAN MEDVID

CIN: XT23575P

Active
Date of Birth: Nov. 17, 1940
Gender: Male
Created: July 26, 2026
Address: 155 BEACH 19TH ST ST 8B , FAR ROCKAWAY, NY 11691
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 — Sept. 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