MONTGOMERY L CLARKE
CIN: VJ48763H
Date of Birth: April 11, 1945
Gender: Male
Created: Aug. 13, 2026
Address:
6411 BEACH CHANNEL DR
, ARVERNE, NY 11692
Last Updated: Aug. 13, 2026 3:20 PM
Latest Eligibility Snapshot
Date of Service: Aug. 14, 2026
Medicaid Eligible:
Yes
Coverage: Aug. 1, 2026 — —
Plan: MA Eligible
MCO: —
Recertification:
Yes — Jan. 31, 2027
Code 60:
Yes
S1:
No
Eligibility History
| Date of Service | Status | Recert | Code 60 | S1 | Import | 271 |
|---|---|---|---|---|---|---|
| Aug. 14, 2026 | Eligible | ✓ | ✓ | — | Expert Census Referrals - CIN_IMPORT (1).csv | View |