Import Eligibility Patient Detail

SAMANTHA MILLER

CIN: ZR98837F

Active
Date of Birth: March 15, 1982
Gender: Female
Created: July 26, 2026
Address: 1155 229TH DR S APT 3D , BRONX, NY 10466
Last Updated: July 26, 2026 10:09 AM

Latest Eligibility Snapshot

Date of Service: July 26, 2026
Medicaid Eligible: Yes
Coverage: July 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: FIDELIS CARE MAINSTREAM
Recertification: Yes — Dec. 31, 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 View