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Profile: QICore Coverageversion: null6.0.0)
identifier: Member Number/084536836
status: Active
type: subsidized supplemental health program
policyHolder: Mom Parent
subscriberId: 98435938934
beneficiary: Pass1 ACH(official) Female, DoB: 2024-02-01 ( MRN: 1601191901010308 (use: usual, ))
relationship: Child
period: 2020-08-01 --> (ongoing)
payor: Medicaid