Identities/MBR-001898
Gold, golden identity

John T Ramos

4 source records from 2 feeds.

MBR-001898Verified4 records

Golden record

Source priority ENR > PRV > CLM > TPA; most recent value for phone, email, address_line1, city, state, zip

First nameENR
John
Middle nameENR
T
Last nameENR
Ramos
Date of birthENR
1994-07-07
GenderENR
M
Member IDENR
UHC-05969-13
SSNENR
•••-••-2963
PhoneENR
2086278814
EmailENR
john.ramos@outlook.com
AddressENR
3869 Baseline Rd
CityENR
Fresno
StateENR
CA
ZIPENR
93712
GroupENR
GRP-4294
PlanENR
MEDICARE-ADV-A
Min confidence
1.00
Sources
ENR ×1CLM ×3
Updated
2026-10-19 19:54:36
run-mvfoap9e

Identity graph

Source records linked to this identity and the confidence of each link

1.001.001.001.00ENRENR-124505CLMCLM-418627CLMCLM-418628CLMCLM-418629IDMBR-001898
Golden identityEnrollmentClaimsProvider networkThird-party administratorAuto link (at or above 0.85)Below thresholdSteward link

Linked source records

Silver values for each record in the cluster, and how it was attached

RecordSourceReceivedNameDOBMember IDPhoneAddressMethodConfidenceRule
ENR-124505ENR2026-01-06John Ramosflagged1994-07-07UHC-05969-1320862788143869 Baseline Rd, Fresno, CAScored1.00—
CLM-418627CLM2026-02-20John Ramosflagged1994-07-07—2086278814—Scored1.00—
CLM-418628CLM2026-02-20John Ramosflagged1994-07-07—2086278814—Scored1.00—
CLM-418629CLM2026-06-02John Ramosflagged1994-07-07UHC-05969-1320862788143869 Baseline Rd, Fresno, CAScored1.00—

Evidence

6 scored pairs among these records, expand a row for the per-field comparison

ABScoreMethodRuleDecision
▶ENR-124505ENRCLM-418627CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-124505ENRCLM-418628CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-418627CLMCLM-418628CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-418627CLMCLM-418629CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-418628CLMCLM-418629CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-124505ENRCLM-418629CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
Phone1.001.5
Address1.002exact
Identifiers agreeing: 3Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

  • Eligibility conflict resolvedProposed
    John Ramos: 2 plan codes across sources → canonical MEDICARE-ADV-A
    ACT-000095, Eligibility engine
  • Orphan claim re-pointedExecuted
    CLM-418627 → UHC-05969-13 (John Ramos)
    ACT-002484, Claims processor
  • Orphan claim re-pointedExecuted
    CLM-418628 → UHC-05969-13 (John Ramos)
    ACT-006681, Claims processor
  • Care coordination outreachProposed
    John Ramos: 3 claims, no attributed provider
    ACT-017920, Next-best-action

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-19 19:54:38Record linked automaticallyde173efa76
    scoring_agent, CLM-418629, identity id MBR-001898, confidence 1, method probabilistic, matched record CLM-418627, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallybb8fd3ab8b
    scoring_agent, CLM-418628, identity id MBR-001898, confidence 1, method probabilistic, matched record ENR-124505, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallyfe05da4fff
    scoring_agent, CLM-418627, identity id MBR-001898, confidence 1, method probabilistic, matched record ENR-124505, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallyb668965ca3
    scoring_agent, ENR-124505, identity id MBR-001898, confidence 1, method probabilistic, matched record CLM-418627, policy version 1
  • 2026-10-19 19:52:08Record linked automatically25265fe2bb
    scoring_agent, CLM-418629, identity id MBR-001898, confidence 1, method probabilistic, matched record CLM-418627, policy version 1
  • 2026-10-19 19:52:08Record linked automatically5ae5a169db
    scoring_agent, CLM-418628, identity id MBR-001898, confidence 1, method probabilistic, matched record ENR-124505, policy version 1
  • 2026-10-19 19:52:08Record linked automatically600494aad6
    scoring_agent, CLM-418627, identity id MBR-001898, confidence 1, method probabilistic, matched record ENR-124505, policy version 1
  • 2026-10-19 19:52:08Record linked automatically2812344715
    scoring_agent, ENR-124505, identity id MBR-001898, confidence 1, method probabilistic, matched record CLM-418627, policy version 1
  • 2026-10-19 19:45:41Record linked automatically47937dcaf8
    scoring_agent, CLM-418629, identity id MBR-001898, confidence 1, method probabilistic, matched record CLM-418627, policy version 1
  • 2026-10-19 19:45:41Record linked automatically875dfa4563
    scoring_agent, CLM-418628, identity id MBR-001898, confidence 1, method probabilistic, matched record ENR-124505, policy version 1
  • 2026-10-19 19:45:41Record linked automatically030a8e583d
    scoring_agent, CLM-418627, identity id MBR-001898, confidence 1, method probabilistic, matched record ENR-124505, policy version 1
  • 2026-10-19 19:45:41Record linked automatically175b2e5f5f
    scoring_agent, ENR-124505, identity id MBR-001898, confidence 1, method probabilistic, matched record CLM-418627, policy version 1
  • 2026-10-19 19:32:31Record linked automatically34cc7b9a14
    scoring_agent, CLM-418629, identity id MBR-001898, confidence 1, method probabilistic, matched record CLM-418627, policy version 1
  • 2026-10-19 19:32:31Record linked automatically9c9cf3cbe5
    scoring_agent, CLM-418628, identity id MBR-001898, confidence 1, method probabilistic, matched record ENR-124505, policy version 1
  • 2026-10-19 19:32:31Record linked automaticallycdbe9f1480
    scoring_agent, CLM-418627, identity id MBR-001898, confidence 1, method probabilistic, matched record ENR-124505, policy version 1
  • 2026-10-19 19:32:31Record linked automatically81ab44866f
    scoring_agent, ENR-124505, identity id MBR-001898, confidence 1, method probabilistic, matched record CLM-418627, policy version 1
  • 2026-10-19 19:31:28Record linked automatically6e82929f28
    matching_agent, ENR-124505, identity id MBR-007945, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record TPA-58177
  • 2026-10-19 19:31:28Record linked automaticallycb649e5cfa
    scoring_agent, CLM-418628, identity id MBR-005813, confidence 1, method probabilistic, matched record PRV-25424, policy version 1
  • 2026-10-19 19:31:28Record linked automatically2f2e011232
    matching_agent, CLM-418629, identity id MBR-005813, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record PRV-25424
  • 2026-10-19 19:31:28Record linked automatically3b531fbafa
    matching_agent, CLM-418627, identity id MBR-004025, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-418625

Claims for this member

Claims attached through the identity graph; holds follow open steward cases automatically

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0109552026-04-18Desert Internal Medicine Associates
in network
80053$65.00$20.30ApprovedApproved
CLM-2026-0201112026-01-12Sunrise Dermatology Clinic
in network
11102$187.00—DeniedDenied
CLM-2026-0201102026-01-12Sunrise Dermatology Clinic
in network
11102$187.00$55.94ApprovedApproved
CLM-2026-0043022026-02-02Desert Internal Medicine Associates
in network
70553$3,347.00—Needs reviewNeeds review