Identities/MBR-001937

Gold, golden identity

Nicholas Santos

6 source records from 3 feeds.

MBR-001937Verified6 records

Golden record

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

First nameENR: Nicholas
Middle name—: —
Last nameENR: Santos
Date of birthENR: 1973-05-25
GenderENR: F
Member IDENR: UHC-65934-13
SSNENR: •••-••-4728
PhoneENR: 6419171258
EmailENR: nicholas.santos@aol.com
AddressENR: 6211 Main St
CityENR: Mesa
StateENR: AZ
ZIPENR: 85237
GroupENR: GRP-3756
PlanENR: MEDICARE-ADV-A

Min confidence

1.00

Sources

TPA ×2CLM ×3ENR ×1

Updated

2026-10-19 19:54:36

run-mvfoap9e

Identity graph

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

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

Record	Source	Received	Name	DOB	Member ID	Phone	Address	Method	Confidence	Rule
TPA-62558	TPA	2026-01-07	Nicholas Santosflagged	1973-05-25	UHC-65934-13	6419171258	6211 Main St Apt 18, Mesa, AZ	Scored	1.00	—
CLM-428416	CLM	2026-01-28	Nicholas Santosflagged	1973-05-25	UHC-65934-13	6419171258	6211 Main St, Mesa, AZ	Scored	1.00	—
ENR-137274	ENR	2026-01-29	Nicholas Santosflagged	1973-05-25	UHC-65934-13	6419171258	6211 Main St, Mesa, AZ	Scored	1.00	—
CLM-428414	CLM	2026-03-20	Nicholas Santosflagged	1973-05-25	—	6419171258	6211 Main St, Mesa, AZ	Scored	1.00	—
TPA-62557	TPA	2026-08-07	Nicholas Santosflagged	1973-05-25	—	—	6211 Main St Apt 5, Mesa, AZ	Scored	1.00	—
CLM-428415	CLM	2026-08-23	Nicholas Santosflagged	1973-05-25	—	6419171258	6211 Main St, Mesa, AZ	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶TPA-62558TPACLM-428414CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-428416CLMCLM-428414CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶ENR-137274ENRCLM-428414CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶TPA-62558TPACLM-428415CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-428416CLMCLM-428415CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶ENR-137274ENRCLM-428415CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-428414CLMCLM-428415CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶TPA-62557TPACLM-428415CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	1.00	2	exact

Identifiers agreeing: 1Conflicts: noneGuard: none

▶TPA-62558TPATPA-62557TPA1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	1.00	2	exact

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-428416CLMTPA-62557TPA1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	1.00	2	exact

Identifiers agreeing: 1Conflicts: noneGuard: none

▶ENR-137274ENRTPA-62557TPA1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Email	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-428414CLMTPA-62557TPA1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	1.00	2	exact

Identifiers agreeing: 1Conflicts: noneGuard: none

▶TPA-62558TPACLM-428416CLM0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Member ID	1.00	4
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶TPA-62558TPAENR-137274ENR0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Member ID	1.00	4
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-428416CLMENR-137274ENR0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Member ID	1.00	4
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-428415 → UHC-65934-13 (Nicholas Santos)
ACT-005018, Claims processor
Orphan claim re-pointedExecuted
CLM-428414 → UHC-65934-13 (Nicholas Santos)
ACT-007517, Claims processor
Care coordination outreachProposed
Nicholas Santos: 3 claims, no attributed provider
ACT-017922, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallyf09377a327
scoring_agent, CLM-428415, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:54:38Record linked automatically938b499171
scoring_agent, TPA-62557, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:54:38Record linked automatically3665df7aef
scoring_agent, CLM-428414, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:54:38Record linked automaticallyb33eecbf87
scoring_agent, ENR-137274, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:54:38Record linked automatically76c230c7b6
scoring_agent, CLM-428416, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:54:38Record linked automatically2d5711cf72
scoring_agent, TPA-62558, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:52:08Record linked automatically7c538459db
scoring_agent, CLM-428415, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:52:08Record linked automatically27ce0eca82
scoring_agent, TPA-62557, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:52:08Record linked automatically9c2f08e7ec
scoring_agent, CLM-428414, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:52:08Record linked automatically4082e7ad21
scoring_agent, ENR-137274, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:52:08Record linked automatically3962360def
scoring_agent, CLM-428416, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:52:08Record linked automatically0d71c333d4
scoring_agent, TPA-62558, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:45:41Record linked automatically4cb2d3b8b4
scoring_agent, CLM-428415, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:45:41Record linked automaticallyec5470d361
scoring_agent, TPA-62557, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:45:41Record linked automaticallyebbf3b6a2e
scoring_agent, CLM-428414, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:45:41Record linked automatically494619d8e2
scoring_agent, ENR-137274, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:45:41Record linked automatically18e6e5975b
scoring_agent, CLM-428416, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:45:41Record linked automaticallyb058c1c7c8
scoring_agent, TPA-62558, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:32:31Record linked automatically865d04c0e5
scoring_agent, CLM-428415, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:32:31Record linked automatically6d98303221
scoring_agent, TPA-62557, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:32:31Record linked automaticallya3c974529e
scoring_agent, CLM-428414, identity id MBR-001937, confidence 1, method probabilistic, matched record TPA-62558, policy version 1
2026-10-19 19:32:31Record linked automatically6b47837a8b
scoring_agent, ENR-137274, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:32:31Record linked automaticallyb1b1bd4078
scoring_agent, CLM-428416, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:32:31Record linked automatically57fa229d78
scoring_agent, TPA-62558, identity id MBR-001937, confidence 1, method probabilistic, matched record CLM-428414, policy version 1
2026-10-19 19:31:28Record linked automatically8a8530d58a
scoring_agent, TPA-62557, identity id MBR-039310, confidence 1, method probabilistic, matched record TPA-62556, policy version 1
2026-10-19 19:31:28Record linked automaticallyac0561302d
matching_agent, ENR-137274, identity id MBR-030373, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-428199
2026-10-19 19:31:28Record linked automatically02fa9c5d00
scoring_agent, CLM-428416, identity id MBR-022260, confidence 1, method probabilistic, matched record CLM-428415, policy version 1
2026-10-19 19:31:28Record linked automaticallya2dc32a221
scoring_agent, CLM-428415, identity id MBR-022260, confidence 1, method probabilistic, matched record CLM-428416, policy version 1
2026-10-19 19:31:28Record linked automatically2f6855208e
scoring_agent, CLM-428414, identity id MBR-006935, confidence 1, method probabilistic, matched record ENR-137523, policy version 1
2026-10-19 19:31:28Record linked automaticallyc22b3042f4
matching_agent, TPA-62558, identity id MBR-004228, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-137770

Claims for this member

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

All claims

Claim	Service	Provider	Procedures	Billed	Plan paid	Rules	Status
CLM-2026-013917	2026-07-09	Desert Internal Medicine Associates in network	99232	$215.00	—	Denied	Denied
CLM-2026-023380	2025-10-21	Summit Medical Group in network	99215, 99214	$662.00	—	Denied	Denied
CLM-2026-022342	2025-12-25	Heritage GI Associates in network	45378, 88305	$2,257.00	—	Denied	Denied
CLM-2026-022341	2025-12-25	Heritage GI Associates in network	45378, 88305	$2,257.00	$786.31	Approved	Approved