Identities/MBR-005234
Gold, golden identity

Randy Flores

5 source records from 3 feeds.

MBR-005234Verified5 records

Golden record

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

First nameENR
Randy
Middle name—
—
Last nameENR
Flores
Date of birthENR
1949-04-14
GenderCLM
M
Member IDENR
UHC-96097-03
SSNENR
•••-••-6876
PhoneENR
8879728592
Email—
—
AddressPRV
9683 Indian School Rd Apt 33
CityENR
Orlando
StateENR
FL
ZIPENR
32876
GroupENR
GRP-8784
PlanENR
OPTIONS-PPO
Min confidence
0.99
Sources
CLM ×3ENR ×1PRV ×1
Updated
2026-10-19 19:54:36
run-mvfoap9e

Identity graph

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

1.000.991.001.001.00CLMCLM-419054CLMCLM-419053ENRENR-125125CLMCLM-419055PRVPRV-25675IDMBR-005234
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
CLM-419054CLM2026-01-17Randy Floresflagged1949-04-14UHC-96097-0388797285929683 Indian School Rd Apt 4, Orlando, FLScored1.00—
CLM-419053CLM2026-05-22Randy Floresflagged1949-04-14UHC-96097-03——Rule0.99D1 member id + dob exact
ENR-125125ENR2026-06-30Randy Floresflagged1949-04-14UHC-96097-0388797285929683 Indian School Rd Apt 25, Orlando, FLScored1.00—
CLM-419055CLM2026-07-06Randy Floresflagged1949-04-14——9683 Indian School Rd, Orlando, FLScored1.00—
PRV-25675PRV2026-09-22Randy Floresflagged1949-04-14UHC-96097-0388797285929683 Indian School Rd Apt 33, Orlando, FLScored1.00—

Evidence

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

ABScoreMethodRuleDecision
▶CLM-419054CLMCLM-419055CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-125125ENRCLM-419055CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-419055CLMPRV-25675PRV 1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-419054CLMCLM-419053CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-419054CLMENR-125125ENR0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Phone1.001.5
Address1.002exact
Identifiers agreeing: 4Conflicts: noneGuard: none
▶CLM-419053CLMENR-125125ENR0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-419054CLMPRV-25675PRV 0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Phone1.001.5
Address1.002exact
Identifiers agreeing: 4Conflicts: noneGuard: none
▶CLM-419053CLMPRV-25675PRV 0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Identifiers agreeing: 2Conflicts: noneGuard: none
▶ENR-125125ENRPRV-25675PRV 0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Phone1.001.5
Address1.002exact
Identifiers agreeing: 4Conflicts: noneGuard: none
▶CLM-419053CLMCLM-419055CLM0.83Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees

Actions

What downstream consumers did with this identity

  • Eligibility conflict resolvedProposed
    Randy Flores: 2 plan codes across sources → canonical OPTIONS-PPO
    ACT-000258, Eligibility engine
  • Orphan claim re-pointedExecuted
    CLM-419055 → UHC-96097-03 (Randy Flores)
    ACT-004402, Claims processor
  • Outreach address correctedProposed
    Randy Flores: 9683 Indian School Rd Apt 25, Orlando → 9683 Indian School Rd Apt 33, Orlando
    ACT-010943, Outreach

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-19 19:54:38Record linked automatically73ab19d465
    scoring_agent, PRV-25675, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:54:38Record linked automatically9bcbc2ee9f
    scoring_agent, CLM-419055, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419054, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallya68f7ea602
    scoring_agent, ENR-125125, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallyaea69cde9b
    matching_agent, CLM-419053, identity id MBR-005234, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-419054
  • 2026-10-19 19:54:38Record linked automaticallyf35395768d
    scoring_agent, CLM-419054, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:52:08Record linked automatically7702efd4a8
    scoring_agent, PRV-25675, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:52:08Record linked automaticallycbb40b619d
    scoring_agent, CLM-419055, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419054, policy version 1
  • 2026-10-19 19:52:08Record linked automaticallyfc3a95c926
    scoring_agent, ENR-125125, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:52:08Record linked automaticallycd8e676c7d
    matching_agent, CLM-419053, identity id MBR-005234, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-419054
  • 2026-10-19 19:52:08Record linked automatically691be5d97d
    scoring_agent, CLM-419054, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:45:42Record linked automatically734bff2818
    scoring_agent, PRV-25675, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallyba074add8b
    scoring_agent, CLM-419055, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419054, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallycfe3436f96
    scoring_agent, ENR-125125, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:45:42Record linked automatically22889c344e
    matching_agent, CLM-419053, identity id MBR-005234, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-419054
  • 2026-10-19 19:45:42Record linked automaticallyfcd1bacef8
    scoring_agent, CLM-419054, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:32:31Record linked automaticallyb98b04e2a4
    scoring_agent, PRV-25675, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:32:31Record linked automatically986df4e9e5
    scoring_agent, CLM-419055, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419054, policy version 1
  • 2026-10-19 19:32:31Record linked automaticallycbbfeb2950
    scoring_agent, ENR-125125, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:32:31Record linked automaticallya7451be510
    matching_agent, CLM-419053, identity id MBR-005234, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-419054
  • 2026-10-19 19:32:31Record linked automaticallyf9f89c4827
    scoring_agent, CLM-419054, identity id MBR-005234, confidence 1, method probabilistic, matched record CLM-419055, policy version 1
  • 2026-10-19 19:31:28Record linked automaticallyab2e8c7811
    scoring_agent, CLM-419054, identity id MBR-030099, confidence 1, method probabilistic, matched record TPA-58300, policy version 1
  • 2026-10-19 19:31:28Record linked automatically1424ecdc34
    scoring_agent, CLM-419055, identity id MBR-030099, confidence 1, method probabilistic, matched record TPA-58300, policy version 1
  • 2026-10-19 19:31:28Record linked automatically204a72b27e
    scoring_agent, PRV-25675, identity id MBR-020840, confidence 1, method probabilistic, matched record PRV-25674, policy version 1
  • 2026-10-19 19:31:28Record linked automatically6a52c4184a
    matching_agent, CLM-419053, identity id MBR-011458, confidence 0.96, rule D3 member_id + name, method deterministic, matched record ENR-124935

Claims for this member

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

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0117022026-06-20Evergreen Medical Group
in network
70553$3,191.00—DeniedDenied
CLM-2026-0209052026-05-11Summit Community Hospital
in network
99284, 71046, 99285$3,738.00—DeniedDenied
CLM-2026-0104302026-01-14Northgate Medical Group
in network
99395, 90471, 36415$331.00$180.22ApprovedApproved