Shirley Lopez

4 source records from 2 feeds.

MBR-016386Verified4 records

Golden record

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

First nameCLM: Shirley
Middle name—: —
Last nameCLM: Lopez
Date of birthCLM: 1991-06-04
GenderCLM: F
Member IDCLM: UHC-44235-49
SSNCLM: •••-••-4489
PhoneCLM: 3136272862
Email—: —
AddressCLM: 1286 Park Pl
CityCLM: Scottsdale
StateCLM: AZ
ZIPCLM: 85214
GroupCLM: GRP-3076
PlanCLM: NAVIGATE-HMO

Min confidence

0.99

Sources

TPA ×1CLM ×3

Updated

2026-10-22 12:43:43

run-mvjj6udb

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-56499	TPA	2026-02-27	Shirley Lopezflagged	1991-06-04	—	3136272862	—	Scored	1.00	—
CLM-414743	CLM	2026-03-15	Shirley Lopezflagged	1991-06-04	UHC-44235-49	—	1286 Park Pl Apt 22, Scottsdale, AZ	Rule	0.99	D1 member id + dob exact
CLM-414741	CLM	2026-06-07	Shirley Loepzflagged	1991-06-04	UHC-44235-49	—	1286 Park Pl, Scottsdale, AZ	Rule	0.99	D1 member id + dob exact
CLM-414742	CLM	2026-06-26	Shirley Lopezflagged	1991-06-04	UHC-44235-49	3136272862	—	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶TPA-56499TPACLM-414742CLM 1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-414743CLMCLM-414741CLM0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact
Member ID	1.00	4
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-414743CLMCLM-414742CLM 0.99RuleD1 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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-414741CLMCLM-414742CLM 0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact
Member ID	1.00	4
SSN (last four)	1.00	2.5

Identifiers agreeing: 2Conflicts: noneGuard: none

▶TPA-56499TPACLM-414741CLM0.83Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact

Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees

▶TPA-56499TPACLM-414743CLM0.83Scoredweighted similaritySent to steward

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

Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees

Actions

What downstream consumers did with this identity

Care coordination outreachProposed
Shirley Lopez: 3 claims, no attributed provider
ACT-018912, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-22 12:43:54Record linked automaticallyfa474740cd
scoring_agent, CLM-414742, identity id MBR-016386, confidence 1, method probabilistic, matched record TPA-56499, policy version 1
2026-10-22 12:43:54Record linked automatically26f1a88cdb
matching_agent, CLM-414741, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414743
2026-10-22 12:43:54Record linked automatically0366332aac
matching_agent, CLM-414743, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414741
2026-10-22 12:43:54Record linked automaticallye1c30039b1
scoring_agent, TPA-56499, identity id MBR-016386, confidence 1, method probabilistic, matched record CLM-414742, policy version 1
2026-10-19 19:54:38Record linked automatically7cf346efc4
scoring_agent, CLM-414742, identity id MBR-016386, confidence 1, method probabilistic, matched record TPA-56499, policy version 1
2026-10-19 19:54:38Record linked automatically01491df003
matching_agent, CLM-414741, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414743
2026-10-19 19:54:38Record linked automatically35e55502c1
matching_agent, CLM-414743, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414741
2026-10-19 19:54:38Record linked automatically40c3dcb392
scoring_agent, TPA-56499, identity id MBR-016386, confidence 1, method probabilistic, matched record CLM-414742, policy version 1
2026-10-19 19:52:09Record linked automaticallya6b50c68c1
scoring_agent, CLM-414742, identity id MBR-016386, confidence 1, method probabilistic, matched record TPA-56499, policy version 1
2026-10-19 19:52:09Record linked automaticallybed7d9d7c7
matching_agent, CLM-414741, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414743
2026-10-19 19:52:09Record linked automaticallya40f7b2738
matching_agent, CLM-414743, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414741
2026-10-19 19:52:09Record linked automatically4755d61dd0
scoring_agent, TPA-56499, identity id MBR-016386, confidence 1, method probabilistic, matched record CLM-414742, policy version 1
2026-10-19 19:45:42Record linked automaticallye5e4bf33f6
scoring_agent, CLM-414742, identity id MBR-016386, confidence 1, method probabilistic, matched record TPA-56499, policy version 1
2026-10-19 19:45:42Record linked automatically7a6930a540
matching_agent, CLM-414741, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414743
2026-10-19 19:45:42Record linked automaticallybb2ef80117
matching_agent, CLM-414743, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414741
2026-10-19 19:45:42Record linked automatically1167662d43
scoring_agent, TPA-56499, identity id MBR-016386, confidence 1, method probabilistic, matched record CLM-414742, policy version 1
2026-10-19 19:32:31Record linked automatically5c4d7a3dca
scoring_agent, CLM-414742, identity id MBR-016386, confidence 1, method probabilistic, matched record TPA-56499, policy version 1
2026-10-19 19:32:31Record linked automatically3dacce4ed4
matching_agent, CLM-414741, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414743
2026-10-19 19:32:31Record linked automatically01c5e8a52d
matching_agent, CLM-414743, identity id MBR-016386, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414741
2026-10-19 19:32:31Record linked automatically2bfc71f748
scoring_agent, TPA-56499, identity id MBR-016386, confidence 1, method probabilistic, matched record CLM-414742, policy version 1
2026-10-19 19:31:28Record linked automatically6f43409400
scoring_agent, CLM-414743, identity id MBR-020995, confidence 1, method probabilistic, matched record PRV-24328, policy version 1
2026-10-19 19:31:28Record linked automaticallye689a99008
scoring_agent, TPA-56499, identity id MBR-018721, confidence 0.94, method probabilistic, matched record ENR-119597, policy version 1
2026-10-19 19:31:28Record linked automatically97b257e2a1
matching_agent, CLM-414742, identity id MBR-010008, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-414741
2026-10-19 19:31:28Record linked automatically61f21b1701
matching_agent, CLM-414741, identity id MBR-010008, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-119312

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-2026-018703	2026-06-11	Heritage Community Hospital in network	96374	$154.00	$0.00	Approved	Approved
CLM-2026-012266	2026-01-30	Sunrise Skin Care Associates in network	11403	$490.00	—	Denied	Denied
CLM-2026-014734	2026-02-20	Riverside Primary Care Associates in network	99214	$308.00	$160.96	Approved	Approved