Identities/MBR-025250
Gold, golden identity

Theresa Espinoza

3 source records from 2 feeds.

MBR-025250Verified3 records

Golden record

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

First nameCLM
Theresa
Middle name—
—
Last nameCLM
Espinoza
Date of birthCLM
1979-02-20
GenderCLM
M
Member IDCLM
UHC-67186-14
SSNCLM
•••-••-1047
PhoneCLM
3879101465
Email—
—
AddressCLM
8697 Mountain View Dr
CityCLM
Orlando
StateCLM
FL
ZIPCLM
32873
GroupTPA
GRP-0884
PlanTPA
MEDICARE-ADV-B
Min confidence
0.99
Sources
TPA ×1CLM ×2
Updated
2026-10-19 19:54:36
run-mvfoap9e

Identity graph

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

0.991.001.00TPATPA-53156CLMCLM-407217CLMCLM-407216IDMBR-025250
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
TPA-53156TPA2026-04-11Theresa Espinosaflagged1979-02-20—38791014658697 Mountain View Dr, Orlando, FLScored0.99—
CLM-407217CLM2026-04-29Theresa Espinozaflagged1979-02-20——8697 Mountain View Dr, Orlando, FLScored1.00—
CLM-407216CLM2026-07-05Theresa Espinozaflagged1979-02-20UHC-67186-1438791014658697 Mountain View Dr, Orlando, FLScored1.00—

Evidence

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

ABScoreMethodRuleDecision
▶CLM-407217CLMCLM-407216CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶TPA-53156TPA CLM-407217CLM0.99Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name0.973
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶TPA-53156TPA CLM-407216CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name0.973
Date of birth1.003exact
SSN (last four)1.002.5
Phone1.001.5
Address1.002exact
Identifiers agreeing: 3Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

  • Orphan claim re-pointedExecuted
    CLM-407217 → UHC-67186-14 (Theresa Espinoza)
    ACT-007203, Claims processor

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-19 19:54:38Record linked automatically7706ceca77
    scoring_agent, CLM-407216, identity id MBR-025250, confidence 1, method probabilistic, matched record CLM-407217, policy version 1
  • 2026-10-19 19:54:38Record linked automatically162f307666
    scoring_agent, CLM-407217, identity id MBR-025250, confidence 1, method probabilistic, matched record CLM-407216, policy version 1
  • 2026-10-19 19:54:38Record linked automatically96f1e7ef8e
    scoring_agent, TPA-53156, identity id MBR-025250, confidence 0.99, method probabilistic, matched record CLM-407217, policy version 1
  • 2026-10-19 19:52:09Record linked automatically6841a06e15
    scoring_agent, CLM-407216, identity id MBR-025250, confidence 1, method probabilistic, matched record CLM-407217, policy version 1
  • 2026-10-19 19:52:09Record linked automatically1f07a4cfba
    scoring_agent, CLM-407217, identity id MBR-025250, confidence 1, method probabilistic, matched record CLM-407216, policy version 1
  • 2026-10-19 19:52:09Record linked automaticallybd8b04e6bc
    scoring_agent, TPA-53156, identity id MBR-025250, confidence 0.99, method probabilistic, matched record CLM-407217, policy version 1
  • 2026-10-19 19:45:42Record linked automatically6425009551
    scoring_agent, CLM-407216, identity id MBR-025250, confidence 1, method probabilistic, matched record CLM-407217, policy version 1
  • 2026-10-19 19:45:42Record linked automatically7799654653
    scoring_agent, CLM-407217, identity id MBR-025250, confidence 1, method probabilistic, matched record CLM-407216, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallyed0b0a6a16
    scoring_agent, TPA-53156, identity id MBR-025250, confidence 0.99, method probabilistic, matched record CLM-407217, policy version 1
  • 2026-10-19 19:32:31Record linked automatically3e928cf6c7
    scoring_agent, CLM-407216, identity id MBR-025250, confidence 1, method probabilistic, matched record CLM-407217, policy version 1
  • 2026-10-19 19:32:31Record linked automatically072a8de6f7
    scoring_agent, CLM-407217, identity id MBR-025250, confidence 1, method probabilistic, matched record CLM-407216, policy version 1
  • 2026-10-19 19:32:31Record linked automatically46b4d6af68
    scoring_agent, TPA-53156, identity id MBR-025250, confidence 0.99, method probabilistic, matched record CLM-407217, policy version 1
  • 2026-10-19 19:31:28Record linked automatically92d0c00595
    scoring_agent, CLM-407216, identity id MBR-034349, confidence 0.94, method probabilistic, matched record ENR-109433, policy version 1
  • 2026-10-19 19:31:28Record linked automaticallye810f18f90
    matching_agent, CLM-407217, identity id MBR-016410, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-109436
  • 2026-10-19 19:31:28Record linked automatically46d8a769c6
    matching_agent, TPA-53156, identity id MBR-006807, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-109345

Claims for this member

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

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0063122026-06-14Sunrise Internal Medicine Associates
in network
99215, 99214$621.00$355.02ApprovedApproved
CLM-2026-0221542026-04-19Mesa Internal Medicine Associates
out of network
93000, 80053$178.00—Needs reviewNeeds review
CLM-2026-0221532026-04-19Mesa Internal Medicine Associates
out of network
93000, 80053$178.00$50.10ApprovedApproved