Identities/MBR-027937

Gold, golden identity

Donna Ramos

5 source records from 3 feeds.

MBR-027937Verified5 records

Golden record

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

First nameENR: Donna
Middle name—: —
Last nameENR: Ramos
Date of birthENR: 1995-10-06
GenderENR: M
Member IDENR: UHC-64152-85
SSNENR: •••-••-2829
PhoneENR: 7827236431
EmailENR: donna.ramos17@hotmail.com
AddressENR: 428 Main St
CityENR: Scottsdale
StateENR: AZ
ZIPENR: 85253
GroupENR: GRP-9368
PlanENR: NAVIGATE-HMO

Min confidence

1.00

Sources

PRV ×1CLM ×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
PRV-28155	PRV	2026-04-27	Donna Ramosflagged	1995-10-06	UHC-64152-85	7827236431	7499 Baseline Rd, Tempe, AZ	Scored	1.00	—
CLM-427823	CLM	2026-07-23	Donna Ramosflagged	1995-10-06	—	7827236431	—	Scored	1.00	—
CLM-427824	CLM	2026-08-05	Donna Ramosflagged	1995-10-06	—	—	7499 Baseline Rd Apt 27, Tempe, AZ	Scored	1.00	—
CLM-427825	CLM	2026-08-05	Donna Ramosflagged	1995-10-06	—	—	7499 Baseline Rd Apt 27, Tempe, AZ	Scored	1.00	—
ENR-136477	ENR	2026-08-31	Donna Ramosflagged	1995-10-06	UHC-64152-85	7827236431	428 Main St, Scottsdale, AZ	Scored	1.00	—

Evidence

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

A

B

Score

Method

Rule

Decision

▶PRV-28155PRVCLM-427823CLM1.00Scoredweighted 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-427824CLMCLM-427825CLM1.00Scoredweighted 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-427823CLMENR-136477ENR 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

▶PRV-28155PRVENR-136477ENR 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
Phone	1.00	1.5
Email	1.00	1.5
Address	0.00	2	different

Identifiers agreeing: 3Conflicts: noneGuard: none

▶PRV-28155PRVCLM-427824CLM0.93Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	0.70	2	street_match

Identifiers agreeing: 1Conflicts: noneGuard: none

▶PRV-28155PRVCLM-427825CLM0.93Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	0.70	2	street_match

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-427823CLMCLM-427824CLM0.83Scoredweighted 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

▶CLM-427823CLMCLM-427825CLM0.83Scoredweighted 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

▶CLM-427824CLMENR-136477ENR 0.75Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	0.00	2	different

Identifiers agreeing: 0Conflicts: noneGuard: none

▶CLM-427825CLMENR-136477ENR 0.75Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	0.00	2	different

Identifiers agreeing: 0Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Eligibility conflict resolvedProposed
Donna Ramos: 2 plan codes across sources → canonical NAVIGATE-HMO
ACT-001087, Eligibility engine
Orphan claim re-pointedExecuted
CLM-427823 → UHC-64152-85 (Donna Ramos)
ACT-003716, Claims processor
Orphan claim re-pointedExecuted
CLM-427824 → UHC-64152-85 (Donna Ramos)
ACT-006879, Claims processor
Orphan claim re-pointedExecuted
CLM-427825 → UHC-64152-85 (Donna Ramos)
ACT-008134, Claims processor

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallya75ad9d316
scoring_agent, ENR-136477, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:54:38Record linked automaticallyf1eb0709ed
scoring_agent, CLM-427825, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427824, policy version 1
2026-10-19 19:54:38Record linked automatically8947e7fc5b
scoring_agent, CLM-427824, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427825, policy version 1
2026-10-19 19:54:38Record linked automatically22d2001651
scoring_agent, CLM-427823, identity id MBR-027937, confidence 1, method probabilistic, matched record PRV-28155, policy version 1
2026-10-19 19:54:38Record linked automaticallyc1d1ec9f77
scoring_agent, PRV-28155, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:52:09Record linked automatically309d4f4764
scoring_agent, ENR-136477, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:52:09Record linked automaticallyad8b81e9a4
scoring_agent, CLM-427825, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427824, policy version 1
2026-10-19 19:52:09Record linked automatically2d30127982
scoring_agent, CLM-427824, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427825, policy version 1
2026-10-19 19:52:09Record linked automatically78fdedd116
scoring_agent, CLM-427823, identity id MBR-027937, confidence 1, method probabilistic, matched record PRV-28155, policy version 1
2026-10-19 19:52:09Record linked automaticallyaeb29927d9
scoring_agent, PRV-28155, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:45:42Record linked automatically9a72c61142
scoring_agent, ENR-136477, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:45:42Record linked automatically53ff35cb3f
scoring_agent, CLM-427825, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427824, policy version 1
2026-10-19 19:45:42Record linked automatically15d89f7975
scoring_agent, CLM-427824, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427825, policy version 1
2026-10-19 19:45:42Record linked automaticallyf289c06ea1
scoring_agent, CLM-427823, identity id MBR-027937, confidence 1, method probabilistic, matched record PRV-28155, policy version 1
2026-10-19 19:45:42Record linked automatically7fbfb3f90b
scoring_agent, PRV-28155, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:32:31Record linked automaticallya018ebea21
scoring_agent, ENR-136477, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:32:31Record linked automaticallyd2cdeaac42
scoring_agent, CLM-427825, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427824, policy version 1
2026-10-19 19:32:31Record linked automaticallya441f9a290
scoring_agent, CLM-427824, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427825, policy version 1
2026-10-19 19:32:31Record linked automaticallyc04e289409
scoring_agent, CLM-427823, identity id MBR-027937, confidence 1, method probabilistic, matched record PRV-28155, policy version 1
2026-10-19 19:32:31Record linked automatically82ff0fa8eb
scoring_agent, PRV-28155, identity id MBR-027937, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:31:28Record linked automatically07bb27e091
matching_agent, ENR-136477, identity id MBR-034661, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-62118
2026-10-19 19:31:28Record linked automatically35b76184ec
scoring_agent, PRV-28155, identity id MBR-011739, confidence 1, method probabilistic, matched record ENR-136779, policy version 1
2026-10-19 19:31:28Record linked automaticallye68ace2cac
scoring_agent, CLM-427824, identity id MBR-002335, confidence 1, method probabilistic, matched record CLM-427823, policy version 1
2026-10-19 19:31:28Record linked automatically803b55287c
scoring_agent, CLM-427823, identity id MBR-002335, confidence 1, method probabilistic, matched record TPA-62235, policy version 1

Claims for this member

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

Claim	Service	Provider	Procedures	Billed	Plan paid	Rules	Status
CLM-2026-025797	2026-07-17	Cornerstone Internal Medicine Associates in network	93000	$84.00	$32.08	Approved	Approved
CLM-2026-020847	2026-07-24	Lakeside Clinical Laboratories in network	85025, 87086, 83036	$141.00	$0.00	Approved	Approved
CLM-2026-008980	2026-03-17	Summit Community Hospital in network	96374	$154.00	—	Denied	Denied