Identities/MBR-031031
Gold, golden identity

Ralph M Pena

4 source records from 2 feeds.

MBR-031031Verified4 records

Golden record

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

First nameENR
Ralph
Middle nameENR
M
Last nameCLM
Pena
Date of birthENR
1993-05-10
GenderENR
F
Member IDENR
UHC-16904-99
SSN—
—
PhoneENR
4703598893
EmailENR
ralph.pena@gmail.com
AddressENR
154 Central Ave
CityENR
Jacksonville
StateENR
FL
ZIPENR
32215
GroupENR
GRP-6150
PlanENR
CORE-HMO
Min confidence
0.99
Sources
CLM ×3ENR ×1
Updated
2026-10-22 12:43:43
run-mvjj6udb

Identity graph

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

1.000.991.001.00CLMCLM-415255ENRENR-120102CLMCLM-415254CLMCLM-415253IDMBR-031031
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-415255CLM2026-05-17Ralph Penaflagged——4703598893154 Central Ave, Jacksonville, FLScored1.00—
ENR-120102ENR2026-07-21Ralph Pnaflagged1993-05-10UHC-16904-994703598893154 Central Ave, Jacksonville, FLRule0.99D1 member id + dob exact
CLM-415254CLM2026-08-10Ralph Penaflagged1993-05-10UHC-16904-994703598893154 Central Ave, Jacksonville, FLScored1.00—
CLM-415253CLM2026-09-19Ralph Penaflagged1993-05-10—4703598893154 Central Ave, Jacksonville, FLScored1.00—

Evidence

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

ABScoreMethodRuleDecision
▶CLM-415254CLM CLM-415253CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-415255CLMCLM-415253CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Phone1.001.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-415255CLMCLM-415254CLM 1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Phone1.001.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶ENR-120102ENRCLM-415254CLM 0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name0.953
Date of birth1.003exact
Member ID1.004
Phone1.001.5
Address1.002exact
Identifiers agreeing: 3Conflicts: noneGuard: none
▶ENR-120102ENRCLM-415253CLM0.99Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name0.953
Date of birth1.003exact
Phone1.001.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-415255CLMENR-120102ENR0.98Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name0.953
Phone1.001.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

  • Orphan claim re-pointedExecuted
    CLM-415255 → UHC-16904-99 (Ralph Pena)
    ACT-003201, Claims processor
  • Orphan claim re-pointedExecuted
    CLM-415253 → UHC-16904-99 (Ralph Pena)
    ACT-004779, Claims processor
  • Care coordination outreachProposed
    Ralph Pena: 3 claims, no attributed provider
    ACT-019464, Next-best-action

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-22 12:43:54Record linked automatically34bd056596
    scoring_agent, CLM-415253, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-22 12:43:54Record linked automatically93c27335f5
    scoring_agent, CLM-415254, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415253, policy version 1
  • 2026-10-22 12:43:54Record linked automatically10309eee44
    matching_agent, ENR-120102, identity id MBR-031031, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-415254
  • 2026-10-22 12:43:54Record linked automatically549364933d
    scoring_agent, CLM-415255, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallydb5abd718d
    scoring_agent, CLM-415253, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:54:38Record linked automatically8355356f32
    scoring_agent, CLM-415254, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415253, policy version 1
  • 2026-10-19 19:54:38Record linked automatically2482366002
    matching_agent, ENR-120102, identity id MBR-031031, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-415254
  • 2026-10-19 19:54:38Record linked automatically1c1566cd74
    scoring_agent, CLM-415255, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:52:09Record linked automaticallya26ab4551a
    scoring_agent, CLM-415253, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:52:09Record linked automatically693a17f266
    scoring_agent, CLM-415254, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415253, policy version 1
  • 2026-10-19 19:52:09Record linked automatically48672ccc1d
    matching_agent, ENR-120102, identity id MBR-031031, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-415254
  • 2026-10-19 19:52:09Record linked automatically492adc20da
    scoring_agent, CLM-415255, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallya40ab49e6e
    scoring_agent, CLM-415253, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallybed0c1f0d8
    scoring_agent, CLM-415254, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415253, policy version 1
  • 2026-10-19 19:45:42Record linked automatically81d15de33b
    matching_agent, ENR-120102, identity id MBR-031031, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-415254
  • 2026-10-19 19:45:42Record linked automatically5a350cd582
    scoring_agent, CLM-415255, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:32:31Record linked automatically1764d74b84
    scoring_agent, CLM-415253, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:32:31Record linked automatically5a9a18c346
    scoring_agent, CLM-415254, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415253, policy version 1
  • 2026-10-19 19:32:31Record linked automatically193cbf6352
    matching_agent, ENR-120102, identity id MBR-031031, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-415254
  • 2026-10-19 19:32:31Record linked automatically1279484c8f
    scoring_agent, CLM-415255, identity id MBR-031031, confidence 1, method probabilistic, matched record CLM-415254, policy version 1
  • 2026-10-19 19:31:28Record linked automaticallyc8eada03f6
    matching_agent, CLM-415254, identity id MBR-029550, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-119983
  • 2026-10-19 19:31:28Record linked automatically71cc29e62c
    matching_agent, ENR-120102, identity id MBR-016308, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-415344
  • 2026-10-19 19:31:28Record linked automatically78b39be2c6
    matching_agent, CLM-415255, identity id MBR-013859, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-119987
  • 2026-10-19 19:31:28Record linked automaticallyde52f2556b
    matching_agent, CLM-415253, identity id MBR-001139, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-119982

Claims for this member

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

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0130842026-08-19Summit Regional Medical Center
in network
71046$124.00$0.00ApprovedApproved
CLM-2026-0079112026-07-23Northgate Internal Medicine Associates
in network
99215$289.00$159.18ApprovedApproved
CLM-2026-0070732026-05-08Sunrise Diagnostic Imaging
in network
77067$417.00$32.75ApprovedApproved