Identities/MBR-034607

Gold, golden identity

James A Ortiz

4 source records from 2 feeds.

MBR-034607Verified4 records

Golden record

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

First nameENR: James
Middle nameENR: A
Last nameENR: Ortiz
Date of birthENR: 1965-01-02
GenderENR: M
Member IDENR: UHC-45402-41
SSNENR: •••-••-3496
PhoneENR: 2544061010
EmailENR: james.ortiz@yahoo.com
AddressENR: 78 Willow Ct
CityENR: Houston
StateENR: TX
ZIPENR: 77043
GroupENR: GRP-7065
PlanENR: SELECT-EPO

Min confidence

1.00

Sources

CLM ×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
CLM-402758	CLM	2026-06-12	James Ortizflagged	1965-01-02	—	—	78 Willow Ct, Houston, TX	Scored	1.00	—
ENR-103547	ENR	2026-07-16	James Ortizflagged	1965-01-02	UHC-45402-41	2544061010	78 Willow Ct, Houston, TX	Scored	1.00	—
CLM-402759	CLM	2026-08-14	James Ortizflagged	1965-01-02	—	—	78 Willow Ct, Houston, TX	Scored	1.00	—
CLM-402760	CLM	2026-10-04	James Ortizflagged	1965-01-02	—	—	78 Willow Ct, Houston, TX	Scored	1.00	—

Evidence

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

A

B

Score

Method

Rule

Decision

▶CLM-402758CLMCLM-402759CLM1.00Scoredweighted 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-402758CLMCLM-402760CLM1.00Scoredweighted 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

▶ENR-103547ENR CLM-402760CLM1.00Scoredweighted 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-402759CLMCLM-402760CLM1.00Scoredweighted 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-402758CLMENR-103547ENR 1.00Scoredweighted 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

▶ENR-103547ENR CLM-402759CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
SSN (last four)	1.00	2.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-402758 → UHC-45402-41 (James Ortiz)
ACT-001855, Claims processor
Orphan claim re-pointedExecuted
CLM-402759 → UHC-45402-41 (James Ortiz)
ACT-008321, Claims processor
Orphan claim re-pointedExecuted
CLM-402760 → UHC-45402-41 (James Ortiz)
ACT-008570, Claims processor
Care coordination outreachProposed
James Ortiz: 3 claims, no attributed provider
ACT-019520, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:39Record linked automatically52ff95e503
scoring_agent, CLM-402760, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:54:39Record linked automatically1bea7a7162
scoring_agent, CLM-402759, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:54:39Record linked automatically8f5c10a66f
scoring_agent, ENR-103547, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:54:39Record linked automaticallycfcdf45267
scoring_agent, CLM-402758, identity id MBR-034607, confidence 1, method probabilistic, matched record ENR-103547, policy version 1
2026-10-19 19:52:09Record linked automaticallycecf4cffb4
scoring_agent, CLM-402760, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:52:09Record linked automaticallya2e545abc3
scoring_agent, CLM-402759, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:52:09Record linked automatically7153d3f28c
scoring_agent, ENR-103547, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:52:09Record linked automatically0a8992060e
scoring_agent, CLM-402758, identity id MBR-034607, confidence 1, method probabilistic, matched record ENR-103547, policy version 1
2026-10-19 19:45:42Record linked automatically1ff1fc4018
scoring_agent, CLM-402760, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:45:42Record linked automatically76b813ad23
scoring_agent, CLM-402759, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:45:42Record linked automaticallycaaf951dd0
scoring_agent, ENR-103547, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:45:42Record linked automatically3abf38fe78
scoring_agent, CLM-402758, identity id MBR-034607, confidence 1, method probabilistic, matched record ENR-103547, policy version 1
2026-10-19 19:32:31Record linked automaticallye7f87fc5fb
scoring_agent, CLM-402760, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:32:31Record linked automatically8402b3f6e7
scoring_agent, CLM-402759, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:32:31Record linked automatically8253eaf52d
scoring_agent, ENR-103547, identity id MBR-034607, confidence 1, method probabilistic, matched record CLM-402758, policy version 1
2026-10-19 19:32:31Record linked automaticallyda16524850
scoring_agent, CLM-402758, identity id MBR-034607, confidence 1, method probabilistic, matched record ENR-103547, policy version 1
2026-10-19 19:31:28Record linked automatically2b5ce98601
scoring_agent, CLM-402760, identity id MBR-030481, confidence 1, method probabilistic, matched record CLM-402759, policy version 1
2026-10-19 19:31:28Record linked automaticallyd6a0d5b96c
scoring_agent, CLM-402759, identity id MBR-030481, confidence 1, method probabilistic, matched record CLM-402760, policy version 1
2026-10-19 19:31:28Record linked automatically156647fd8e
scoring_agent, CLM-402758, identity id MBR-020459, confidence 1, method probabilistic, matched record TPA-51261, policy version 1
2026-10-19 19:31:28Record linked automatically007243f121
matching_agent, ENR-103547, identity id MBR-015526, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-402711

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-2026-027413	2026-09-24	Northgate Medical Group in network	99215, 99214	$552.00	$302.24	Approved	Approved
CLM-2026-026427	2026-07-29	Sunrise Behavioral Health in network	90837, 90834, 90791	$754.00	$407.48	Approved	Approved
CLM-2026-002051	2026-05-17	Canyon Internal Medicine Associates out of network	93000, 99215, 99214	$816.00	—	Denied	Denied