SYNTHETIC HOSPITAL CLINICAL SOURCE. NOT A REAL PATIENT RECORD.
Document: CLN-000025
Claim number: MER-000025
Specialty: Neurology
Author: Lindqvist, Sara MD
Recorded: 2026-05-02

SYNTHETIC CLINICAL SOURCE. NOT A REAL PATIENT RECORD. Claim MER-000025, patient token SYN-PT-99GKK6GRC, service date 2026-04-30. Indication M54.16, with G20 also documented. Needle electromyography, complete, each extremity (95886) was performed by Lindqvist, Sara MD. Findings were documented in the procedure log and images or specimens were retained where applicable. The patient tolerated the procedure. Post-procedure instructions were given. This record is fictional source material for document to claim linkage. It is not a coverage determination and asserts no payment entitlement.

REVIEW REQUIREMENTS
A linked document is not a verified clinical criterion. A qualified reviewer must confirm that
this record satisfies the payer requirement in force on the service date before any appeal.
