SYNTHETIC HOSPITAL CLINICAL SOURCE. NOT A REAL PATIENT RECORD.
Document: CLN-000072
Claim number: MER-000072
Specialty: Neurology
Author: Patel, Anjali MD
Recorded: 2024-10-19

SYNTHETIC CLINICAL SOURCE. NOT A REAL PATIENT RECORD. Claim MER-000072, patient token SYN-PT-7WAD49869, service date 2024-10-17. Indication M54.16, with G40.909 also documented. Polysomnography, sleep staging with four or more parameters (95810) was performed by Patel, Anjali 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.
