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Dr. Pam  Grewall  Md image

Dr. Pam Grewall Md

2340 Clay St 2Nd Floor
San Francisco CA 94115
415 003-3458
Medical School: New York College Of Osteo Medicine Of New York Institute Of Technology - 2000
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: Yes
Participates In EHR: No
License #: A78443
NPI: 1578580445
Taxonomy Codes:
207R00000X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Pam Grewall is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:99291 Description:Critical care first hour Average Price:$1,010.00 Average Price Allowed
By Medicare:
$241.46
HCPCS Code:99223 Description:Initial hospital care Average Price:$692.00 Average Price Allowed
By Medicare:
$219.54
HCPCS Code:99239 Description:Hospital discharge day Average Price:$375.00 Average Price Allowed
By Medicare:
$118.48
HCPCS Code:99233 Description:Subsequent hospital care Average Price:$368.00 Average Price Allowed
By Medicare:
$112.90
HCPCS Code:99217 Description:Observation care discharge Average Price:$260.00 Average Price Allowed
By Medicare:
$80.51

HCPCS Code Definitions

99291
Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes
99239
Hospital discharge day management; more than 30 minutes
99223
Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
99233
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
99217
Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from "observation status" if the discharge is on other than the initial date of "observation status." To report services to a patient designated as "observation status" or "inpatient status" and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1700832201
Internal Medicine
1,647
1669421202
Internal Medicine
1,478
1720009160
Gastroenterology
1,138
1942258728
Gastroenterology
985
1215928197
Internal Medicine
963
1750309621
Surgical Oncology
788
1548282999
Gastroenterology
752
1639156326
Diagnostic Radiology
535
1780604645
Gastroenterology
455
1962441394
Diagnostic Radiology
415
*These referrals represent the top 10 that Dr. Grewall has made to other doctors

Publications

Diphenhydramine as an adjunct to sedation for colonoscopy: a double-blind randomized, placebo-controlled study. - Gastrointestinal endoscopy
Intravenous benzodiazepines in combination with opiates are used to achieve moderate sedation for colonoscopy. Although effective, these agents have potential adverse effects, such as respiratory depression and hypotension. Diphenhydramine hydrochloride possesses central nervous system depressant effects that theoretically could provide a synergistic effect for sedating patients.The objective was to assess the efficacy of adding diphenhydramine hydrochloride as an adjunct to improve sedation and to reduce the amount of standard sedatives used during colonoscopy.We conducted a prospective, randomized, double-blind, placebo-controlled study.The study was conducted in a university hospital with an active GI fellowship training program.The study group comprised 270 patients undergoing screening/diagnostic/therapeutic colonoscopy were enrolled.Patients were randomized to receive either 50 mg of diphenhydramine or placebo, given intravenously 3 minutes before starting conscious sedation with intravenous midazolam and meperidine.The main outcome measure was anesthetic effect as assessed by the endoscopy team and by the patient; quantity of adjunctive sedatives to achieve adequate sedation.Of 270 patients, data were analyzed for 258 patients, with 130 patients in the diphenhydramine group and 128 patients in the placebo group. There was a 10.1% reduction in meperidine usage and 13.7% reduction in midazolam usage in favor of the diphenhydramine group. The mean evaluation scores as judged by the faculty, the fellows, and the nurses were statistically significant in favor of the diphenhydramine group. In addition, patient scores for overall sedation and pain level favored the group that received diphenhydramine.Intravenous diphenhydramine given before initiation of standard sedation offers a significant benefit to conscious sedation for patients undergoing colonoscopy.

Map & Directions

2340 Clay St 2Nd Floor San Francisco, CA 94115
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2200 Ofarrell St
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415 332-2000