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Although pentosan polysulfate is an approved treatment for interstitial cystitis, some patients on this medication experience treatment failure after one year, and its long-term use has been linked to pigmentary maculopathy

It shows that the E/M visit is significant and separately identifiable

Otherwise it may fail and affect the effect

Moschos MM, Dettoraki M, Tsatsos M, Kitsos G, Kalogeropoulos C

doi: 10.1111/BDI.13016

[10] According to in vitro research, the pharmacological effects of kava stem primarily from six major kavalactones that modulate GABA A , dopamine, norepinephrine, and CB1 receptors, and inhibit MAO-B and ion channel mechanisms