Active NPI 1790794634 Individual Practitioner Male Practitioner

Dr. Robert W Holmes , MD

Internal Medicine • Topeka, KS

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Robert Holmes, MD is a certified Internal Medicine practicing in Topeka, KS. With approximately 49 years of clinical experience since graduating from University Of Kansas School Of Med (Kc/Wich/Sal) in 1977, Dr. Holmes delivers high-quality medical care to the local community at 823 SW MULVANE ST.

Dr. Holmes maintains professional affiliations with Cotton-O'Neil Clinic Revocable Trust, Stormont Vail Health Flint Hills Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include removal of skin and tissue, 20.0 sq cm or less, established patient outpatient office visit, ultrasound study of arm and leg arteries. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

823 Sw Mulvane St

Topeka, KS 666061764

Telephone 7856804011

Associated Practice Facility / Clinic

🏢 Anesthesia Associates Of Topeka Pa Facility NPI 1518933837

Medicare Profile & Education

Medical School

University Of Kansas School Of Med (Kc/wich/sal)

Graduation Year

1977

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Topeka, KS

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

49 Yrs +20.6 yrs vs City Avg

City Avg: 28.4 Yrs

State Avg: 25.6 Yrs

Regional Practice Density

54 Specialists

Practicing in Topeka, KS (1061 Statewide)

Telehealth Adoption Rate

13.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

63.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Holmes (49 Years) 49 Yrs

Topeka Specialty Average (28.4 Years) 28.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	301	41	$261.70	$54.70
99213 Established patient office or other outpatient visit, typically 15 minutes	285	43	$130.18	$60.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	81	37	$191.66	$89.85
93922 Ultrasound study of arm and leg arteries	51	47	$80.00	$10.76
36415 Insertion of needle into vein for collection of blood sample	35	11	$16.00	$8.65
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	18	$77.45	$32.58
97597 Removal of tissue from wound, 20.0 sq cm or less	24	17	$130.75	$32.79
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	16	14	$258.42	$133.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	216	29	$261.70	$55.93
99213 Established patient office or other outpatient visit, typically 15 minutes	215	34	$130.18	$62.79
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	116	35	$191.66	$92.83
36415 Insertion of needle into vein for collection of blood sample	43	17	$16.00	$8.40
93922 Ultrasound study of arm and leg arteries	33	28	$80.00	$11.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	13	$77.45	$33.73
97597 Removal of tissue from wound, 20.0 sq cm or less	20	12	$130.75	$33.95
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	20	18	$258.42	$136.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	478	258	$16.00	$2.96
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	221	212	$243.09	$171.55
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	183	139	$180.15	$121.37
11042 Removal of skin and tissue, 20.0 sq cm or less	146	29	$261.70	$56.63
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	103	32	$181.43	$94.48
77080 Dxa bone density measurement of hip, pelvis, spine	95	95	$162.00	$35.23
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	81	81	$214.25	$125.23
G0008 Administration of influenza virus vaccine	75	74	$35.93	$27.43
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	73	72	$113.88	$70.15
99213 Established patient office or other outpatient visit, typically 15 minutes	64	21	$122.85	$64.02
77067 Screening mammography	50	50	$175.00	$86.24
77063 Screening digital tomography of both breasts	50	50	$43.10	$21.91
93922 Ultrasound study of arm and leg arteries	30	28	$80.00	$11.49
99213 Established patient office or other outpatient visit, typically 15 minutes	25	25	$122.52	$86.37
71046 X-ray of chest, 2 views	21	20	$62.43	$21.72
97597 Removal of tissue from wound, 20.0 sq cm or less	19	11	$130.75	$34.87
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	13	13	$62.75	$5.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	527	294	$16.00	$3.00
77080 Dxa bone density measurement of hip, pelvis, spine	236	236	$161.40	$35.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	227	157	$177.80	$123.81
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	226	215	$239.80	$172.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	223	37	$177.80	$96.15
11042 Removal of skin and tissue, 20.0 sq cm or less	198	30	$261.70	$55.49
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	136	136	$214.25	$127.04
G0008 Administration of influenza virus vaccine	96	95	$33.30	$15.91
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	96	95	$73.63	$66.20
99213 Established patient office or other outpatient visit, typically 15 minutes	68	27	$120.60	$65.01
97597 Removal of tissue from wound, 20.0 sq cm or less	61	20	$130.75	$34.98
99213 Established patient office or other outpatient visit, typically 15 minutes	32	30	$120.60	$87.27
71046 X-ray of chest, 2 views	32	31	$59.70	$20.85
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	21	21	$321.25	$161.65
93000 Routine ekg using at least 12 leads including interpretation and report	20	20	$85.25	$13.98
93922 Ultrasound study of arm and leg arteries	19	19	$233.50	$63.90
93922 Ultrasound study of arm and leg arteries	18	16	$80.00	$12.02
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	17	17	$62.75	$5.91
93926 Ultrasound of one leg arteries or artery grafts	12	12	$416.00	$122.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	535	294	$16.00	$2.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	297	209	$167.43	$104.79
77080 Dxa bone density measurement of hip, pelvis, spine	194	194	$162.00	$37.25
99213 Established patient office or other outpatient visit, typically 15 minutes	167	39	$112.47	$49.91
11042 Removal of skin and tissue, 20.0 sq cm or less	153	39	$258.63	$58.44
99183 Management and supervision of oxygen chamber therapy per session	150	12	$323.75	$108.01
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	129	126	$231.05	$140.00
G0008 Administration of influenza virus vaccine	124	122	$32.85	$15.85
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	115	115	$65.00	$61.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	96	96	$214.25	$111.87
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	32	$165.03	$77.17
93000 Routine ekg using at least 12 leads including interpretation and report	76	76	$85.25	$16.17
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	61	12	$127.50	$25.89
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	43	43	$42.50	$8.37
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	43	43	$62.75	$7.83
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	39	35	$231.17	$109.21
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	34	20	$42.50	$13.62
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	33	33	$321.25	$164.89
93922 Ultrasound study of arm and leg arteries	32	32	$233.50	$62.62
71046 X-ray of chest, 2 views	25	24	$65.60	$20.79
93926 Ultrasound of one leg arteries or artery grafts	23	23	$416.00	$126.02
99213 Established patient office or other outpatient visit, typically 15 minutes	23	23	$109.79	$71.77
93922 Ultrasound study of arm and leg arteries	15	15	$80.00	$12.29
69210 Removal of impacted ear wax	13	12	$106.25	$45.69
93970 Ultrasound study of arm or leg veins with compression and maneuvers	13	13	$778.25	$183.15
G0009 Administration of pneumococcal vaccine	12	12	$29.33	$15.76
93925 Ultrasound of leg arteries or artery grafts	11	11	$778.25	$237.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,020	15	$36.78	$18.59
36415 Insertion of needle into vein for collection of blood sample	577	300	$16.00	$2.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	389	233	$145.19	$103.85
77080 Dxa bone density measurement of hip, pelvis, spine	197	197	$162.00	$37.37
99213 Established patient office or other outpatient visit, typically 15 minutes	178	40	$98.00	$49.56
11042 Removal of skin and tissue, 20.0 sq cm or less	134	35	$255.00	$59.21
G0008 Administration of influenza virus vaccine	125	124	$24.00	$15.55
90653 Vaccine for influenza for injection into muscle	122	121	$58.00	$56.79
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	117	114	$218.00	$137.73
93000 Routine ekg using at least 12 leads including interpretation and report	85	84	$85.25	$16.07
99183 Management and supervision of oxygen chamber therapy per session	72	13	$314.25	$106.38
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	62	62	$321.25	$164.68
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	58	39	$42.50	$15.85
93922 Ultrasound study of arm and leg arteries	51	46	$80.00	$12.08
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	51	44	$218.00	$107.78
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	48	48	$214.25	$111.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	43	19	$145.00	$76.52
93922 Ultrasound study of arm and leg arteries	40	40	$233.50	$63.78
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	39	39	$62.75	$7.76
99213 Established patient office or other outpatient visit, typically 15 minutes	38	38	$98.00	$70.89
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	36	36	$42.50	$8.31
69210 Removal of impacted ear wax	29	28	$106.25	$42.80
93926 Ultrasound of one leg arteries or artery grafts	27	27	$416.00	$125.23
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	25	23	$466.75	$112.13
71046 X-ray of chest, 2 views	24	24	$82.25	$23.02
20610 Aspiration and/or injection of fluid from large joint	22	15	$181.09	$56.59
93880 Ultrasound of both sides of head and neck blood flow	14	14	$700.00	$188.50
93970 Ultrasound study of arm or leg veins with compression and maneuvers	14	14	$778.25	$182.34
93979 Ultrasound scan of blood flow of aorta, vena cava, bypass graphs, or one side of the groin or limited scan	13	13	$311.25	$90.23
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	12	$66.00	$24.72
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	11	11	$622.25	$140.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1071 Injection, testosterone cypionate, 1 mg	3,575	11	$0.15	$0.02
J0897 Injection, denosumab, 1 mg	660	11	$19.41	$17.53
36415 Insertion of needle into vein for collection of blood sample	616	315	$16.00	$2.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	285	179	$145.00	$101.12
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	229	223	$218.00	$137.24
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	193	42	$117.00	$69.81
77080 Dxa bone density measurement of hip, pelvis, spine	167	167	$242.03	$38.48
99213 Established patient office or other outpatient visit, typically 15 minutes	162	36	$98.00	$49.14
G0008 Administration of influenza virus vaccine	125	125	$24.00	$19.07
90653 Vaccine for influenza for injection into muscle	121	121	$57.94	$53.54
11042 Removal of skin and tissue, 20.0 sq cm or less	87	27	$255.00	$58.67
93000 Routine ekg using at least 12 leads including interpretation and report	85	85	$85.25	$15.86
99183 Management and supervision of oxygen chamber therapy per session	77	11	$314.25	$105.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	64	27	$145.00	$75.31
99213 Established patient office or other outpatient visit, typically 15 minutes	60	51	$98.00	$68.20
99231 Follow-up hospital inpatient care per day, typically 15 minutes	59	29	$74.75	$37.59
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	58	34	$42.50	$19.19
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	52	39	$167.00	$100.03
93922 Ultrasound study of arm and leg arteries	41	37	$80.00	$12.10
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	40	40	$62.75	$7.66
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	39	38	$321.00	$194.36
71046 X-ray of chest, 2 views	36	34	$82.25	$20.94
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	35	35	$42.50	$8.19
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	33	30	$218.00	$106.44
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	28	27	$443.11	$101.31
93922 Ultrasound study of arm and leg arteries	25	25	$227.36	$60.60
93926 Ultrasound of one leg arteries or artery grafts	24	23	$416.00	$121.09
G0009 Administration of pneumococcal vaccine	20	20	$26.50	$19.07
93970 Ultrasound study of arm or leg veins with compression and maneuvers	19	19	$778.25	$182.55
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	12	$66.00	$24.35
93979 Ultrasound scan of blood flow of aorta, vena cava, bypass graphs, or one side of the groin or limited scan	14	14	$311.25	$81.86
69210 Removal of impacted ear wax	13	12	$105.44	$44.02
90670 Pneumococcal vaccine for injection into muscle	11	11	$259.00	$197.68
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	11	11	$579.11	$146.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	760	169	$117.00	$68.99
36415 Insertion of needle into vein for collection of blood sample	640	338	$16.00	$2.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	372	207	$145.00	$101.19
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	257	253	$218.00	$136.18
99213 Established patient office or other outpatient visit, typically 15 minutes	243	55	$98.00	$48.68
99231 Follow-up hospital inpatient care per day, typically 15 minutes	236	112	$74.75	$37.48
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	191	156	$167.00	$99.74
G0008 Administration of influenza virus vaccine	170	168	$24.00	$23.43
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	162	154	$321.00	$192.54
90653 Vaccine for influenza for injection into muscle	155	155	$51.00	$49.22
77080 Dxa bone density measurement of hip, pelvis, spine	154	154	$315.50	$37.47
11042 Removal of skin and tissue, 20.0 sq cm or less	146	43	$255.00	$58.77
93000 Routine ekg using at least 12 leads including interpretation and report	117	115	$85.25	$15.80
99183 Management and supervision of oxygen chamber therapy per session	77	13	$314.25	$105.19
99213 Established patient office or other outpatient visit, typically 15 minutes	55	50	$98.00	$68.78
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	51	48	$218.00	$104.64
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	46	22	$42.50	$23.63
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	38	34	$458.04	$107.97
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	35	24	$66.00	$24.28
93922 Ultrasound study of arm and leg arteries	35	33	$80.00	$12.06
71020 X-ray of chest, 2 views, front and side	33	31	$81.32	$18.52
93922 Ultrasound study of arm and leg arteries	31	29	$233.50	$63.74
93970 Ultrasound study of arm or leg veins with compression and maneuvers	28	28	$756.36	$175.13
69210 Removal of impacted ear wax	25	25	$95.75	$45.29
G0009 Administration of pneumococcal vaccine	24	24	$26.50	$23.43
93926 Ultrasound of one leg arteries or artery grafts	22	20	$416.00	$120.14
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	15	$145.00	$75.09
J1040 Injection, methylprednisolone acetate, 80 mg	20	17	$17.75	$10.98
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	18	18	$321.25	$160.93
90670 Pneumococcal vaccine for injection into muscle	18	18	$259.00	$181.85
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	18	18	$214.25	$108.59
93880 Ultrasound of both sides of head and neck blood flow	13	13	$664.23	$174.33

Medical Specialties & State Licenses

CMS Verified: 2026-05-27

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License KS 04-17855

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

100082990B (KS)

Commercial Insurance / Payer ID Medicare Ptan

067019 (KS)

Hospital & Practice Group Affiliations

Cotton-O'neil Clinic Revocable Trust

901 Sw Garfield Ave, Topeka, KS 666061670

Phone: 7853549591

Cotton-O'neil Clinic Revocable Trust

2902 Sw Asbury Dr, Topeka, KS 666144466

Phone: 7853549591

Stormont Vail Health Flint Hills Llc

1102 Saint Marys Rd, Junction City, KS 664414139

Phone: 7857622585

Secondary Practice Locations

1500 Sw 10th Ave

Topeka, KS 666041301

Phone: 7853549591

1102 Saint Marys Rd

Junction City, KS 664414139

Phone: 7852380325

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Donnett Streeter , APRN

Nurse Practitioner

NPI 1023026564

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Practice Location July 06, 2023

Registered at 823 SW MULVANE ST, TOPEKA, KS 666061764 (Tel: 7856804011)

📍

Updated Business Mailing Address July 06, 2023

Registered at 823 SW MULVANE ST, TOPEKA, KS 666061764 (Tel: 7856804011)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 06, 2023

Internal Medicine (License #04-17855 in KS)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 27, 2022

Internal Medicine (License #04-17855 in KS)

✅

NPI Profile Active June 04, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location June 04, 2014

Registered at 901 SW GARFIELD AVE, TOPEKA, KS 666061670 (Tel: 7853549591)

📍

Updated Business Mailing Address June 04, 2014

Registered at 901 SW GARFIELD AVE, TOPEKA, KS 666061670 (Tel: 7853549591)

👤

Provider Name / Credentials Updated June 04, 2014

Recorded as ROBERT HOLMES, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 04, 2014

Internal Medicine (License #04-17855 in KS)

🟢

Initial NPI Registration & Enumeration August 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1790794634

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 07, 2006

Last Update: May 27, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

823 Sw Mulvane St

Topeka, KS 666061764

Phone: 7856804011

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.