Active NPI 1720084460 Individual Practitioner Male Practitioner

Dr. Parameswaran Hariharan , MD

Internal Medicine • Batavia, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Parameswaran Hariharan, MD is a certified Internal Medicine practicing in Batavia, OH. With approximately 35 years of clinical experience since completing medical education in 1991, Dr. Hariharan delivers high-quality medical care to the local community at 2055 HOSPITAL DR.

Dr. Hariharan maintains professional affiliations with Clermont Internists Associates Inc, Oxford Physical Therapy And Rehabilitation and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2055 Hospital Dr
Suite 300

Batavia, OH 451031923

Telephone 5137320663

Fax 5137321232

Associated Practice Facility / Clinic

🏢 Jesus C Hontanosas Md Inc Facility NPI 1639139017

Medicare Profile & Education

Medical School

Other

Graduation Year

1991

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Batavia, OH

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

35 Yrs +2.7 yrs vs City Avg

City Avg: 32.3 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

6 Specialists

Practicing in Batavia, OH (5516 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

13.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Hariharan (35 Years) 35 Yrs

Batavia Specialty Average (32.3 Years) 32.3 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
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	301	183	$135.00	$120.68
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	294	174	$120.00	$112.52
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	190	121	$90.00	$74.73
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	147	147	$150.00	$122.02
99238 Hospital discharge day management, 30 minutes or less	145	140	$90.00	$75.54
99239 Hospital discharge day management, more than 30 minutes	136	122	$125.00	$108.01
G0008 Administration of influenza virus vaccine	94	94	$35.00	$30.39
90662 Influenza vaccine split virus, preservative free	93	93	$85.00	$81.82
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	82	79	$215.00	$164.07
99213 Established patient office or other outpatient visit, typically 15 minutes	81	69	$100.00	$85.80
81002 Urinalysis, manual test	55	50	$7.00	$3.36
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	20	20	$295.00	$287.94
G0009 Administration of pneumococcal vaccine	19	19	$35.00	$30.43
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	13	13	$85.00	$50.25
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$175.00	$155.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	338	192	$134.70	$121.91
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	329	157	$120.00	$114.47
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	162	105	$90.00	$76.46
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	141	141	$150.00	$122.52
99238 Hospital discharge day management, 30 minutes or less	111	108	$90.00	$77.66
99239 Hospital discharge day management, more than 30 minutes	107	104	$125.00	$110.34
G0008 Administration of influenza virus vaccine	103	101	$34.85	$29.36
90662 Influenza vaccine split virus, preservative free	100	100	$75.00	$71.21
99213 Established patient office or other outpatient visit, typically 15 minutes	100	76	$100.00	$86.26
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	74	74	$215.00	$167.67
81002 Urinalysis, manual test	68	59	$7.00	$3.41
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	24	12	$65.00	$38.93
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	22	22	$290.00	$269.37
G0009 Administration of pneumococcal vaccine	18	18	$33.33	$29.36
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$175.00	$157.21
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$150.00	$125.97
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	12	12	$85.00	$49.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	456	210	$120.00	$99.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	354	200	$135.00	$123.16
99239 Hospital discharge day management, more than 30 minutes	187	179	$125.00	$101.45
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	171	123	$90.00	$69.22
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	156	156	$150.00	$125.85
G0008 Administration of influenza virus vaccine	130	130	$30.00	$27.95
90662 Influenza vaccine split virus, preservative free	126	126	$74.92	$68.54
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	116	113	$215.00	$192.39
99238 Hospital discharge day management, 30 minutes or less	88	86	$90.00	$69.45
99213 Established patient office or other outpatient visit, typically 15 minutes	88	67	$100.00	$86.52
81002 Urinalysis, manual test	74	62	$7.00	$3.38
99497 Advance care planning, first 30 minutes	30	30	$100.00	$82.10
99220 Hospital observation care, typically 70 minutes	20	20	$200.00	$173.36
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	19	19	$175.00	$161.13
99217 Hospital observation care on day of discharge	19	19	$95.00	$69.11
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	16	16	$85.00	$50.79
93000 Routine ekg using at least 12 leads including interpretation and report	13	13	$45.00	$13.78
G0009 Administration of pneumococcal vaccine	13	13	$27.69	$26.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	416	197	$120.00	$101.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	392	231	$133.47	$124.92
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	319	196	$90.00	$70.30
99239 Hospital discharge day management, more than 30 minutes	230	211	$125.00	$102.98
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	150	150	$146.17	$128.10
G0008 Administration of influenza virus vaccine	133	132	$25.00	$16.19
90662 Influenza vaccine split virus, preservative free	126	125	$70.00	$65.23
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	112	111	$215.00	$193.50
99238 Hospital discharge day management, 30 minutes or less	98	97	$90.00	$70.40
81002 Urinalysis, manual test	82	70	$7.00	$3.44
99213 Established patient office or other outpatient visit, typically 15 minutes	78	61	$98.97	$88.54
99497 Advance care planning, first 30 minutes	48	48	$100.00	$83.55
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	30	30	$175.00	$163.35
99217 Hospital observation care on day of discharge	28	26	$95.00	$70.40
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	20	20	$123.80	$120.17
G0009 Administration of pneumococcal vaccine	20	20	$25.00	$16.19
99220 Hospital observation care, typically 70 minutes	18	18	$200.00	$178.36
93000 Routine ekg using at least 12 leads including interpretation and report	14	13	$45.00	$14.34
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	14	14	$85.00	$51.09
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$150.00	$133.49

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	527	289	$90.00	$71.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	405	219	$115.00	$105.30
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	387	216	$120.00	$103.14
99239 Hospital discharge day management, more than 30 minutes	252	231	$125.00	$105.27
99238 Hospital discharge day management, 30 minutes or less	141	133	$90.00	$71.56
G0008 Administration of influenza virus vaccine	140	135	$25.00	$16.06
90662 Influenza vaccine split virus, preservative free	133	128	$70.00	$60.71
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	127	119	$215.00	$200.67
99213 Established patient office or other outpatient visit, typically 15 minutes	126	95	$80.00	$70.99
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	74	74	$125.00	$112.03
81002 Urinalysis, manual test	71	65	$7.00	$3.47
99217 Hospital observation care on day of discharge	39	39	$95.00	$71.74
99497 Advance care planning, first 30 minutes	26	26	$100.00	$84.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$175.00	$161.41
99291 Critical care, first 30-74 minutes	19	19	$290.00	$221.21
G0009 Administration of pneumococcal vaccine	17	17	$25.00	$16.07
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	17	17	$85.00	$51.68
82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	16	13	$22.00	$15.88
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	16	16	$125.00	$119.92
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	14	14	$175.00	$166.02
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$150.00	$128.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	533	249	$115.00	$104.00
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	475	251	$90.00	$71.09
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	354	219	$120.00	$101.43
99239 Hospital discharge day management, more than 30 minutes	199	183	$125.00	$102.43
99238 Hospital discharge day management, 30 minutes or less	163	152	$90.00	$70.06
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	146	146	$125.00	$110.94
99213 Established patient office or other outpatient visit, typically 15 minutes	117	87	$80.00	$70.52
G0008 Administration of influenza virus vaccine	117	117	$25.00	$15.75
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	116	113	$215.00	$196.33
90662 Influenza vaccine split virus, preservative free	105	105	$69.57	$54.85
81002 Urinalysis, manual test	95	81	$7.00	$3.34
99497 Advance care planning, first 30 minutes	67	67	$100.00	$82.57
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	48	21	$65.00	$39.17
99291 Critical care, first 30-74 minutes	39	37	$290.00	$219.02
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	38	38	$173.68	$163.28
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	33	32	$85.00	$50.93
G0009 Administration of pneumococcal vaccine	26	26	$25.00	$15.14
99217 Hospital observation care on day of discharge	26	26	$95.00	$71.16
99220 Hospital observation care, typically 70 minutes	22	21	$200.00	$175.04
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	18	18	$150.00	$133.89
82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	15	14	$22.00	$17.32
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$118.00	$109.27
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	12	$55.00	$42.99
90670 Pneumococcal vaccine for injection into muscle	11	11	$210.00	$186.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	544	259	$115.00	$103.01
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	415	247	$90.00	$70.76
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	361	213	$120.00	$101.22
99239 Hospital discharge day management, more than 30 minutes	210	192	$125.00	$104.62
99238 Hospital discharge day management, 30 minutes or less	186	183	$90.00	$70.69
G0008 Administration of influenza virus vaccine	181	181	$25.00	$19.30
90662 Influenza vaccine split virus, preservative free	166	166	$54.06	$51.75
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	149	143	$215.00	$197.26
99213 Established patient office or other outpatient visit, typically 15 minutes	135	97	$80.00	$69.82
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	112	112	$175.00	$165.06
81002 Urinalysis, manual test	86	80	$7.00	$3.41
99497 Advance care planning, first 30 minutes	70	69	$100.00	$82.14
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	64	64	$125.78	$111.79
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	41	15	$65.00	$39.78
G0009 Administration of pneumococcal vaccine	36	36	$25.00	$19.30
99291 Critical care, first 30-74 minutes	33	32	$290.00	$213.68
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	29	28	$150.00	$134.08
99217 Hospital observation care on day of discharge	29	29	$95.00	$71.28
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	26	26	$104.23	$100.79
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	24	23	$85.00	$51.49
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	18	$55.00	$40.64
82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	20	16	$22.00	$19.25
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	16	16	$175.00	$160.23
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	15	15	$28.00	$23.57
99220 Hospital observation care, typically 70 minutes	15	15	$200.00	$182.43
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$175.00	$159.81
90670 Pneumococcal vaccine for injection into muscle	11	11	$190.91	$184.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	727	300	$115.00	$102.82
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	493	289	$90.00	$70.41
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	302	202	$120.00	$101.26
99239 Hospital discharge day management, more than 30 minutes	216	198	$125.00	$104.40
99238 Hospital discharge day management, 30 minutes or less	203	186	$90.00	$70.13
G0008 Administration of influenza virus vaccine	184	184	$25.00	$23.76
99213 Established patient office or other outpatient visit, typically 15 minutes	166	116	$80.00	$69.52
90662 Influenza vaccine split virus, preservative free	162	162	$48.73	$47.03
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	154	147	$215.00	$197.76
81002 Urinalysis, manual test	101	92	$7.00	$3.14
G0009 Administration of pneumococcal vaccine	58	58	$25.00	$23.76
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	51	51	$175.00	$163.71
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	43	43	$125.00	$110.51
99291 Critical care, first 30-74 minutes	41	41	$290.00	$214.67
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	39	18	$65.00	$39.36
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	31	31	$94.68	$92.30
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	30	30	$85.00	$51.35
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	28	27	$150.00	$133.62
90670 Pneumococcal vaccine for injection into muscle	27	27	$174.26	$170.77
99220 Hospital observation care, typically 70 minutes	23	23	$200.00	$181.22
Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)	23	23	$20.00	$17.34
82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	16	16	$22.00	$20.04
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	15	14	$25.00	$7.83
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	15	14	$20.00	$8.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	14	$55.00	$41.48
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$145.00	$139.18

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OH 68751

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

0260177 (OH)

Hospital & Practice Group Affiliations

Clermont Internists Associates Inc

2055 Hospital Dr, Batavia, OH 451031981

Phone: 5137320663

Oxford Physical Therapy And Rehabilitation

7567 Central Parke Blvd, Mason, OH 450406852

Practice Associates & Co-Workers

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

9 Associated Practitioners

Ashley Dodds , FNP-C

Nurse Practitioner

NPI 1053762195

Family Nurse Practitioner (Certified)

Dr. Susheela Rajan , MD

Internal Medicine

NPI 1144273673

Doctor of Medicine (M.D.)

Mackenzie Flowers , PA

Physician Assistant

NPI 1285354381

Physician Assistant

Haley Rodeffer , PA-C

Physician Assistant

NPI 1447136916

Physician Assistant (Certified)

Mary Garrett , PA-C

Physician Assistant

NPI 1629587829

Physician Assistant (Certified)

Huston Dockery , PA-C

Physician Assistant

NPI 1659048718

Physician Assistant (Certified)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active June 05, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location June 05, 2012

Registered at 2055 HOSPITAL DR, SUITE 300, BATAVIA, OH 451031923 (Tel: 5137320663)

📍

Updated Business Mailing Address June 05, 2012

Registered at 2055 HOSPITAL DR, SUITE 300, BATAVIA, OH 451031978 (Tel: 5137320663)

👤

Provider Name / Credentials Updated June 05, 2012

Recorded as PARAMESWARAN HARIHARAN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2012

Internal Medicine (License #68751 in OH)

🟢

Initial NPI Registration & Enumeration June 27, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1720084460

Entity Type:

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

Enumeration Date: June 27, 2005

Last Update: June 05, 2012

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2055 Hospital Dr, Suite 300

Batavia, OH 451031978

Phone: 5137320663

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

⚠️ Medical Disclaimer

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.