Active NPI 1780620823 Individual Practitioner Male Practitioner

Dr. Ronald Lu Chio , MD

Internal Medicine • Euless, TX

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Ronald Chio, MD is a certified Internal Medicine practicing in Euless, TX. With approximately 34 years of clinical experience since completing medical education in 1992, Dr. Chio delivers high-quality medical care to the local community at 479 WESTPARK WAY.

Dr. Chio is affiliated with Catalyst Physician Group - Ntx, Pllc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, telephone medical discussion with physician. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

479 Westpark Way

Euless, TX 76040

Telephone 8173585500

Fax 8173585511

Medicare Profile & Education

Medical School

Other

Graduation Year

1992

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Euless, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

34 Yrs +4.2 yrs vs City Avg

City Avg: 29.8 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

21 Specialists

Practicing in Euless, TX (9538 Statewide)

Telehealth Adoption Rate

57.1% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Chio (34 Years) 34 Yrs

Euless Specialty Average (29.8 Years) 29.8 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	267	220	$385.32	$122.89
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	222	222	$387.27	$127.27
99213 Established patient office or other outpatient visit, typically 15 minutes	203	154	$273.35	$88.38
99442 Telephone medical discussion with physician, 11-20 minutes	67	28	$268.41	$89.19
36415 Insertion of needle into vein for collection of blood sample	63	61	$25.71	$8.65
80053 Blood test, comprehensive group of blood chemicals	59	59	$31.68	$10.35
80061 Blood test, lipids (cholesterol and triglycerides)	56	56	$40.17	$13.12
99495 Transitional care management services for problem of at least moderate complexity	53	37	$615.47	$201.62
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	46	46	$23.00	$7.61
84443 Blood test, thyroid stimulating hormone (TSH)	46	46	$50.40	$16.46
83036 Hemoglobin A1C level	41	41	$29.13	$9.52
G0008 Administration of influenza virus vaccine	40	39	$31.64	$30.40
90662 Influenza vaccine split virus, preservative free	34	34	$323.00	$81.24
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	24	22	$48.36	$16.10
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	22	22	$494.10	$162.46
0241U Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected	19	16	$427.95	$139.78
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	16	13	$42.58	$14.08
G0103 Prostate cancer screening; prostate specific antigen test (psa)	14	14	$57.93	$18.92
81002 Urinalysis, manual test	12	11	$10.44	$3.41

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	249	216	$245.03	$124.74
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	222	222	$277.37	$127.76
80053 Blood test, comprehensive group of blood chemicals	189	167	$25.30	$10.35
80061 Blood test, lipids (cholesterol and triglycerides)	182	164	$35.22	$13.12
99213 Established patient office or other outpatient visit, typically 15 minutes	170	140	$175.26	$85.08
G0444 Annual depression screening, 5 to 15 minutes	148	148	$29.76	$18.31
84443 Blood test, thyroid stimulating hormone (TSH)	132	121	$40.53	$16.46
83036 Hemoglobin A1C level	120	108	$82.67	$9.52
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	108	101	$20.14	$7.61
99495 Transitional care management services for problem of at least moderate complexity	36	31	$399.94	$198.61
G0103 Prostate cancer screening; prostate specific antigen test (psa)	29	29	$40.62	$18.92
G0008 Administration of influenza virus vaccine	27	27	$17.73	$17.23
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	23	23	$215.00	$75.81
84153 Psa (prostate specific antigen) measurement, total	22	21	$35.91	$18.02
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	20	20	$186.37	$162.62
0241U Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected	18	17	$348.89	$139.78
82306 Vitamin d-3 level	11	11	$52.00	$29.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
80061 Blood test, lipids (cholesterol and triglycerides)	309	208	$35.00	$13.23
80053 Blood test, comprehensive group of blood chemicals	308	207	$25.00	$10.43
99213 Established patient office or other outpatient visit, typically 15 minutes	281	190	$120.00	$85.46
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	249	217	$185.00	$126.95
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	241	241	$200.00	$131.32
84443 Blood test, thyroid stimulating hormone (TSH)	234	183	$40.00	$16.60
G0444 Annual depression screening, 5 to 15 minutes	219	219	$25.00	$18.38
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	181	169	$20.00	$7.67
83036 Hemoglobin A1C level	173	120	$85.00	$9.59
G0103 Prostate cancer screening; prostate specific antigen test (psa)	63	63	$40.00	$19.06
G0008 Administration of influenza virus vaccine	51	50	$35.00	$29.31
84153 Psa (prostate specific antigen) measurement, total	36	26	$35.00	$18.16
90662 Influenza vaccine split virus, preservative free	34	33	$85.76	$68.25
99495 Transitional care management services for problem of at least moderate complexity	28	23	$275.00	$204.34
82306 Vitamin d-3 level	23	18	$52.00	$29.25
0241U Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected	18	17	$230.56	$139.86
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	13	13	$100.00	$70.25
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	12	12	$175.00	$167.85
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	11	11	$153.64	$122.55
G0009 Administration of pneumococcal vaccine	11	11	$35.00	$29.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
80053 Blood test, comprehensive group of blood chemicals	368	236	$25.00	$10.56
84443 Blood test, thyroid stimulating hormone (TSH)	308	223	$40.00	$16.75
80061 Blood test, lipids (cholesterol and triglycerides)	303	220	$35.00	$13.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	254	223	$185.00	$129.04
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	239	239	$200.00	$133.63
G0444 Annual depression screening, 5 to 15 minutes	231	231	$25.00	$18.79
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	226	206	$20.00	$7.77
99213 Established patient office or other outpatient visit, typically 15 minutes	217	143	$120.00	$86.33
83036 Hemoglobin A1C level	195	123	$85.00	$9.71
87804 Detection test by immunoassay with direct visual observation for influenza virus	73	32	$30.00	$16.55
G0103 Prostate cancer screening; prostate specific antigen test (psa)	72	72	$40.00	$19.31
85610 Blood test, clotting time	68	11	$25.00	$4.29
84153 Psa (prostate specific antigen) measurement, total	50	37	$35.00	$18.39
G0008 Administration of influenza virus vaccine	48	48	$35.00	$16.98
83718 Hdl cholesterol level	48	48	$20.00	$8.19
82465 Cholesterol level	47	47	$20.00	$4.35
83721 Ldl cholesterol level	44	44	$40.00	$10.50
90662 Influenza vaccine split virus, preservative free	42	42	$72.00	$65.16
99495 Transitional care management services for problem of at least moderate complexity	37	28	$275.00	$199.40
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	37	32	$60.00	$45.23
82306 Vitamin d-3 level	32	25	$52.00	$29.60
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	17	17	$200.00	$169.58
84550 Uric acid level, blood	16	16	$20.00	$4.52
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	16	11	$35.00	$14.29
G0009 Administration of pneumococcal vaccine	15	15	$35.00	$16.95
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$115.00	$115.00
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$175.00	$169.93
93000 Routine ekg using at least 12 leads including interpretation and report	11	11	$62.00	$14.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
80053 Blood test, comprehensive group of blood chemicals	336	239	$25.00	$10.48
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	322	246	$180.22	$108.98
99213 Established patient office or other outpatient visit, typically 15 minutes	303	190	$120.18	$74.69
84443 Blood test, thyroid stimulating hormone (TSH)	261	211	$40.00	$16.65
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	250	250	$193.00	$117.10
G0444 Annual depression screening, 5 to 15 minutes	207	207	$25.00	$18.46
80061 Blood test, lipids (cholesterol and triglycerides)	205	202	$35.00	$13.26
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	190	181	$20.00	$7.72
83036 Hemoglobin A1C level	164	116	$85.00	$9.65
82465 Cholesterol level	124	124	$20.00	$4.33
83718 Hdl cholesterol level	120	120	$20.00	$8.15
83721 Ldl cholesterol level	119	119	$40.00	$10.45
G0103 Prostate cancer screening; prostate specific antigen test (psa)	77	77	$40.00	$19.18
G0008 Administration of influenza virus vaccine	47	46	$33.89	$16.71
84153 Psa (prostate specific antigen) measurement, total	41	33	$35.00	$18.32
90662 Influenza vaccine split virus, preservative free	38	38	$72.00	$60.34
99495 Transitional care management services for problem of at least moderate complexity	30	22	$266.67	$187.55
81002 Urinalysis, manual test	28	24	$17.00	$3.46
84550 Uric acid level, blood	25	20	$20.00	$4.49
82306 Vitamin d-3 level	23	19	$50.96	$29.55
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	22	22	$175.00	$169.02
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	19	17	$27.47	$14.36
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	18	18	$115.00	$115.00
G0009 Administration of pneumococcal vaccine	18	18	$35.00	$16.74
J1040 Injection, methylprednisolone acetate, 80 mg	18	16	$22.00	$11.70
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$200.00	$173.44

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	545	322	$175.00	$108.60
80053 Blood test, comprehensive group of blood chemicals	411	263	$25.00	$11.51
99213 Established patient office or other outpatient visit, typically 15 minutes	363	199	$120.00	$74.06
84443 Blood test, thyroid stimulating hormone (TSH)	331	247	$40.00	$18.23
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	264	239	$20.00	$8.46
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	257	257	$175.00	$116.65
80061 Blood test, lipids (cholesterol and triglycerides)	241	236	$35.00	$14.58
83036 Hemoglobin A1C level	201	132	$85.00	$10.47
G0444 Annual depression screening, 5 to 15 minutes	195	195	$25.00	$18.14
82465 Cholesterol level	159	159	$20.00	$4.74
83721 Ldl cholesterol level	159	158	$40.00	$10.39
83718 Hdl cholesterol level	158	158	$20.00	$8.92
85610 Blood test, clotting time	92	12	$25.00	$4.28
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	91	58	$22.00	$16.59
J1040 Injection, methylprednisolone acetate, 80 mg	76	55	$22.00	$12.12
G0103 Prostate cancer screening; prostate specific antigen test (psa)	76	76	$40.00	$20.03
84153 Psa (prostate specific antigen) measurement, total	55	36	$35.00	$20.03
G0008 Administration of influenza virus vaccine	50	49	$22.00	$16.41
90662 Influenza vaccine split virus, preservative free	47	47	$70.47	$54.67
99495 Transitional care management services for problem of at least moderate complexity	35	31	$250.00	$164.45
84550 Uric acid level, blood	33	25	$20.00	$4.79
81002 Urinalysis, manual test	32	26	$17.00	$3.41
82306 Vitamin d-3 level	31	29	$40.00	$32.23
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	17	17	$175.00	$166.93
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	15	15	$200.00	$172.18
87804 Detection test by immunoassay with direct visual observation for influenza virus	13	13	$30.00	$16.22

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	562	330	$172.78	$103.29
80053 Blood test, comprehensive group of blood chemicals	445	285	$25.00	$12.78
99213 Established patient office or other outpatient visit, typically 15 minutes	367	202	$117.62	$69.79
84443 Blood test, thyroid stimulating hormone (TSH)	337	255	$40.00	$20.33
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	275	249	$20.00	$9.40
80061 Blood test, lipids (cholesterol and triglycerides)	271	257	$35.00	$16.20
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	264	264	$175.00	$111.95
83036 Hemoglobin A1C level	224	140	$85.00	$11.70
G0444 Annual depression screening, 5 to 15 minutes	180	180	$25.00	$17.26
82465 Cholesterol level	171	165	$20.00	$5.23
83718 Hdl cholesterol level	169	163	$20.00	$9.92
83721 Ldl cholesterol level	162	156	$40.00	$11.54
85610 Blood test, clotting time	110	13	$25.00	$4.75
G0103 Prostate cancer screening; prostate specific antigen test (psa)	88	88	$40.00	$22.26
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	86	71	$22.00	$19.56
J1040 Injection, methylprednisolone acetate, 80 mg	83	70	$22.00	$12.81
G0008 Administration of influenza virus vaccine	65	64	$22.00	$20.22
90662 Influenza vaccine split virus, preservative free	59	58	$54.00	$52.08
84153 Psa (prostate specific antigen) measurement, total	52	35	$35.00	$22.26
99495 Transitional care management services for problem of at least moderate complexity	33	30	$250.00	$157.79
82306 Vitamin d-3 level	33	30	$40.00	$35.82
81002 Urinalysis, manual test	33	29	$17.00	$3.31
84550 Uric acid level, blood	29	22	$20.00	$5.47
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	15	15	$200.00	$164.76
80048 Blood test, basic group of blood chemicals (calcium, total)	15	15	$20.00	$10.23
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$175.00	$157.40
87804 Detection test by immunoassay with direct visual observation for influenza virus	14	14	$30.00	$16.22
G0009 Administration of pneumococcal vaccine	14	14	$22.00	$20.22
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	12	12	$111.25	$103.69

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	592	337	$170.29	$103.65
99213 Established patient office or other outpatient visit, typically 15 minutes	504	238	$115.00	$70.41
80053 Blood test, comprehensive group of blood chemicals	454	291	$25.00	$9.37
84443 Blood test, thyroid stimulating hormone (TSH)	331	255	$40.00	$22.53
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	282	282	$175.00	$111.61
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	279	250	$20.00	$10.45
80061 Blood test, lipids (cholesterol and triglycerides)	262	256	$35.00	$14.56
83036 Hemoglobin A1C level	219	139	$85.00	$13.05
G0444 Annual depression screening, 5 to 15 minutes	206	206	$25.00	$17.35
82465 Cholesterol level	185	184	$20.00	$6.11
83721 Ldl cholesterol level	181	179	$40.00	$12.83
83718 Hdl cholesterol level	175	174	$20.00	$11.02
85610 Blood test, clotting time	132	17	$25.00	$5.28
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	94	74	$34.31	$24.43
G0103 Prostate cancer screening; prostate specific antigen test (psa)	87	87	$40.00	$24.73
J1040 Injection, methylprednisolone acetate, 80 mg	86	70	$22.00	$10.88
G0008 Administration of influenza virus vaccine	85	85	$22.00	$21.56
90662 Influenza vaccine split virus, preservative free	66	66	$54.00	$48.05
84153 Psa (prostate specific antigen) measurement, total	57	38	$35.00	$24.73
80048 Blood test, basic group of blood chemicals (calcium, total)	37	30	$20.00	$11.17
36415 Insertion of needle into vein for collection of blood sample	33	30	$5.00	$2.94
82306 Vitamin d-3 level	31	28	$40.00	$36.53
81002 Urinalysis, manual test	30	24	$17.00	$3.43
84550 Uric acid level, blood	30	22	$20.00	$5.67
99495 Transitional care management services for problem of at least moderate complexity	25	20	$250.00	$158.17
77080 Dxa bone density measurement of hip, pelvis, spine	25	25	$254.00	$39.57
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	22	22	$100.00	$94.89
G0009 Administration of pneumococcal vaccine	22	22	$22.00	$21.56
87804 Detection test by immunoassay with direct visual observation for influenza virus	18	17	$30.00	$16.11
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	17	17	$175.00	$159.59
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	12	$81.00	$52.08
93000 Routine ekg using at least 12 leads including interpretation and report	13	13	$62.00	$16.42
Q2039 Influenza virus vaccine, not otherwise specified	12	12	$27.00	$22.33

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License TX L7333

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.

Hospital & Practice Group Affiliations

Catalyst Physician Group - Ntx, Pllc

469 Westpark Way, Euless, TX 760403957

Phone: 8172832888

Practice Associates & Co-Workers

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

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Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active March 11, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location March 11, 2011

Registered at 479 WESTPARK WAY, EULESS, TX 76040 (Tel: 8173585500)

📍

Updated Business Mailing Address March 11, 2011

Registered at 479 WESTPARK WAY, EULESS, TX 76040 (Tel: 8173585500)

👤

Provider Name / Credentials Updated March 11, 2011

Recorded as RONALD CHIO, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 11, 2011

Internal Medicine (License #L7333 in TX)

🟢

Initial NPI Registration & Enumeration June 20, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1780620823

Entity Type:

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

Enumeration Date: June 20, 2006

Last Update: March 11, 2011

Sole Proprietor: No

Update or Correct Profile

Mailing Address

479 Westpark Way

Euless, TX 76040

Phone: 8173585500

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.