PROF. ROBERT LINGLE II MD
NPI 1992931133
Internal Medicine - Cardiovascular Disease in Humble, TX

Medicare Participation & PECOS Enrollment Status

Robert Lingle is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Robert Lingle is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 8123172335

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20090821000181

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Blood creatinine level

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

This service was performed 11 times for 11 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 58 times for 51 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 49 times for 44 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 48 times for 45 patients

Ct scan of abdominal aorta and both leg arteries with contrast

A CT scan of the abdominal aorta and both leg arteries with contrast is a medical imaging procedure. A special dye is injected to make your blood vessels visible on the scan. This helps to check for any blockages or abnormalities in these areas.

This service was performed 43 times for 41 patients

Ct scan of blood vessels and grafts of heart with contrast

A CT scan of the heart's blood vessels and grafts with contrast is a diagnostic test. A special dye (contrast) is injected into your veins, which helps create clear images of your heart's vessels and grafts. This helps doctors detect blockages or other abnormalities.

This service was performed 194 times for 194 patients

Ct scan of blood vessels of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is a medical imaging procedure. A special dye, called contrast, is used to make blood vessels more visible. The scan produces detailed images of your abdomen and pelvis, helping doctors to diagnose conditions or plan treatments.

This service was performed 109 times for 104 patients

Ct scan of blood vessels of chest with contrast

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

This service was performed 113 times for 110 patients

Ct scan of blood vessels of neck with contrast

A CT scan of the neck's blood vessels with contrast is a diagnostic procedure. It uses X-rays and a special dye to create detailed images of your neck's blood vessels. This helps doctors detect issues such as blockages or abnormalities.

This service was performed 48 times for 48 patients

Ct scan of chest without contrast

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

This service was performed 69 times for 68 patients

Ct scan of heart structure with contrast

A CT scan of the heart with contrast is a non-invasive test. A dye is injected into your veins, which helps to highlight heart structures in the images. The CT scanner uses X-rays to create detailed pictures of your heart, aiding in diagnosis.

This service was performed 55 times for 53 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 211 times for 156 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 305 times for 188 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

This service was performed 74 times for 74 patients

Heart rhythm recording, analysis, report, review, and interpretation of continous external ekg over more than 48 hours up to 7 days

This procedure involves wearing a device for up to 7 days to continuously record your heart's electrical activity. The data collected helps in understanding your heart's rhythm and detecting irregularities if any. The results are then analyzed, reported, and interpreted by experts.

This service was performed 22 times for 21 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 15 times for 15 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 24 times for 23 patients

Injection of additional new drug or substance into vein

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

This service was performed 72 times for 71 patients

Injection of drug or substance into vein

This procedure involves introducing a medication or substance directly into your vein using a syringe. It's a quick and efficient way to deliver treatment throughout your body. You might feel a small prick when the needle enters. It's generally safe and effective.

This service was performed 466 times for 433 patients

Injection, regadenoson, 0.1 mg

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

This service was performed 116 times for 29 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 70 times for 62 patients

Low dose ct scan of chest for lung cancer screening

A low-dose CT scan of the chest is a quick, painless procedure that uses a small amount of radiation to create detailed images of your lungs. It's a key tool for early detection of lung cancer, especially for those at high risk.

This service was performed 19 times for 19 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 42,616 times for 447 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 48 times for 48 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

This service was performed 58 times for 58 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 392 times for 263 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 123 times for 112 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 130 times for 97 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 31 times for 26 patients

Technetium tc-99m sestamibi, diagnostic, per study dose

Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.

This service was performed 63 times for 59 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 41 times for 41 patients

Unclassified drugs

Unclassified drugs are medications that don't fit into an existing category or class due to their unique properties or uses. They may be used for various conditions and their effects may differ widely. Always ask your healthcare provider for more information about these drugs.

This service was performed 75 times for 71 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $33.51 for a new patient copayment and $18.15 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 77338 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 80.22, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 80.22 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: 62.19

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: 97

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: 40

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Robert Lingle is affiliated with the following medical facilities:

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Frequently Asked Questions