DR. CRAIG MICHAEL RUNDBAKEN DO
NPI 1720072903
Internal Medicine - Pulmonary Disease in Sun City West, AZ

Medicare Participation & PECOS Enrollment Status

Craig Rundbaken 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.

Craig Rundbaken 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: 8022906601

  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: I20040305000700

  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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Other DME (DE001N)

  Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

  20 DME suppliers used 836 Medicare Claims 836 Services Paid

• DME-Other DME (DE000N)

  Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)

  8 DME suppliers used 154 Medicare Claims 299 Services Paid

• DME-Other DME (DE000N)

  Small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7004)

  1 DME suppliers used 75 Medicare Claims 150 Services Paid

• DME-Other DME (DE000N)

  Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable (HCPCS:A7005)

  8 DME suppliers used 58 Medicare Claims 58 Services Paid

• DME-Other DME (DE000N)

  Filter, disposable, used with aerosol compressor or ultrasonic generator (HCPCS:A7013)

  3 DME suppliers used 29 Medicare Claims 115 Services Paid

• DME-Other DME (DE000N)

  Aerosol mask, used with dme nebulizer (HCPCS:A7015)

  2 DME suppliers used 46 Medicare Claims 47 Services Paid

• DME-Other DME (DE001N)

  Full face mask used with positive airway pressure device, each (HCPCS:A7030)

  17 DME suppliers used 451 Medicare Claims 451 Services Paid

• DME-Other DME (DE001N)

  Face mask interface, replacement for full face mask, each (HCPCS:A7031)

  14 DME suppliers used 456 Medicare Claims 1219 Services Paid

• DME-Other DME (DE001N)

  Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

  24 DME suppliers used 393 Medicare Claims 2007 Services Paid

• DME-Other DME (DE001N)

  Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)

  13 DME suppliers used 245 Medicare Claims 1347 Services Paid

• DME-Other DME (DE001N)

  Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

  31 DME suppliers used 653 Medicare Claims 653 Services Paid

• DME-Other DME (DE001N)

  Headgear used with positive airway pressure device (HCPCS:A7035)

  34 DME suppliers used 623 Medicare Claims 623 Services Paid

• DME-Other DME (DE001N)

  Chinstrap used with positive airway pressure device (HCPCS:A7036)

  8 DME suppliers used 36 Medicare Claims 36 Services Paid

• DME-Other DME (DE001N)

  Tubing used with positive airway pressure device (HCPCS:A7037)

  25 DME suppliers used 172 Medicare Claims 172 Services Paid

• DME-Other DME (DE001N)

  Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

  34 DME suppliers used 944 Medicare Claims 5487 Services Paid

• DME-Other DME (DE001N)

  Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

  19 DME suppliers used 60 Medicare Claims 60 Services Paid

• DME-Other DME (DE001N)

  Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

  25 DME suppliers used 455 Medicare Claims 455 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

  8 DME suppliers used 117 Medicare Claims 127 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable oxygen contents, gaseous, 1 month's supply = 1 unit (HCPCS:E0443)

  2 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Other DME (DE005N)

  Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)

  1 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Other DME (DE001N)

  Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0470)

  7 DME suppliers used 212 Medicare Claims 212 Services Paid

• DME-Other DME (DE001N)

  Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0471)

  4 DME suppliers used 65 Medicare Claims 67 Services Paid

• DME-Other DME (DE000N)

  High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each (HCPCS:E0483)

  3 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Other DME (DE000N)

  Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment (HCPCS:E0486)

  1 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Other DME (DE001N)

  Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

  8 DME suppliers used 115 Medicare Claims 115 Services Paid

• DME-Other DME (DE001N)

  Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

  2 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Other DME (DE000N)

  Nebulizer, with compressor (HCPCS:E0570)

  10 DME suppliers used 306 Medicare Claims 307 Services Paid

• DME-Other DME (DE001N)

  Continuous positive airway pressure (cpap) device (HCPCS:E0601)

  12 DME suppliers used 977 Medicare Claims 977 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  18 DME suppliers used 1208 Medicare Claims 1221 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Portable oxygen concentrator, rental (HCPCS:E1392)

  10 DME suppliers used 789 Medicare Claims 797 Services Paid

• DME-Other DME (DE000N)

  Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary (HCPCS:G0333)

  10 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Other DME (DE000N)

  Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each (HCPCS:K0552)

  3 DME suppliers used 14 Medicare Claims 54 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:K0738)

  5 DME suppliers used 89 Medicare Claims 89 Services Paid

• DME-Other DME (DE000N)

  Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

  30 DME suppliers used 562 Medicare Claims 562 Services Paid

• DME-Other DME (DE000N)

  Pharmacy dispensing fee for inhalation drug(s); per 90 days (HCPCS:Q0514)

  15 DME suppliers used 38 Medicare Claims 38 Services Paid

Unknown

• Treatment-Injections and Infusions (nononcologic) (RI008N)

  Injection, immune globulin (cuvitru), 100 mg (HCPCS:J1555)

  2 DME suppliers used 13 Medicare Claims 3840 Services Paid

Drugs Administered Through DME

• DME-Drugs Administered Through DME (DG006N)

  Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms (HCPCS:J7605)

  8 DME suppliers used 34 Medicare Claims 3000 Services Paid

• DME-Drugs Administered Through DME (DG006N)

  Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms (HCPCS:J7606)

  4 DME suppliers used 312 Medicare Claims 18120 Services Paid

• DME-Drugs Administered Through DME (DG006N)

  Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

  27 DME suppliers used 103 Medicare Claims 25889 Services Paid

• DME-Drugs Administered Through DME (DG006N)

  Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

  22 DME suppliers used 172 Medicare Claims 20037 Services Paid

• DME-Drugs Administered Through DME (DG000N)

  Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

  10 DME suppliers used 292 Medicare Claims 16476 Services Paid

• DME-Drugs Administered Through DME (DG006N)

  Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram (HCPCS:J7644)

  4 DME suppliers used 12 Medicare Claims 714 Services Paid

• DME-Drugs Administered Through DME (DG006N)

  Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram (HCPCS:J7677)

  4 DME suppliers used 95 Medicare Claims 498750 Services Paid

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.

Device supply with scheduled recording and transmission for remote monitoring of respiratory system, per 30 days

This service involves providing a device that records and transmits data about your respiratory system. It helps in remote monitoring of your breathing patterns for a period of 30 days. This method aids in early detection of any potential respiratory issues.

This service was performed 24 times for 24 patients

Established patient office or other outpatient visit, 20-29 minutes

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 433 times for 398 patients

Established patient office or other outpatient visit, 30-39 minutes

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 3,012 times for 1,628 patients

Exam of lung airways using an endoscope

This procedure, known as a bronchoscopy, involves a doctor examining your lung airways with a thin tube called an endoscope. It helps detect any issues in your lungs or airways, such as infections or blockages. It's a safe, routine procedure.

This service was performed 24 times for 23 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 54 times for 53 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 133 times for 101 patients

Injection, dexamethasone sodium phosphate, 1 mg

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

This service was performed 917 times for 102 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 142 times for 142 patients

New patient office or other outpatient visit, 45-59 minutes

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 443 times for 443 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 125 times for 120 patients

Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month

Principal care management services focus on managing a single high-risk disease. This involves a health care professional directing clinical staff for the first 30 minutes each month. The aim is to monitor your health, coordinate care, and provide necessary support for your disease management.

This service was performed 38 times for 38 patients

Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month

Remote therapeutic monitoring treatment management services involve a healthcare professional monitoring your health data remotely. This could include vital signs or other health information. The professional will manage your treatment for the first 20 minutes each month, adjusting as necessary based on the data received.

This service was performed 48 times for 43 patients

Set-up and patient education for remote monitoring of therapy

Remote therapy monitoring involves using digital devices to track your health and treatment progress from home. You'll receive a device to record health data, like heart rate or blood sugar. This data is shared with your healthcare team, allowing them to adjust your treatment as needed.

This service was performed 44 times for 44 patients

Sleep study including heart rate, breathing, and sleep time

A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.

This service was performed 92 times for 92 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 281 times for 112 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 214 times for 155 patients

Test to determine lung volumes using sensors

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

This service was performed 512 times for 507 patients

Test to examine how well the lungs exchange gases

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

This service was performed 512 times for 507 patients

Test to measure expiratory airflow and volume

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

This service was performed 640 times for 614 patients

Test to measure expiratory airflow and volume changes before and after medication administration

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

This service was performed 504 times for 497 patients

Test to measure oxygen level in blood using ear or finger device continuously overnight

This procedure involves using a small device, placed on your ear or finger, to continuously monitor your blood oxygen level overnight. It's painless, non-invasive, and helps assess your body's oxygen supply during sleep.

This service was performed 13 times for 11 patients

Test to measure rate of airflow

This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.

This service was performed 36 times for 36 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.92 for a new patient copayment and $24.5 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 85375 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 76.5, 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: 76.5 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: 68.36

  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: N/A

  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: 59.46

  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: 59.46

  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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number

03D2343083

Facility Type

Physician Office

Certificate Effective Date

May 01, 2026

Certificate Expiration Date

April 30, 2028

Laboratory Director

CRAIG M. RUNDBAKEN

Certificate Type

Certificate of Waiver

Certificate Type Description

This CLIA certificate is issued to Craig Rundbaken to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for DR. CRAIG MICHAEL RUNDBAKEN DO

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

Frequently Asked Questions