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Bilegsaikhan Balkhaa, MD

Internal Medicine · Mountain View

NPI 1982098885

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
Not verified
Not the same as out of network.
Offices
2

Offices

2 locations · Quantum Bay Area Hospitalist Medical Group Inc · 60 clinicians in this group

Looking this up.

Hospitals listed: El Camino Health · 05t248. That is not proof they admit you there this week.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Balkhaa’s office to ask if they take your plan before you enroll.

California Medical Board record

Licence A155469 · Current

Licensed to practise in California · since 2018 · expires 2027-07-31 · Ross University School of Medicine.

No disciplinary actions, convictions, malpractice judgments or citations in this record.

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score
72.0 / 100
Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • El Camino HealthMountain View, CAAcute Care Hospital · Government - Hospital District or Authority · Has an emergency department · Birthing-friendlyPart of El Camino Health, which runs 2 hospitalsPatients rate it 4 of 5 · 80% would definitely recommend it
    Overall rating: 4 of 5 starsBetter than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.291, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.393, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0, Oct 2024 – Sep 2025
See every measure and the patient survey for El Camino Health

Behind the star rating — Deaths: 3 better, 5 the same, 0 worse of 8 measures. Safety: 3 better, 5 the same, 0 worse of 8 measures. Readmissions: 1 better, 9 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at El Camino Health
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.291BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.393BetterOct 2024 – Sep 2025
MRSA BacteremiaInfections0BetterOct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths0.96 (0.12 to 1.79) · 2,340 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths1.02 (0.76 to 1.28)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths167.38 (125.03 to 209.73) · 96 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths2.6 · 68 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths7.1 · 185 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths11.8 · 200 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths8.9 · 814 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths13 · 842 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths9.6 · 361 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths2.6 · 4,633 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.16 (0 to 0.34) · 11,474 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.27 (0.1 to 0.45) · 11,626 casesNo differentJul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths3.14 (1.39 to 4.9) · 2,814 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths2 (0.61 to 3.39) · 1,327 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.11 (0.8 to 3.43) · 2,641 casesNo differentJul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths9.39 (4.18 to 14.6) · 1,287 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths6.57 (3.47 to 9.68) · 1,308 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths2.14 (0.71 to 3.57) · 827 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.6 (0.05 to 1.15) · 9,460 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths4.5 · 122 casesNoneApr 2023 – Mar 2025
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.993No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections0.706No differentOct 2024 – Sep 2025
SSI - Colon SurgeryInfections1.376No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits15.5 · 218 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits19.5 · 962 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits3.8 · 200 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits-17 · 922 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits18.6 · 860 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits18.7 · 827 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits6.1 (4.5 to 8.2) · 313 casesNo differentJan 2024 – Dec 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits13.4 (10.6 to 16.5) · 313 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits6.1 · 144 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits10.3 · 80 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits20.7 · 237 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits12.8 (10 to 16.1) · 1,639 casesNo differentJan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits0.9 (0.8 to 1.1) · 1,619 casesNo differentJan 2024 – Dec 2024

What patients said (1,535 patients answered, 22% of those asked)

Patient survey stars by topic at El Camino Health
Cleanliness4
Nurse communication4
Doctor communication4
Communication about medicines3
Discharge information3
Overall hospital rating4
Quietness2
Recommend hospital5
Share of patients giving the best answer at El Camino Health
Room was "always" clean75%
Nurses "always" communicated well79%
Doctors "always" communicated well81%
Staff "always" explained61%
Yes, staff "did" give patients this information86%
Yes, staff "did" give patients information about help after discharge86%
Doctors "always" explained things so they could understand76%
Doctors "always" listened carefully80%
Doctors "always" treated them with courtesy and respect87%
Patients who gave a rating of "9" or "10" (high)76%
Staff "always" explained new medications76%
Nurses "always" explained things so they could understand75%
Nurses "always" listened carefully76%
Nurses "always" treated them with courtesy and respect87%
"Always" quiet at night47%
"YES", patients would definitely recommend the hospital80%
Staff "always" explained possible side effects46%
Yes, staff "did" give patients information about possible symptoms86%

Original Medicare doctor bills

$59,970

Medicare paid this office $59,970 for 205 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes133$24,565$70
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes95$23,684$106
Hospital discharge day management, more than 30 minutes66$7,078$104
Initial hospital care with moderate level of medical decision making at least 75 minutes28$4,338$155

Who their Medicare patients are

205 Original Medicare patients in 2024. Average age 76 · Under 65 10% · 85 and older 24% · Women 49% · Also on Medicaid 44% · Health risk score 2.81. Above the middle of the specialty; the typical internal medicine clinician is at 1.76.

Conditions among them: High blood pressure 75% · Diabetes 50% · Coronary heart disease 49% · Chronic kidney disease 48% · Heart failure 46% · Depression 40% · Atrial fibrillation 39% · Dementia 37% · COPD 32% · Stroke 29% · Cancer 21%.

The office billed $333,053, Medicare allowed $75,269 and paid $59,970; for 673 services of 6 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
2024205673762.81$333,053$59,970
2023223722752.30$401,961$65,163
2022228795782.45$384,332$72,320
2021202661782.33$331,292$60,484
2020280972772.77$493,619$96,248
2019354935792.53$491,357$96,519
201874217782.46$101,453$20,726

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 5 services

Original Medicare services billed in 2023
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes149$40,186$96
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes84$11,925$68
Hospital discharge day management, more than 30 minutes77$7,315$95
Initial hospital care with moderate level of medical decision making at least 75 minutes30$4,237$141
Hospital discharge day management, 30 minutes or less16$1,036$65

2022: 5 services

Original Medicare services billed in 2022
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes181$47,287$96
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes71$11,149$65
Hospital discharge day management, more than 30 minutes84$8,552$99
Initial hospital care with moderate level of medical decision making at least 75 minutes15$2,721$181
Hospital observation care on day of discharge12$807$67

2021: 5 services

Original Medicare services billed in 2021
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes166$36,976$95
Hospital discharge day management, more than 30 minutes81$8,380$100
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes63$8,150$66
Follow-up observation care per day, typically 35 minutes12$1,993$95
Hospital observation care on day of discharge15$1,013$68

2020: 7 services

Original Medicare services billed in 2020
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes199$53,430$98
Hospital discharge day management, more than 30 minutes125$13,890$103
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes75$10,882$68
Critical care, first 30-74 minutes21$9,131$203
Initial hospital care with moderate level of medical decision making at least 75 minutes15$2,801$187
Follow-up observation care per day, typically 35 minutes22$2,218$96
Hospital observation care on day of discharge28$1,918$69

2019: 7 services

Original Medicare services billed in 2019
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes206$43,981$93
Initial hospital care with moderate level of medical decision making at least 75 minutes105$19,534$181
Hospital discharge day management, more than 30 minutes99$10,260$98
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes71$7,741$65
Initial hospital observation care per day, typically 70 minutes27$4,482$166
Follow-up observation care per day, typically 35 minutes22$3,056$93
Hospital observation care on day of discharge32$2,130$67

2018: 3 services

Original Medicare services billed in 2018
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes46$10,766$94
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes24$2,680$65
Hospital discharge day management, more than 30 minutes25$2,469$99

Medicaid work

$7,453 in 2024

Medicaid paid $7,453 for 366 billed services this clinician did in 2024, up to 27 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES266$5,519
SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES54$1,475
SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES34$357
Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter12$101
Medicaid work by year
2024366427$7,453
2023276320$8,317
2022355229$6,524
2021327326$4,608
2020385326$7,003
2019313421$5,327
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES237$7,099
SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES20$737
SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES19$481

2022

Largest Medicaid services in 2022
SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES309$5,625
SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES46$899

2021

Largest Medicaid services in 2021
SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES265$3,633
Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter41$625
SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES21$351

2020

Largest Medicaid services in 2020
SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES306$5,829
Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter44$951
SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES35$223

2019

Largest Medicaid services in 2019
SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES228$3,438
1ST HOSP IP/OBS HIGH 7533$945
SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES25$650
Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter27$294

Drugs they prescribed that Part D paid

$13,679

Pharmacies billed $13,679 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 8% of their Part D prescriptions (23 of 291) in 2024. A higher opioid share than 9 in 10 peers; the typical internal medicine clinician is at 1%.

257 generic and fewer than 11 brand-name prescriptions · $13,679 in drug cost · 28 antibiotic prescriptions to 24 people.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Gabapentin12$137$11
Pantoprazole15$75$5
Amlodipine Besylate12$55$5
Metformin11$38$3

Year by year

Part D prescribing by year
2024291948% (23)None$13,679
20232861037% (19)None$28,110
2022188787% (13)10%$10,974
202117371NoneNone$11,543
2020293106NoneNone$11,376
201917070NoneNone$8,880
201814936NoneNone$9,902
2017176290% (0)None$5,521
201622227None24%$13,296
20157814None27%$6,177

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 2 drugs

Part D drugs prescribed in 2023
Eliquis11$7,139$649
Amlodipine Besylate13$77$6

2022: 2 drugs

Part D drugs prescribed in 2022
Pantoprazole12$99$8
Furosemide12$26$2

2021: 1 drug

Part D drugs prescribed in 2021
Pantoprazole11$153$14

2020: 3 drugs

Part D drugs prescribed in 2020
Atorvastatin18$118$7
Pantoprazole17$96$6
Furosemide14$30$2

2019: 1 drug

Part D drugs prescribed in 2019
Pantoprazole13$85$7

2018: 1 drug

Part D drugs prescribed in 2018
Atorvastatin18$161$9

2017: 2 drugs

Part D drugs prescribed in 2017
Duloxetine16$830$52
Atorvastatin15$118$8

2016: 3 drugs

Part D drugs prescribed in 2016
Atorvastatin25$210$8
Allopurinol16$160$10
Metformin14$60$4

Money from drug and device companies

$97 in 2023

A payment is not proof that care is biased.

Payments by company
VivusQsymia$97
1 payment
  • Meals for Qsymia · 2023-10-28 · $97
See the published payment
Every published payment
VivusMeals · 2023-10-28Qsymia$97

Professional record

NPI
1982098885
Licence
CA A155469California A155469: Current · expires 2027-07-31
Gender
Female
More record details
Sole proprietor
No
Taxonomy
Internal medicine (207R00000X)
Mailing address
2500 Hospital Dr Bldg 4, Mountain View, CA, 94040
NPI first listed
2015-03-27
NPI last updated
2025-04-08
NPI record certified
2025-04-08

This is when the NPI record was last certified, not a medical board exam.

Extra NPI addresses: 2500 Grant Rd, Mountain View, CA, 94040