⚠️

Risk scores are statistical indicators based on prescribing patterns compared to specialty peers. They are NOT allegations of fraud, misconduct, or improper care. Many legitimate medical reasons can explain outlier prescribing.

Read our methodology →

Nicholas BirlewD.O.

Family Practice · Stockton, CA 95209

NPI: 1821188483

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29

🟡 Moderate

🚫 This provider appears on the OIG List of Excluded Individuals/Entities (LEIE)

Exclusion type: 1128(b)(4) — License Revocation/Suspension · Date: 05/20/2025 · State: NV

Risk Flags

Elevated antipsychotic prescribing (65+)OIG Excluded Provider

Risk indicators are statistical patterns, not allegations. Learn more

12,456

Total Claims

$924K

Drug Cost

1,222

Beneficiaries

$756

Cost/Patient

Risk Score Breakdown 29/100

Low (0)Moderate (15)Elevated (30)High (50+)
OIG excluded provider+20
Elderly antipsychotic prescribing+5

Score components are additive. Read full methodology

Peer Comparison vs. 106,889 Family Practice providers

+314%

Opioid rate vs peers

10.7% vs 2.6% avg

-29%

Cost per patient vs peers

$756 vs $1,068 avg

+10%

Brand preference vs peers

9.9% vs 9.0% avg

🔎 Data Overview

🚫

This provider appears on the federal OIG exclusion list, meaning they have been formally barred from participating in federal healthcare programs due to fraud, patient abuse, licensing issues, or other misconduct. The fact that they still appear in active prescribing data is a significant concern.

💊

Opioid rate is 314% above Family Practice peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.

Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.

Opioid Prescribing

10.7%

Opioid Rate

1,331

Opioid Claims

$41K

Opioid Cost

Long-Acting Rate

Brand vs Generic

90% generic

Brand: 1,220 claims · $657K

Generic: 11,129 claims · $263K

Patient Profile

73

Avg Age

53%

Female

1.40

Avg Risk Score

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Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations of wrongdoing.Methodology · About · Dispute this data