Cividanes, Nicole

Cividanes, Nicole was paid $149K by Medicaid between Dec 2018 and Mar 2022, across 15 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 21% of everything it billed.

33Billing provider infoCIVIDANES, NICOLE
BREWER, ME 04412

33aNPI1720335748assigned 08/08/2012

33bProvider typeGeneral Practice Dentistry

28Total paid$149K

24GClaims5,850

24DCodes billed15

24AFirst – last monthDec 2018 – Mar 2022

Compared with peers

Next to other General Practice Dentistry providers in Maine

Rank by total paid#12 of 44

Median peer was paid$10K

This provider vs. median15×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	12	$240.00
2019	395	$4K
2020	1,275	$30K
2021	3,944	$110K
2022	224	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0150	Comprehensive oral evaluation - new or established patient	21%	655	624	$32K
D1120	Dental cleaning, childProphylaxis - child	13%	712	654	$19K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	12%	202	113	$18K
D7140	Extraction, erupted tooth or exposed root	10%	180	58	$16K
D1330		8.7%	1,018	940	$13K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	7.1%	431	388	$11K
D1110	Prophylaxis - adult	7.1%	352	335	$11K
D0140	Limited oral evaluation - problem focused	5.7%	472	421	$9K
D1206	Topical application of fluoride varnish	5.5%	761	701	$8K
D0274	Bitewings - four radiographic images	3.3%	263	254	$5K
D0220	Intraoral - periapical first radiographic image	2.8%	539	358	$4K
D1320		1.6%	124	118	$2K

3 more codes

D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	19	$1K
D0272	Bitewings - two radiographic images	<1%	52	$750.00
D0230	Intraoral - periapical each additional radiographic image	<1%	70	$442.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.