Providers
PATRICIA MARIE LUTFY, M.D.
NPI 1497024061, individual, Crescent City, CA, Physical Medicine & Rehabilitation
5
Evidence tier
informational
score 30 of 100, rank 11565, $136K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PATRICIA MARIE LUTFY, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | December 27, 2011, last updated April 14, 2016 |
| Practice location | 800 E WASHINGTON BLVD, Crescent City, CA 95531-8359, 707-464-8989 |
| Mailing address | 616 FM 1960 W, 230, Houston, TX 77090 |
| Specialties | Physical Medicine & Rehabilitation (208100000X, primary, license 133725 CA) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $162K | 54% | $104 | $60 (top 5% from $133) | 88th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $85K | 28% | $76 | $44 (top 5% from $110) | 86th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $33K | 11% | $95 | $67 (top 5% from $121) | 84th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $15K | 5% | $163 | $95 (top 5% from $171) | too few months to rank | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $4K | 1% | $51 | $28 (top 5% from $147) | too few months to rank | |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | $1K | 0% | $96 | $57 (top 5% from $195) | too few months to rank | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $187 | 0% | $13 | $14 (top 5% from $58) | too few months to rank | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | $26 | 0% | $1.00 | $0.62 (top 5% from $14) | too few months to rank |
In this area
2 providers in Del Norte County, CA carry an indicator in the public record, with $785 at stake between them. The most common is part of a provider network, on 1 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | SUTTER COAST HOSPITAL Crescent City, CA, ranked 5326 | $0 |
|
| 4 | CLINT PEARSON Crescent City, CA, ranked 9774 | $785 |
|
Recent enforcement in CA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 27, 2026
Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare
Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit
Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit
Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.