Medicare Enrolled

Dr. Joseph Modica, MD

Neurology · Rochester, NY
Practice pattern: Mixed Practice — Diverse clinical practice across multiple procedure types
601 ELMWOOD AVE, Rochester, NY 14642
5853417500
Registered in NPPES since 2017
NPI: 1023545654 verify on NPPES ↗
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating. This page presents federal public records about Dr. Modica from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Modica

Dr. Joseph Modica is a neurology specialist in Rochester, NY, with 9 years of NPI registration. Based on federal Medicare data, Dr. Modica performed 3,531 Medicare services in 2023. These records do not provide a deduplicated patient total.

Between the years covered by Open Payments, Dr. Modica received a total of $4,327 from 36 pharmaceutical and/or device companies across 206 payment records. A record can group multiple payments. These transfers are publicly reported through CMS Open Payments. Disclosure alone does not establish their effect on care. A reliable breakdown by payment category is not available in this snapshot. Patients may wish to discuss these relationships with their provider.

The Data Coverage level for Dr. Modica is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.

✓ 9 years of NPI registration ▲ Top 14% volume in NY $4,327 industry payments

Medicare Practice Summary — 2023

Medicare Utilization ↗
3,531
Medicare services
Top 14% in NY for neurology
Not available
Unique patients (not deduplicated)
$43
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →

Top procedures by volume

Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.

Procedure Volume Avg. paid Avg. submitted
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg 2,960 $38 $65
Office visit, established patient (30-39 min)
A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition.
98 $89 $150
Office visit, established patient, complex (40-54 min)
An office or outpatient visit for an existing patient lasting between 40 and 54 minutes. This level of service is determined by the total time spent on the date of the encounter.
64 $124 $200
Normal saline infusion, 250 cc
Administration of 250 cubic centimeters of normal saline solution into a vein. This procedure involves the intravenous delivery of a sterile saltwater fluid.
61 $0 $6
Additional hour of intravenous infusion
This code represents each additional hour of intravenous infusion beyond the initial hour for therapy, prevention, or diagnosis.
56 $15 $53
New patient office visit (45-59 min)
An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter.
55 $113 $225
Intravenous infusion, 1 hour or less
Administration of medication or fluid directly into a vein for therapeutic, preventive, or diagnostic purposes. The procedure lasts one hour or less.
46 $47 $125
Intravenous chemotherapy infusion, 1 hour or less
Administration of chemotherapy medication directly into a vein. The procedure takes one hour or less to complete.
39 $96 $220
New patient office visit, complex (60-74 min) 37 $148 $275
Intravenous injection of additional new drug or substance
Administration of an additional new medication or substance directly into a vein.
34 $10 $34
Office visit, established patient (20-29 min)
An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition.
33 $65 $100
Ketorolac injection, per 15 mg
An injection of ketorolac tromethamine, a nonsteroidal anti-inflammatory drug, administered in doses measured per 15 mg.
30 $0 $2
Additional sequential IV infusion, 1 hour or less
This code represents an additional intravenous infusion administered sequentially to a primary infusion. It covers the administration time of one hour or less.
18 $18 $53
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. These counts do not measure clinical quality or years of experience.
6.2% high complexity
85.6% medium
8.1% routine

Industry Payment Transparency

Open Payments through 2024 ↗
$4,327
Total received (2022-2024)
Avg $1,442/year across 3 years
Top 35% in NY for neurology
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
36
Companies
206
Payment records
Payments are publicly reported; disclosure does not establish legality · Not evidence of wrongdoing · How to interpret →

Payment categories are unavailable while the source breakdown is being rebuilt. Company and year totals do not identify how much belongs to each category.

Payment trend by year

Annual totals from pharmaceutical and medical device companies.

2024
$2,136
2023
$1,768
2022
$423

Payments by company (2024)

Teva Pharmaceuticals USA, Inc.
$282
ABBVIE INC.
$278
Collegium Pharmaceutical, Inc.
$170
JAZZ PHARMACEUTICALS INC.
$169
UCB, Inc.
$166
Lundbeck LLC
$149
REVANCE THERAPEUTICS, INC.
$140
Neurocrine Biosciences, Inc.
$119
Amneal Pharmaceuticals LLC
$92
CSL Behring
$82
Averitas Pharma Inc.
$63
Kyowa Kirin, Inc.
$47
Amgen Inc.
$47
Axsome Therapeutics, Inc.
$45
Lilly USA, LLC
$40
SK Life Science, Inc.
$34
PFIZER INC.
$32
GE HEALTHCARE
$28
Eisai Inc.
$23
CATALYST PHARMACEUTICALS, INC.
$21
LivaNova USA, Inc.
$21
HARMONY BIOSCIENCES LLC
$20
Otsuka America Pharmaceutical, Inc.
$19
Neurelis, Inc.
$18
SCILEX PHARMACEUTICALS INC.
$16
VERTEX PHARMACEUTICALS INCORPORATED
$15
Top 3 companies account for 34.2% of 2024 payments
All-time payments by company (2022-2024) ›
Teva Pharmaceuticals USA, Inc.
$674
ABBVIE INC.
$503
Collegium Pharmaceutical, Inc.
$277
Amneal Pharmaceuticals LLC
$275
Neurocrine Biosciences, Inc.
$257
Lundbeck LLC
$249
Medtronic, Inc.
$243
JAZZ PHARMACEUTICALS INC.
$219
UCB, Inc.
$216
Abbott Laboratories
$202
CSL Behring
$167
REVANCE THERAPEUTICS, INC.
$140
Kyowa Kirin, Inc.
$112
Corium, LLC
$64
SK Life Science, Inc.
$64
Averitas Pharma Inc.
$63
Amgen Inc.
$62
Otsuka America Pharmaceutical, Inc.
$60
Axsome Therapeutics, Inc.
$60
Lilly USA, LLC
$54
Neurelis, Inc.
$52
PFIZER INC.
$32
GE HEALTHCARE
$28
Boston Scientific Corporation
$25
Eisai Inc.
$23
CATALYST PHARMACEUTICALS, INC.
$21
LivaNova USA, Inc.
$21
Acorda Therapeutics, Inc
$21
HARMONY BIOSCIENCES LLC
$20
GE HealthCare
$20
Scilex Pharmaceuticals Inc.
$19
Harmony Biosciences LLC
$18
Alexion Pharmaceuticals, Inc.
$17
MITSUBISHI TANABE PHARMA AMERICA, INC.
$17
SCILEX PHARMACEUTICALS INC.
$16
VERTEX PHARMACEUTICALS INCORPORATED
$15
Top 3 companies account for 33.6% of all-time payments
Associated products mentioned in payments ›
ACTIVA PC · ADLARITY · AJOVY · AMYVID · AUSTEDO · AVASTIN · Aimovig · Austedo XR · BOTOX · Belbuca · Briviact · DAXXIFY · DUOPA · EMGALITY · EPIDIOLEX · FIRDAPSE · Hizentra · INBRIJA · INFINITY · INGREZZA · KOSELUGO · LYVISPAH · Leqembi · NOURIANZ · NUEDEXTA · NURTEC ODT · Nayzilam · Nourianz · Ongentys · QULIPTA · QUTENZA · RADICAVA · REXULTI · RYTARY · Sunosi · UBRELVY · UPLIZNA · VALTOCO · VNS THERAPY SENTIVA MODEL 1000 GENERATOR · VYEPTI · WAKIX · XTAMPZA · XYWAV · ZTLido
Should you be concerned? Industry payments are disclosed through CMS Open Payments. Disclosure alone does not establish their purpose, legality, or effect on care. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Looking for a neurology specialist in Rochester?
Compare neurologists in the Rochester area by procedure volume, costs, and industry payment transparency.
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Geographic Context

Neurologists in nearby ZIP areas
107
County median income
$74,409
Nearest hospital to ZIP centroid (approximate)
STRONG MEMORIAL HOSPITAL
0.0 mi

Data Sources

Provider Registry NPPES NPPES snapshot; verify current record
Medicare Enrollment PECOS PECOS snapshot
Practice Data Medicare Util. Annual (CY lag)
Industry Payments Open Payments CY 2024
Disciplinary History — Not included N/A

This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →

Summary

Dr. Modica is a mixed practice specialist, with above-average Medicare volume (top 14% in NY).

This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →

Frequently Asked Questions

Is Dr. Modica experienced with injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg?
Based on Medicare claims data, Dr. Modica performed 2,960 injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg services. These records cover Medicare fee-for-service activity, including eligible younger beneficiaries; they do not measure total practice volume or clinical quality.
Does Dr. Modica receive payments from pharmaceutical companies?
Yes. Dr. Modica received a total of $4,327 from 36 companies across 206 payment records. A record can group multiple payments. These transfers are publicly disclosed through CMS Open Payments. Disclosure alone does not establish their legality or effect on care. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Modica's costs compare to other neurologists in Rochester?
Dr. Modica's average Medicare payment per service is $43. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Modica) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating the presence of registry, enrollment, activity or payment records, not verified experience or clinical quality. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Source publication dates and the snapshots loaded on this site can differ. Rebuilding a page does not refresh its source records. Check the Medicare reporting year and the payment interval shown above; consult the linked official sources for newer releases and current registry details. See our data freshness policy →
About this page

This page combines public CMS records with calculated summaries and explanatory procedure labels. These transformations are not verbatim federal records. Sources: NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.

This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.

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Data Disclaimer — Data sourced from the Centers for Medicare & Medicaid Services (CMS): National Plan and Provider Enumeration System (NPPES), Open Payments program, Medicare Provider Utilization and Payment Data, and Provider Enrollment & Certification data (PECOS). Published under the Freedom of Information Act (FOIA). This website is not affiliated with, endorsed by, or authorized by CMS, HHS, or the U.S. Government. Data may contain errors as reported to CMS by providers and reporting entities. Industry payment disclosure alone establishes neither wrongdoing nor legality. Medicare data reflects only patients aged 65+ or those with qualifying disabilities. For corrections, contact CMS directly. This information does not constitute medical advice and should not be used as the sole basis for choosing a healthcare provider. Procedure descriptions use plain language and do not reference CPT® codes, which are copyrighted by the American Medical Association. Full methodology → · Report a data error → · Privacy policy →