`Case 1:20-cv-01644-RGA Document 1-25 Filed 12/03/20 Page 1 of 2 PageID #: 926
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`EXHIBIT 25
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`EXHIBIT 25
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`10/28/2020
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`Prelude(TM) Prenatal Screen - Northwell Health Laboratories
`Case 1:20-cv-01644-RGA Document 1-25 Filed 12/03/20 Page 2 of 2 PageID #: 927
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`Test Code VERIFI
`Prelude(TM) Prenatal Screen
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`Performing Laboratory
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`Illumina
`Methodology
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`Massively Parellel Shorgun Sequencing (MTS) of cell-free DNA
`Reference Values
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`See Report
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`Basic reports contain results for chromosomes 21, 18 and 13. Test reports include
`one of three possible results for chromosomes 21, 18, and 13: No Aneuploidy
`Detected, Aneuploidy Detected, or Aneuploidy Suspected (Borderline Value).
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`If the sex chromosomes option is selected, results for Monosomy X, XXX, XXY and XYY
`will be included. (If no aneuploidies are detected, fetal sex will be reported.) Sex
`chromosomes will be reported as No Aneuploidy Detected or Aneuploidy Detected.
`Test Classification and CPT Coding
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`84999
`81599
`81479
`81507
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`Specimen Requirements
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`Container/Tube: One Steck BCT tube
`Specimen: 10 ml whole blood (7 ml min)
`Transport Temperature: Room Temperature
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`Note: Counsyl request form completely filled out is required.
`The following information is required with each specimen:
`1. Reason for referral
`2. Maternal age
`3. Number of fetuses
`4. Gestation age (weeks and days)
`5. Method of determining gestational age
`6. Maternal height (inches)
`7. Maternal weight (pounds)
`The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be delayed or compromised.
`Useful For
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`The Verifi prenaltal test is a non-invasive prenatal test that detect multiple fetal chromosomal aneuploidies.
`The verifi test use the enhanced SAFeR™ algorithm which increases the specific signal
`of aneuploid chromosomes and hence improves the overall accuracy of classifying
`affected samples. The test output provides definitive results, not a risk score, and it
`is not dependent on maternal age, maternal weight, gestational age (after 10 weeks)
`or ethnicity.
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`Computer Interface Code
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`PDM # 1459886
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`Portions ©2020 Mayo Foundation for Medical Education and Research.
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`https://nslijlab.testcatalog.org/show/VERIFI
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`1/1
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