Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Pennsylvania for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Pennsylvania only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Pennsylvania (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Prelude Corporation (NPI 1952044943)

Field	Value
Entity Type	Organization
Organization	Prelude Corporation
Address	60 Laurel Ridge Rd
City	Hershey
State	PA
ZIP	17033
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	April 18, 2022

Payer Source	Total Paid
Medicare	$4.9M
Medicaid	$0

Key Findings

PRELUDE CORPORATION is operating as a specialized clinical medical laboratory focused on a proprietary PLA breast–cancer risk assay: the Medicare billing is entirely for code 0295U (DCISionRT®, PreludeDX™), an IHC‑based test combined with clinicopathologic factors to report a recurrence risk score and inform radiation therapy decisions. This code description indicates a high-complexity, pathology/molecular diagnostic service line rather than routine clinical lab panels.

Medicare revenue is highly concentrated: the top 3 Medicare codes account for 100.0% of this provider's total Medicare revenue, and the single reported code 0295U alone accounts for $4.9M in Medicare revenue (100.0% of this provider's total Medicare revenue), derived from 1K claims with a $4706 avg paid/claim. This concentration means the provider’s financial performance is tightly coupled to utilization and reimbursement of this one PLA test.

Payer mix is effectively single-payer at present: PRELUDE CORPORATION reports $4.9M in total Medicare revenue and has no Medicaid billing on file, so Medicaid contributes $0 to its recorded lifetime revenue. That absence of Medicaid activity implies limited engagement with state programs and exposure concentrated in the Medicare market.

Competitive standing for the paid PLA test is niche: PRELUDE ranks #1 of 2 providers nationally for 0295U (100th percentile), indicating leadership among a very small national cohort of billers for this assay. Being top-ranked within a two-provider universe signals a leading position for this specific test but does not imply a broad national footprint across other services.

Volume characterization of the 0295U activity is described as "typical, unremarkable volume for this code," so although the provider is a top-ranked biller, its utilization per the record does not represent an extreme outlier in claim volume compared with peers. In practice this means PRELUDE’s role is important within a narrow market segment without showing unusually high utilization relative to the small peer set.

The reimbursement profile shows a high per-claim payment: the $4706 avg paid/claim for 0295U drives the $4.9M Medicare revenue total. This payment level underscores that revenue is driven more by per-test reimbursement than by high claim counts, and it creates sensitivity to any changes in Medicare coverage or pricing for PLA laboratory assays.

Tenure is relatively short: the NPI was enumerated on 2022-04-18 (~4 years ago). As a newer entrant, PRELUDE may have limited historical claims data for trend analysis and could still be in an early growth or market-establishment phase for its proprietary assay.

Operational risk and strategic opportunity both stem from reliance on a single proprietary PLA code: dominance in a narrow, high-cost test creates an opportunity to be the go-to provider for DCISionRT® testing, but it also concentrates regulatory, reimbursement, and competitive risk into a single service line. Analysts should monitor changes in utilization, payer coverage decisions, and any entry of additional providers billing 0295U to assess future revenue stability.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
0295U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code describes only one unique lab test made by a specific manufacturer or performed by a specific lab. Code…	1,050	$4,710	$4.9M

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Prelude Corporation — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

1 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0295U	1	10	1,050	$4,710	$4.9M

Related Providers

Other providers that share a Tax Identification Number (TIN) with Prelude Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prelude Corporation	CA	Clinical Medical Laboratory	$1M	$9K

Nearby Providers

Other providers in the same ZIP code as Prelude Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Milton S Hershey Medical Center	PA	General Acute Care Hospital	$0	$78.9M
The Milton S. Hershey Medical Center Physicians Group	PA	Sports Medicine (Neuromusculoskeletal Medicine) Physician	$0	$26.6M
The Vista Foundation	PA	Public Health or Welfare Agency	$0	$19.4M
Hershey Outpatient Surgery Center LLC	PA	Ambulatory Surgical Clinic/Center	$802.7K	$186.3K
Ghulam Mustafa	PA	Nuclear Medicine Physician	$628.8K	$140
Rebecca Roller	PA	Internal Medicine Physician	$608.8K	$0
Ivan Zucker	PA	Nuclear Medicine Physician	$359.6K	$0
Kristen Foering	PA	Dermatology Physician	$298.5K	$0
Shane Lince	PA	Surgery Physician	$266.4K	$1.1K
Hersheycare Inc	PA	Long Term Care Pharmacy	$202.5K	$0

Prelude Corporation — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References