Biodesix Inc (BDSX) 2025 Q4 法說會逐字稿

Good day and thank you for standing by. Welcome to the Biodesix, fourth quarter 2025 earnings conference call. (Operator Instructions) Please be advised that today's conference is being recorded.

I would now like to hand the conference over to your first speaker today, Chris Brinzy. Please go ahead.

Thank you, operator, and good afternoon, everyone. Today, Biodesix released results from the fourth quarter and fiscal year of 2025. Leading the call today will be Scott Hutton, Chief Executive Officer. He is joined by Robin Harper Cowie, Chief Financial Officer. An audio recording of today's call and the press release announcement with the quarterly results can be found in the investor relations section of the company's website at biodesics.com.

As today's call includes forward-looking statements, we encourage you to review the statements contained in today's press release and the risks and uncertainties described in our SEC filings, which identify certain factors that may cause the company's actual events, performance, and results to differ materially from those contained in the forward-looking statements made on today's webcast.

In addition, we will discuss non-GAAP financial measures on this call. Description of these non-GAAP financial measures and reconciliations of GAAP to non-GAAP financial measures are included in today's press release.

I would now like to turn the call over to Scott Hutton, Chief Executive Officer. Scott.

Thank you, Chris, and thank you all for joining today. At Biodesix, our mission is to transform patient care and improve outcomes through personalized diagnostics that are timely, accessible, and address immediate clinical needs.

We leverage a multimodal approach that includes genomics, proteomics, and radiomics combined with AI to discover, develop, and commercialize innovative diagnostic tests for physicians, biopharmaceutical, life sciences, and diagnostic companies to help improve patient care.

In 2025 and 2026 we're focused on three main goals growing top-line revenue. Improving organizational effectiveness and operational leverage and advancing our pipeline for future commercial growth and expansion.

In the fourth quarter we made progress on all three goals. Our top-line growth accelerated with revenue up 41%. We improved upon already strong gross margins by 400 basis points to 83%. We achieved adjusted EBITDA positivity and we presented real world clinical data that continues to support the use of our on-market test and demonstrates the potential of our product pipeline.

Starting with our clinical offerings in lung diagnostics, our major focus remains on lung nodule management, where nodules are either found during low dose CT screening for lung cancer or incidentally, when the patient has an image taken for another medical purpose.

We've implemented a three-tiered commercial strategy focused on improving the management of patients with lung nodules through the use of our on-market test. This strategy started at the launch of notified lung testing with interventional pulmonologists who are typically responsible for diagnosing lung cancer. We then expanded into their referral network in general and community pulmonology.

In 2025, we selectively expanded further into the primary care referral network, allowing us to access the remaining 50% of the available nodule market being managed by those physicians. This approach enhances the value of notified lung testing by first helping general pulmonologists and primary care providers triage patients by risk of malignancy and deciding who should be referred for intervention or managed locally by surveillance, then helping interventionalists prioritize higher risk patients for prompt diagnostic intervention.

We continue to see a positive response from our customers with this expanded sales strategy, resulting in strong growth from both pulmonology and primary care. In the fourth quarter, volumes from primary care accounted for 12% of the total notified test, growing 67% over the fourth quarter of 2024. And volumes from pulmonology growing 26%. In total for the fourth quarter, we had 97 sales representatives active in the field delivering 18,000 tests or 23% growth.

In our last earnings call, we told you about a recent webinar from Dr. Susan Garwood, the National Physician director for the Pulmonology Service Line at HCA, the largest hospital system in the US. Doctor Garward detailed her experience and successes with implementing notified testing in her referring primary care network.

This experience is replicating across the country with notified testing being utilized to help health systems identify cancers earlier and manage the sheer volume of patients with lung nodules through better triaging to either intervention or monitoring.

In addition to growth in testing volumes, we continue to see improvements in average revenue per test that started to pick up in the third quarter. This is a result of our market access and revenue cycle management teams delivering additional coverage policies and improved claims collection, particularly for Notify Excel 2 and Notify CDT.

On the development services front, we continue to see increasing interest in our distinctive offerings where we leverage our multi-omic approach and R&D expertise to help deliver insights that our biopharma, life science tools, and diagnostic partners use to personalize patient care and help improve disease detection and treatment decisions across various disease types.

We announced two major partnerships to develop and validate test as a centre of excellence for Thermo Fisher Scientific and separately with Bio-Rad Laboratories. These partnerships are an important recognition of the strength and breadth of capabilities in our team to deliver high-quality and rapid results for our partners.

In December at the Association for Molecular Pathology or AMP annual meeting, we were joined by collaborators from Memorial Sloan Kettering Cancer Centre, Thermo Fisher, and Bio-Rad to present on these key partnerships and provide insights into portions of our product development pipeline.

Today, our development pipeline consists of a unique MRD test that combines the proteomic information from our proprietary risk of recurrence test that provides insights into a patient's immune profile, along with tumour-informed genomics that leverages the high sensitivity and specificity of multiplex droplet digital PCR for disease monitoring.

It also includes expansion of the Vistreat test into immunotherapy selection in several new tumour types, including colorectal cancer, as well as another expansion of the Vestreat test for prostate cancer, predicting the likelihood of response to standard of care hormone therapy.

We also have a new ESR-1 genomic test which is available to help guide treatment in breast cancer. And lastly, AI-based digital diagnostics that will initially supplement our current on-market tests in lung disease. You'll hear more about the new AI-based digital diagnostic test offering in the coming quarters.

Throughout the course of 2025, we continued to generate, present, and publish real-world clinical and health economics data for our on-market and pipeline products.

In order to help drive the adoption of our tests by healthcare systems, healthcare providers, and payers, we published new clinical data and had multiple data presentations at a variety of physician Society meetings. Our efforts were supplemented by data presentations from our partners and by a number of independent clinicians publishing on their own data on the real world use of our test.

To summarize, we finished 2025 strong with excellent fourth quarter performance, including accelerated revenue growth to 41%. Delivered 83% gross margins, which are the strongest in advanced diagnostics. Recognize significant improvements in reimbursement. Achieved adjusted EBITDA positivity. Generated strong clinical and real-world evidence for our on market and pipeline products. Announced additional key development partnerships. And increase the number of services contracts and customers utilizing our offering.

With that, let me turn it over to Robin to review our financial performance and provide initial 2026 guidance, Robin.

Thanks, Scott, and good afternoon, everyone. Total revenue was $28.8 million and $88.5 million for the fourth quarter and fiscal 2025, an increase of 41% and 24% over the respective prior year periods. Lung diagnostics revenue of $25.1 million and $79.2 million for the fourth quarter in fiscal 2025 was an increase of 46% and 22% over the respective prior year periods.

Lung diagnostics revenue, excluding claims older than one year, was $24.1 million, representing core organic growth of 40% over the prior year comparable period. The overall increase in lung diagnostics revenue was driven by growth in test volumes and an increase in average revenue per test. Test volumes were 18,000 and 62,600, growth of 23% and 15% respectively.

The increase in average revenue per test was driven by the advancements in reimbursement that began in the third quarter from improvements in payer coverage and revenue cycle management and approximately $1 million in collections from claims older than 1 year.

Development services revenue of $3.6 million and $9.3 million for the fourth quarter in fiscal 2025 with an increase of 12% and 41% respectively and was a result of both delivering against our book of contracted business and securing new agreements. Following a strong finish and the highest revenue of any quarter in 2025, we finished the year with $11.8 million of contracted business going into 2026.

Our gross margin percentage was 83% for the fourth quarter and 81% for the fiscal 2025, a 400 basis point and 300 basis point improvement respectively. The ongoing improvement was driven by growth in lung diagnostic testing, improvements in average revenue per test, and optimization of testing workflows that resulted in decreases in average cost per test. Gross margins continue to be a hallmark of biodesic performance. And operational excellence, and we expect them to remain near 80% throughout 2026.

Overall operating expense, excluding direct costs and expenses were $25.8 million and $99.7 million for the fourth quarter and fiscal 2025, an increase of 14% and 10% respectively. Sales and marketing investment increased 14% to support the 40% core organic lung diagnostic revenue growth in the quarter.

Total SG&A was $23 million and $87.5 million for the fourth quarter in fiscal 2025, a 14% and 9% increase respectively. Growth in SG&A was primarily driven by the expansion of our sales organization from an average of 65 reps in the field in the first quarter to an average of 97 active in the field in the fourth quarter. In 2026, we plan to add approximately 6 reps per quarter as we continue to build out our commercial structure to drive growth through increased market penetration.

We expect continued operating leverage as the recently expanded sales team gains tenure and experience selling the Biodesix test. R&D expense was $2.9 million.12 million dollars, and 19% and 26% increase over the prior year. R&D reflects the investments in clinical studies to help advance adoption of our lung diagnostic tests as well as advancement of our pipeline.

Net loss was $4 million and $35.3 million for the fourth quarter and fiscal year, an improvement of 52% and 18% over the prior year period.

Adjusted EBITDA, which excludes non-cash and other one-time items, was a positive 530,000 for the quarter, which was an improvement of 113% over the fourth quarter of 24 and is the company's first ever positive adjusted EBITDA quarter. This milestone reflects strong revenue flow through and operating leverage across the organization. Adjusted EBITDA for the year was a loss of $17.5 million and improved 21% over 2024.

Pro forma cash and cash equivalents is $33.7 million, including subsequent at the market proceeds supported by our first quarter of adjusted EBITDA positivity, which positions us to reduce quarterly cash consumption as revenue scale.

We ended the quarter with $19.0 million in unrestricted cash and cash equivalents, which was an increase of 14% over the third quarter, including $2.3 million in at the market proceeds. Subsequent to the end of the quarter, an additional $14.7 million in at the-market proceeds were raised, and we amended our senior secured term loan with Perceptive Advisors to extend the maturity date and interest-only period to November 2028. The extension and additional cash strengthen the balance sheet and provides increased flexibility for the organization.

Turning to guidance for 2026, we expect to deliver $106 million to $112 million in annual revenue, the midpoint of which represents 23% annual growth over 2025 and expect continued improvement towards sustained adjusted EBITDA positivity.

The revenue growth and improvement on the path to profitability is expected to be driven by increased tenure and experience of the recently expanded sales force, increases in average revenue per test demonstrated in the second half of 2025, additional clinical data on the notified lung test to help drive adoption from healthcare providers and payers.

Increase in the development services pipeline and the demonstrated operational leverage. We do want to acknowledge the recent weather events and seasonality historically seen in the first quarter, which has been considered in the guidance range provided today.

Now I'll turn it back to Scott for some closing thoughts before the Q&A.

Thank you, Robin. In closing, I want to thank every member of the Biodesix team for your unwavering commitment to our mission, the healthcare professionals we serve, and the patients they treat. Our culture is not just aspirational, it is operational. It shows up in disciplined execution in how we serve healthcare providers and in how we build trusted industry partnerships.

2025 demonstrated the strength of our strategy and the resilience of our model. As adoption expands and awareness grows, we continue to deliver clinical value, strengthen customer relationships, and drive scalable, durable growth. We remain focused on operational discipline, capital efficiency, and expanding our impact in lung cancer care.

The opportunity in front of us is significant. Our team, culture, differentiated test portfolio, and discipline execution create sustainable long-term value for healthcare professionals, patients, and shareholders alike. We are operating from a position of increasing strength and remain confident in our ability to execute against a significant long-term opportunity.

Thank you to our team, our customers, our partners, and our investors for your continued trust. We are building a high performance organization designed to deliver meaningful impact and sustained value quarter after quarter, year after year.

Let's now move to questions. Operator let's start with the Q&A session.

(Operator Instructions) Kyle Mixon, Canoco Genuity - Analyst

Hey guys, thanks for the questions. Congrats on a great year. I want to go back to the first quarter comments and just trying to understand, how much of a step down we should expect with, revenue and volume as, with respect to the, I guess it's relative to the fourth quarter because.

There seemed like there was a little bit of a flush, maybe some revenue that was from prior periods or pulled forward in the fourth, so we could talk about. You know how we should think about the step down for volume and then pricing and especially given the deductible dynamics and then the weather too. I mean I know you referenced that but there's obviously been some storms and stuff in the Northeast and other places so it would be helpful to understand that thanks.

Thanks, Kyle. It's a great question. Yes, there's a lot of dynamics at play here and the weather disruption across the country and most recently in the Northeast absolutely is a consideration for us. And you're right, we did have some, increased collections in the fourth quarter, about a million dollars of collections from claims over 1 year. So, when we're looking at the First quarter versus fourth quarter, would encourage everyone to compare it to the revenues excluding that million dollars. In the First quarter, we usually always see a step down in ASP, and we expect that similar step down that we've seen in prior years. Same with the volume, so we're anticipating that the volume dynamics and the ASP dynamics are consistent with our historic seasonality.

All right, great, thanks for that. And maybe just one on the pipeline as well. I think I heard Scott, you were mentioning, going into some detail about some of the tests. Could you, maybe just to the extent that you have not already shared on the call, could you talk a little bit more and elaborate on those, on those new tests, what you're developing, what you aim to launch in the next, 12 to 18 months, let's say, and, ultimately like what are you the most excited about in the, kind of future portfolio for the company?

Yeah, thanks, Kyle. Great question. You may recall at AM, Dr. Gary Pastano led an R&D day representing Biodesix where we had other participants from Bio-Rad, Thermo Fisher, and Memorial Sloan Kettering. We are planning on providing another R&D update this year where Gary and that team will have an ability to highlight the progress that's been made sense that last meeting.

In your question, we are not planning on commercializing any of those within the next 12 months. We're very mindful, we have laser focus on our march towards profitability, and we don't want to launch any no pay tests. We want to be very mindful of reimbursement timing, and the appropriate studies that'll help put us in a positive reimbursement position. We'll continue to give other updates as to what the opportunities look like for those tests. And when you ask the question of what excites me most, I think it's really about highlighting what our development team is capable of, has done in the past and will do in the future. We think the world of our team, and it's about time that others start to see what they're able to deliver, and so we're eager to give Gary and team an opportunity to do so.

Perfect. And finally on the primary care, kind of rep cohort that you've been building, I think now that are almost all of them are probably up to speed and mature and, kind of full productivity at this point, given they've had this time to ramp, what is the approximate volume that, is accounted for by that rep base by primary care rep base? Is it, above the 11% that you saw in the third quarter? And you know how do you feel about that mix I guess as you sort of look to the, throughout 26 that's a year to you you've had the proven ground in 25 and now 26 is the year to kind of, that will pay dividends, I guess.

Yeah, it's a great question. We continue to see the primary care focus, perform and deliver. It grew over the 11% that you referenced up to 12% of total notify orders coming out of primary care. We expect that to continue to grow as we scale. You referenced some of our sales professionals. I was honoured to be in San. Antonio, Texas this week with our sales team as we kicked off our 2026 national sales meeting and I can tell you sitting both with our pulmonology focused and primary care focused sales teams, they both feel strongly and feel confident about their ability to continue to grow and they're eager to do so and so we're, we'll continue to provide highlights there but as we look at adding.

Approximately 24 sales reps again this year in 2026, we think we can continue to grow in scale across the board, so we'll give updates on a quarterly basis, but we see both teams thriving right now, we're. Proud of them, but we also think it speaks volumes about the opportunity and our ability to address more of that market by going into PCP. And just as a reminder again, this is not about us calling on every primary care physician. This is about us building relationships within pulmonology, better understanding their referral network and patterns, and working through them to reach those primary care physicians so that we can increase the opportunity. To diagnose and detect cancers earlier and we feel confident that in doing so we'll see a state shift over time.

Awesome. Okay, thanks, Scott. Thanks, Robin. Appreciate it.

Thanks, Kyle.

(Operator Instructions) William Ruby, TD Cowen - Analyst

Hi, thanks for the questions. First question is just you reached a just a little bit of positivity in the quarter and you tapped into your ATM and you're sitting in a pro forma with $33.7 million in cash, just wondering if you feel well positioned now from a cash perspective and if you see any need to add additional cushion in 26, and I'll follow-up as well.

Thanks, William. I appreciate the questions. Yeah, we feel very good about, the cash position. We not only showed the operational improvement, strong gross margin improvement, that helped contribute to our operating leverage for the quarter, but then also, adding the extra cash, opportunistically through the ATM, really strengthened the balance sheet. And gives us flexibility going forward. So yes, we feel very good about where we are from a cash perspective.

Got you. And then also just on the guide came in above the street just wondering what do you see as some of the most likely upside levers, this year to guidance?

Yeah, we think we have a couple upside levers. We've got a sales organization that is gaining in tenure and experience out in the field. We hired quite a few sales team members in really in the last part of the year and so they're really just getting their feet under them and for most of the or or a larger portion of the organization, this will be their first full year in the field.

So we think we've got opportunity for increased rep productivity from a test perspective, continuing the ASP stability that, and growth that we saw in the second half of last year. Not to mention the, increased excitement about our development services portfolio and what we're able to offer to partners. So we think really we've got opportunities to grow both portions of the business and really it's volume, ASP and development services funnel.

Gotcha. If I could just ask one more actually, I think you mentioned on the Q1 call and I think Scott mentioned earlier, talking and Susan Garwood's presentation mentioned as well that she seemed to see some stage shift by referring through primary care. Just wondering if you've seen any additional evidence of like shifting stage and if you'd even potentially want to do real-world studies to demonstrate this effect where you're shifting stage earlier.

Yeah thanks it's a great question we have the way it usually transpires is is physicians will share with us what they're seeing some of their performance, we've encouraged those individual physicians in sites, to publish that data, so it's a little bit out of our control, but we encourage them to do that because we think that that'll speak. Or at least send a very powerful message, because it's not company sponsored, we are, talking about that whether we're able to achieve that through Clarify or not we'll continue to investigate and explore options to do so. But most importantly, we want to encourage those physicians that are seeing the positive impact of utilizing notified testing, we want to see them them share that data, and it's not really about a promotion, it's about awareness and if we can increase more awareness.

We think we'll have greater compliance. We think patients will be interested in receiving the testing, and so will physicians, and they'll allow that to guide them. But as we know, we're in lung cancer, we're dealing with the deadliest cancer, so any material impact in, shifting stage of diagnosis is going to be meaningful in overall long-term survival.

Thank you very much.

Thanks, William.

(Operator Instructions) Andrew Bragman, William Blair - Analyst

Hey Scott. Hey, Robin. Good afternoon. Thanks for taking the questions. Maybe I'll pick up on that last question there, sort of around the data readouts that you expect. I think, you've been making some good progress on clarify over the last couple of quarters. So, anything new to share there, when we should maybe expect some of that data to read out and then on altitude, just an update on potential readout for that study as well. Thanks.

Yeah, thanks Andrew great questions with Clarify we're going to continue to look at different inter analysis, and kind of subgroups if you will, with Clarify we're not going to wait for chest, so we'll continue to. To submit those abstracts and papers to different journals we don't feel the need to wait we think it's more important to get that data out there we have submitted some here recently and so we'll keep you updated as we receive word back on their acceptance and then publication timing.

But that's going to be again that's real-world data. It's very exciting for us to get that out there and demonstrate how physicians are utilizing the test, how it's performing, and the impact it's making in regard to altitude. You may recall that we stopped enrolling altitude, and now we just have to monitor those patients for a minimum of a year, and then up to 2 years. So, for 2026 we won't hit the one-year in. Point until third quarter, so that what that means is we will miss the chest submission timing for 2026, so at the earliest that we'll see any data out of altitude is going to be at some point in time in 2027.

Perfect. Thank you, thanks for all that color. And then I want to go back to the sort of the different channels here, primary care, sort of being one of them, and thanks for all that color that you gave on sort of the mix and growth within the different channels. Can you maybe just sort of talk about what you're seeing in the field in terms of these efforts being complementary to each other as opposed to maybe cannibalistic? Thanks.

Yeah, it's a great question. It's one of the reasons why we highlight that we start by building a strong relationship within pulmonology. We know that pulmonologists are responsible for diagnosing lung cancer. We also know that they're stressed. There's a significant burden there. There's lengthy wait times in their clinics. Their practices are filling up more and more. And so, if you take kind of that needle in the haystack approach, anything that we can do to help them enrich the patients that they're seeing, increasing the likelihood that they're spending time with the highest risk patients, those with the highest likelihood of lung cancer, then we know that they'll have a greater impact.

That in and of itself is what this. About those pulmonologists, and we referenced Dr. Susan Garwood using her as an example. It's one of the reasons why they really see the value in promoting and pushing notified testing out into their referral network so that a positive CDT is referred on quickly and pulled to the front of the line. And on the other. Extreme somebody that's positive for notify X2, meaning that they can sit back and take a wait and watch approach supported with CT surveillance on an annual basis, those patients aren't referred into a pulmonologist because they just block or take up an available slot for a high-risk patient.

So, we continue to see a number of those on a on a weekly and monthly basis. Those positive stories really reinforced that not only was it the right strategic decision, but that we continue to have success. And then internally we've talked a lot about having 50 sales territories and having a squad or team approach within the field and I referenced being at our national sales meeting. What I saw was a team that is heavily motivated and focused on the team. There's lots of collaboration. They're sharing of best practices, and they're excited to possibly impact patients first and foremost, and so we're seeing it work exceptionally well, and we continue to anticipate a broader adoption as we progress through 2026.

Very helpful, Appreciate all the color.

Thanks, Andrew.

(Operator Instructions) Thomas Flaten Lake Street Capital Markets - Analyst

Great, good afternoon, guys. Thanks for taking the questions. Just, kind of teeing off the last question there. So, when you think about the additions you're making to the Salesforce in 2026. Can you just help us understand what that allocation is going to be between PCP and pulmonology?

Yeah, thanks Thomas, we haven't disclosed that and one of the things that we pride ourselves on is being agile and being able to adapt and so what really will lead us to hiring one or the other is current performance today as we continue. To grow and scale, we want to take a need-based approach. We don't want to be too prescriptive. We've got some territories that are that are very mature. We've had great success in penetrating that market for a lengthy period of time.

Those are going to be the teams or squads where you've got great representation of the different specialization and call point focus, we still have some territories that are newer or earlier in that that maturation and so. That mix based upon performance will guide us, and we'll give you guys updates as we make those hires, but right now, we're really focused on it's going to be the majority will be a blend of associate sales professionals and primary care focused sales professionals.

And maybe just Playing that out, you probably won't be able to share anything qualitative anything quantitative, maybe qualitative. How do you see the differential growth rates through 2026 between the two channels?

Yeah, not again, can't really be that prescriptive because we don't know exactly where we'll be focused on hiring and when we just know there's a massive opportunity ahead we're barely scratching the surface in this this addressable market on both the primary care and the pulmonology front, so we see growth opportunities across the board in both, but reminding everybody reimbursement is the same, right?

In this patient population we're still focused on. Patients that are of Medicare age predominantly, so we've got a pretty well defined reimbursement path and trajectory for us. It doesn't really matter where it's coming out of. It just matters that we're getting to more and more patients on a quarterly basis.

And then just a quick one, any insight to share on the HAS guidelines?

Oh yeah, nothing new on hiatus. I think it was September time frame of last year that they stated that they wouldn't provide the update for 2025. We're eager to see what they say here in 2026. We know that the problem isn't going away. The challenge is still will remain, and we know that once they make those statements, it will create a different change then we're able to facilitate ourselves and so we've referenced the example in breast cancer historically.

We're eager and supportive of this. It will benefit us and help, but most importantly, it'll impact those patients that need to get screening earlier and get into this queue so that we can see earlier detection and diagnosis. But when it comes to hiatus and guidelines, no material updates, both parties just continue to state that they will, continue to prioritize it and provide updates in, 2026.

That's great, thank you.

Thank you, Thomas.

(Operator Instructions) John Wilkin, Craig - Hallam Capital Group - Analyst

Hi guys, congrats on hitting the [dot] milestone in Q4.Wanted to want to touch a little bit more on sales rep productivity. Are you able to parse out at all? So, you added around 8,000 tasks for the year. Are you able to parse out how much of that growth came from the new reps you hired within the year versus your existing sales force?

Yeah, absolutely, we track everything very closely. The important thing to remember is the majority of the new reps were hired later in the year, so a lot of the growth that we saw came from our existing reps. We of course saw growth from the new reps and so it was pretty balanced, but where we really expect to see growth from the new reps is in 2026 as they have a full year in the field and more time and more experience selling the test.

Got it. And then for the, I don't know if to the extent that you're able to quantify. So I mean thinking about reps that are maybe hired like earlier in 2025, are you able to give us any sense of how productive those reps were by year end just to give us a sense of how long it has been taking recently for newly added reps to ramp.

Yeah, we've been very pleased with the caliber of reps that have been hired and brought in. We, historically have seen that it takes 2 to 3 months for a rep to pay for themselves, and that has continued with the new batch of reps. So we've been very consistent there, but that's, it's important to note that's not the end of the ramp, that's really just the beginning. And so we see reps continue to ramp. Not just in their 1st year but ongoing as I stated, we continue to see growth from existing reps and some who have been here for a couple of years, so the growth trajectory is there we're seeing it and there is huge opportunity for every rep in our field.

Perfect, thank you so Much.

Thanks John.

Thank you. This concludes our question-and-answer session in today's conference call. Thank you for participating and you may now disconnect.