CareDx Inc (CDNA) 2024 Q2 法說會逐字稿

Good day, everyone, and welcome to today's Care Dx Incorporated second quarter 2024 earnings conference call. (Operator Instructions) Please note this call may be recorded and I'll be standing by if you should need any assistance.

大家好，歡迎參加今天的 Care Dx Incorporated 2024 年第二季財報電話會議。（操作員說明）請注意，此通話可能會被錄音，如果您需要任何協助，我將隨時待命。

And it is now my pleasure to turn the call over to Mr. Greg Chodaczek. Managing Director.

現在我很高興將電話轉給 Greg Chodaczek 先生。常務董事。

Thanks, Leo, and good afternoon and thank you for joining us today. Earlier today, Care Dx released financial results for the quarter ending June 30, 2024 the release is currently available on the company's website at www.Caredx.com. John Hanna, President and Chief Executive Officer and Abhishek Jain, Chief Financial Officer will host this afternoon's call.

謝謝，Leo，下午好，謝謝您今天加入我們。今天早些時候，Care Dx 發布了截至 2024 年 6 月 30 日的季度財務業績，該新聞稿目前可在公司網站 www.Caredx.com 上取得。總裁兼執行長 John Hanna 和財務長 Abhishek Jain 將主持今天下午的電話會議。

Before we get started, I would like to remind everyone that management will be making statements during this call that include forward-looking statements within the meaning of the federal securities laws, which are made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that are not statements of historical facts should be deemed to be forward-looking statements.

在我們開始之前，我想提醒大家，管理層將在本次電話會議中發表聲明，其中包括聯邦證券法含義內的前瞻性聲明，這些聲明是根據私人證券訴訟改革的安全港條款制定的1995 年法案。本次電話會議中包含的任何非歷史事實陳述的陳述均應被視為前瞻性陳述。

All forward-looking statements, including, without limitation, our examination of historical operating operating trends, expectations regarding coverage decisions, pricing and enrollment matters, and our financial expectations and results are based upon current estimates and various assumptions. And these statements involve material risks and uncertainties that could cause actual results to differ materially from those anticipated or implied by these forward-looking statements. Accordingly, you should not place undue reliance on these statements For a list and description of the risks and uncertainties associated with our business, please see our filings with the Securities and Exchange Commission.

所有前瞻性陳述，包括但不限於我們對歷史營運趨勢的審查、有關承保決策、定價和註冊事宜的預期，以及我們的財務預期和結果均基於當前的估計和各種假設。這些陳述涉及重大風險和不確定性，可能導致實際結果與這些前瞻性陳述預期或暗示的結果有重大差異。因此，您不應過度依賴這些聲明。

The information provided in this conference call speaks only to the live broadcast today, July 31, 2024 CareDx. disclaims any intention or obligation except as required by law to update or revise any information, financial projections or other forward-looking statements, whether because of new information, future events or otherwise. This call will also include a discussion of certain financial measures that are not calculated in accordance with Generally Accepted Accounting Principles. Reconciliations to the most directly comparable GAAP financial measure may be found in today's earnings release filed with the SEC.

本次電話會議提供的資訊僅適用於今天（2024 年 7 月 31 日）CareDx 的直播。除非法律要求，否則不承擔任何更新或修改任何資訊、財務預測或其他前瞻性聲明的意圖或義務，無論是由於新資訊、未來事件或其他原因。此次電話會議也將討論某些不依照公認會計原則計算的財務指標。與最直接可比較的 GAAP 財務指標的調整可以在今天向 SEC 提交的收益報告中找到。

I will now turn the call over to John.

我現在將把電話轉給約翰。

Thank you, Greg, and thank you to everyone who's joined today's call after a good start to the year, we had another strong quarter marked by growth across all of our businesses and disciplined operational execution. CareDx's commitment to patients, innovation and providing robust solutions that address transplant centers needs are driving our growth. We continue to publish compelling evidence supporting the role of our testing services in extending allograft survival. Our digital solutions are vital to helping our customers navigate complex workflows and achieve high quality outcomes. And in our NGS space, Laboratory products are gaining wider adoption, supplanting legacy technologies.

謝謝格雷格，也感謝參加今天電話會議的所有人，在今年取得了良好的開局之後，我們又迎來了一個強勁的季度，其特點是我們所有業務的增長和嚴格的運營執行。CareDx 對患者的承諾、創新以及提供滿足移植中心需求的強大解決方案正在推動我們的發展。我們繼續發布令人信服的證據，支持我們的測試服務在延長同種異體移植物存活方面的作用。我們的數位解決方案對於幫助客戶駕馭複雜的工作流程並實現高品質的成果至關重要。在我們的 NGS 領域，實驗室產品正在獲得更廣泛的採用，取代了傳統技術。

In my prepared remarks, I will share examples of how our solutions benefit patients, transplant centers and labs underpinning the drivers of increased utilization and top line growth. We reached an inflection point in our business. Our revenue growth, coupled with our disciplined approach to expense management, has translated into sizable improvements in our adjusted EBITDA, resulting in both top line and bottom line growth. We became adjusted EBITDA positive this quarter and expect to be adjusted EBITDA neutral for the remaining two quarters of the year, resulting in positive adjusted EBITDA for the full year as reflected in our updated guidance. Given our strong year-to-date results and expected growth for the remainder of the year, we are raising our revenue guidance for fiscal year 2024 to $320 million to $328 million, a growth rate of 15% year-over-year at the midpoint of our guidance.

在我準備好的發言中，我將分享一些例子，說明我們的解決方案如何使患者、移植中心和實驗室受益，從而推動利用率提高和收入成長。我們的業務達到了轉捩點。我們的收入成長，加上嚴格的費用管理方法，已轉化為調整後 EBITDA 的大幅改善，從而實現營收和利潤的成長。我們本季調整後 EBITDA 為正，預計今年剩餘兩個季度調整後 EBITDA 為中性，從而導致全年調整後 EBITDA 為正，如我們更新的指導中所反映的那樣。鑑於我們今年迄今的強勁業績和今年剩餘時間的預期增長，我們將 2024 財年的收入指導上調至 3.2 億至 3.28 億美元，中間值同比增長率為 15%我們的指導。

Turning to our financial results. For the second quarter, we reported revenue of $92.3 million, up 31% from the prior year. In our testing services business, we delivered approximately 43,700 tests, up 17% from the prior year and up 4% from the previous quarter. This represents the fourth consecutive quarter of sequential growth in testing services volumes. Testing Services revenue was $70.9 million, up 33% year-over-year. We accrued $13.2 million in revenue from tests performed in prior quarters, making our adjusted testing services revenue in the quarter of $57.7 million, up 21% year-over-year. In the second quarter, we achieved a significant milestone, the first peer-reviewed publication of our shore study in the Journal of Heart and Lung Transplantation.

轉向我們的財務表現。第二季度，我們報告營收為 9,230 萬美元，比上年增長 31%。在我們的測試服務業務中，我們交付了約 43,700 次測試，比上年增長 17%，比上季度增長 4%。這代表測試服務量連續第四個季度實現環比增長。測試服務收入為 7,090 萬美元，較去年同期成長 33%。我們從前幾季進行的測試中獲得了 1,320 萬美元的收入，使得本季調整後的測試服務收入達到 5,770 萬美元，年增 21%。第二季度，我們實現了一個重要的里程碑，我們的岸上研究首次在《心肺移植雜誌》上發表了經過同行評審的出版物。

As shown on slide 6 of our earnings presentation, this prospective observational study demonstrates that HeartCare, which combines AlloSure Heart and AlloMap Heart identifies acute cellular rejection in heart transplant patients better than donor-derived cell-free DNA alone.

正如我們的收益簡報第6 張幻燈片所示，這項前瞻性觀察性研究表明，結合了AlloSure Heart 和AlloMap Heart 的HeartCare 比單獨使用供體來源的遊離DNA 更能識別心臟移植患者的急性細胞排斥反應。

The findings also demonstrate on slide 7 that using HeartCare as associated with lower biopsy rates and excellent clinical outcomes two years post transplant, we believe that HeartCare could potentially guide clinicians to perform surveillance biopsies more sparingly. SHORE study is the most extensive prospective study of its kind in heart transplantation with 67 participating centers and over 2,700 patients enrolled SHORE is designed to follow patients for five years. So we expect SHORE will continue to generate meaningful publications for the foreseeable future.

幻燈片 7 上的研究結果還表明，使用 HeartCare 與移植後兩年較低的活檢率和優異的臨床結果相關，我們相信 HeartCare 可能會指導臨床醫生更謹慎地進行監測活檢。SHORE 研究是心臟移植領域同類研究中最廣泛的前瞻性研究，共有 67 個參與中心和超過 2,700 名患者入組。因此，我們預計 SHORE 在可預見的未來將繼續產生有意義的出版品。

Moving to our kidney business, a landmark study was published last month in Nature Medicine, validating our [AL of UAI]. enabled risk prediction model and demonstrating that AlloSure Kidney detect subclinical rejection in stable patients. The international multicenter study of 2,882 patients that underwent donor-derived cell-free DNA testing was conducted by the Paris Institute for transplantation and organ regeneration, along with researchers in the US and Belgium. Several key findings from the study shown in slide 9 of our investor presentation are AlloSure Kidney. Donor-derived cell-free DNA levels were elevated before biopsy-proven rejection in an analysis of patients receiving consecutive biopsies.

轉向我們的腎臟業務，上個月在 Nature Medicine 上發表了一項具有里程碑意義的研究，驗證了我們的 [AL of UAI]。啟用風險預測模型並證明 AlloSure Kidney 可偵測穩定患者的亞臨床排斥反應。巴黎移植和器官再生研究所以及美國和比利時的研究人員對 2,882 名患者進行了這項國際多中心研究，這些患者接受了供體來源的無細胞 DNA 檢測。我們的投資者簡報第 9 張投影片中顯示的幾個主要研究結果是 AlloSure Kidney。在對接受連續活檢的患者進行分析時，在活檢證實出現排斥反應之前，供體來源的遊離 DNA 水平有所升高。

AlloSure Kidney donor-derived cell-free DNA levels decreased for patients with successfully treated rejection, suggesting AlloSure Kidney may be used to assess treatment response, AlloSure Kidney surveillance testing detected subclinical rejection in clinically stable patients and surveillance monitoring with AlloSure Kidney and our view improves the detection of antibody-mediated rejection in [T cell] mediated rejection compared to standard of care measures such as serum creatinine and donor specific antibodies and biopsies.

對於成功治療排斥反應的患者，AlloSure 腎臟捐贈者來源的遊離DNA 水平降低，表明AlloSure 腎臟可用於評估治療反應，AlloSure 腎臟監測測試檢測到臨床穩定患者的亞臨床排斥反應，並且使用AlloSure 腎臟進行監測，我們的觀點有所改善與標準護理措施（例如血清肌酸酐和供體特異性抗體和活檢）相比，檢測 [T 細胞] 介導的排斥反應中抗體介導的排斥反應。

This study underscores our SHORE's role as a leading indicator of kidney transplant rejection. It enables clinicians to intervene before clinical symptoms of rejection occur and monitor post treatment progress while avoiding invasive biopsy procedures. These findings contribute to a growing body of evidence that may establish new standards globally in routine monitoring of rejection and treatment response in kidney transplantations.

這項研究強調了我們的 SHORE 作為腎臟移植排斥反應領先指標的作用。它使臨床醫生能夠在出現排斥反應的臨床症狀之前進行幹預，並監測治療後的進展，同時避免侵入性活檢程序。這些發現有助於提供越來越多的證據，這些證據可能會在全球腎臟移植排斥反應和治療反應的常規監測中建立新標準。

Turning to coverage. We look forward to the finalization of the draft Medicare local coverage determination likely in the third quarter. Care Dx transplant clinicians and their specialty societies and transplant patients continue to advocate to permanently restore long-standing coverage language. Recall, in February of this year, CMS issued a statement affirming their commitment to ensuring that patients with transplanted hearts, lungs and kidneys who meet Medicare's local coverage criteria can continue to access molecular blood tests and that these tests remain available to patients when medically necessary and ordered by a physician.

轉向覆蓋範圍。我們預期醫療保險本地覆蓋範圍確定草案可能在第三季最終確定。Care Dx 移植臨床醫生及其專業協會和移植患者繼續主張永久恢復長期存在的承保語言。回想一下，今年2 月，CMS 發表了一份聲明，確認他們致力於確保符合Medicare 當地承保標準的移植心臟、肺和腎臟的患者可以繼續接受分子血液檢測，並且在醫療必要時仍然可以對患者進行這些檢測並由醫生訂購。

We have had significant success in increasing commercial payer coverage for our kidney and heart testing services. In the first half of 2024, we gained additional coverage from BlueCross BlueShield plans and other commercial plans totalling approximately 27 million lives nationwide. This includes new policies for AlloMap Heart, AlloSure Heart, AlloSure Kidney, the coverage, coupled with improvements in revenue cycle management have contributed to ASP growth that we will continue to benefit from in future quarters.

我們在增加腎臟和心臟檢測服務的商業付款人覆蓋範圍方面取得了巨大成功。2024 年上半年，我們獲得了 BlueCross BlueShield 計劃和其他商業計劃的額外保障，覆蓋全國約 2,700 萬人。這包括 AlloMap Heart、AlloSure Heart、AlloSure Kidney 的新保單、保險範圍以及收入週期管理的改進，促進了 ASP 的成長，我們將在未來幾個季度繼續受益。

Moving to our patient and Digital Solutions business, we achieved our first quarter of over $10 million in revenue, representing 19% year-over-year growth. This growth can be attributed to SaaS conversions and an uptake of our lab information management system software solution for HLA laboratories. Our digital offerings continue to gain traction in US-based transplant centers with over 70%, having at least one of our patient and digital solutions because our value-added solutions complement each other and deliver positive outcomes transplant centers or acquiring additional products from us.

轉向患者和數位解決方案業務，我們第一季的收入超過 1000 萬美元，年增 19%。這一增長可歸因於 SaaS 轉換以及我們針對 HLA 實驗室的實驗室資訊管理系統軟體解決方案的採用。我們的數位產品繼續在美國移植中心獲得關注，超過70% 的移植中心至少擁有我們的患者和數位解決方案之一，因為我們的增值解決方案相輔相成，可以為移植中心帶來積極的成果或從我們這裡購買其他產品。

Florida Memorial Hospital and Joe DiMaggio Children's Hospital renowned for their adult and paediatric transplant program have implemented Care Dx quality reporting software to facilitate their engagement with regulatory accreditation and payer organizations, security access software solutions, our cloud-based tools that in this case, transform raw utilization, data into insights, aiding centers in achieving high quality outcomes.

以其成人和兒科移植計劃而聞名的佛羅裡達紀念醫院和Joe DiMaggio 兒童醫院實施了Care Dx 品質報告軟體，以促進他們與監管認證和付款人組織的互動，安全存取軟體解決方案，我們基於雲端的工具，在這種情況下，轉變原始利用、數據洞察、幫助中心實現高品質的結果。

In our lab products business, we reported another first achieving over $10 million in revenue, representing 35% year-over-year growth. This strong growth was primarily driven by continued global adoption of our industry-leading [AlloSeq Tx], NGS-based HLA typing kits for use in bone marrow transplantation and solid organ transplantation. Centers are discovering that our [AlloSeq Tx] has many benefits over legacy typing technologies. We expect this migration toward our best-in-class NGS HLA typing will continue.

在我們的實驗室產品業務中，我們再次首次實現收入超過 1000 萬美元，年增 35%。這一強勁成長主要得益於我們業界領先的 [AlloSeq Tx]、基於 NGS 的 HLA 分型試劑盒在骨髓移植和實體器官移植的應用。各中心發現我們的 [AlloSeq Tx] 比傳統打字技術有許多優點。我們預計這種向一流 NGS HLA 分型的遷移將會持續下去。

For example, two top HLA labs in Rome, Italy, Cagliara and San Camilo transitioned from legacy HLA typing solutions using real-time PCR methods to NGS-based AlloSeq Tx. They recognize the value it provides and eliminating the need for reflex testing to resolve ambiguous results, thereby increasing operational efficiencies this growth in a price-sensitive market like Italy, which is one of the top five markets in Europe reflects the value AlloSeq Tx innovation brings to the region. In summary, we had a strong quarter across all three businesses, testing services, digital solutions and lab products and demonstrated solid year-over-year growth, and we will believe this will continue.

例如，位於義大利羅馬卡利亞拉和聖卡米洛的兩個頂級 HLA 實驗室從使用即時 PCR 方法的傳統 HLA 分型解決方案過渡到基於 NGS 的 AlloSeq Tx。他們認識到它提供的價值，並消除了透過反射測試來解決不明確結果的需要，從而提高了營運效率。 AlloSeq Tx 創新帶來的價值到該地區。總而言之，我們在測試服務、數位解決方案和實驗室產品這三個業務領域都取得了強勁的季度業績，並表現出穩健的同比增長，我們相信這種情況將持續下去。

I want to thank the entire CareDx team globally for their commitment to transplant patients and for their disciplined execution and delivering against our plan to return to growth.

我要感謝全球整個 CareDx 團隊對移植患者的承諾，以及他們嚴格執行和實現我們恢復成長計畫的成果。

With that, I will ask Abhishek to share more details on our second quarter results, Abhishek?

接下來，我將請 Abhishek 分享有關我們第二季度業績的更多詳細信息，Abhishek？

Thank you, John. In my remarks today, I will discuss our second quarter results before turning to our revised 2024 guidance. Unless otherwise noted, my remarks will focus on non-GAAP results. For further information, please refer to GAAP to non-GAAP reconciliations in our press release, earnings presentation and recent SEC filings.

謝謝你，約翰。在今天的演講中，我將討論我們第二季的業績，然後再討論修訂後的 2024 年指引。除非另有說明，我的評論將重點放在非公認會計原則的結果上。欲了解更多信息，請參閱我們的新聞稿、收益報告和最近向 SEC 提交的文件中的 GAAP 與非 GAAP 調節表。

Let me start with the key financial highlights before providing more details around our revised 2024 guidance. We reported total revenue of $92.3 million for the second quarter, up 31% year-over-year, delivered over 43,700 test results, up 17% year-over-year and 4% as compared to the last quarter, representing the fourth consecutive quarter of sequential testing services volume growth. Reported testing services revenue of $70.9 million, up 33% year-over-year, including 13.2 million associated with tests performed in prior periods.

讓我先介紹一下主要的財務亮點，然後再提供有關我們修訂後的 2024 年指引的更多詳細資訊。我們報告第二季度總收入為 9,230 萬美元，年增 31%，交付超過 43,700 份測試結果，年增 17%，環比增長 4%，連續第四個季度增長順序測試服務量增長。報告的測試服務收入為 7,090 萬美元，年增 33%，其中包括與前期進行的測試相關的 1,320 萬美元。

On a comparable basis, our adjusted revenue grew 41% year-over-year, driven by strong testing services, volume growth, Infotech, patient and Digital Solutions revenue of $10.7 billion, up 19% year-over-year and product revenue of $10.6 million, up 35% year-over-year. Reported adjusted EBITDA gain of $12.9 million as compared to $10.4 million loss in Q2 of 2023. Finally, generated cash of $18.9 million from operations and ended the quarter with $229 million in cash, cash equivalents and marketable securities. Due to the strong overall performance in the second quarter, we are raising our full year 2024 revenue guidance to $320 million to $328 million from our prior guidance of $274 million to $282 million.

在可比較基礎上，我們的調整後營收年增41%，這得益於強勁的測試服務、銷售成長、資訊科技、病患和數位解決方案營收為107 億美元，較去年同期成長19%，產品營收為10.6美元萬元，年增35%。報告調整後 EBITDA 收益為 1,290 萬美元，而 2023 年第二季虧損為 1,040 萬美元。最後，營運產生了 1,890 萬美元的現金，本季末現金、現金等價物和有價證券為 2.29 億美元。由於第二季整體表現強勁，我們將 2024 年全年營收指引從先前的 2.74 億美元至 2.82 億美元上調至 3.2 億美元至 3.28 億美元。

Moving to the details starting with gross margins. Our non-GAAP testing services gross margin was 81% in the second quarter compared to 73% in the second quarter of 2023. Adjusted for the $13.2 million in revenue associated with tests performed in prior periods. Testing Services gross margin was 76%. Our patient and Digital Solutions non-GAAP gross margin for the second quarter was 37%, up from 33% in the second quarter of 2023. Excluding our Transplant pharmacy business, that has a lower gross margin profile our digital Inpatient Solutions business. Non-GAAP gross margin for the second quarter was 59% for our products business, non-GAAP gross margin was 47% in the second quarter, down from 59% in the second quarter of 2023 and flattish compared to 46% last quarter.

從毛利率開始討論細節。我們第二季的非 GAAP 測試服務毛利率為 81%，而 2023 年第二季為 73%。根據與前期測試相關的 1,320 萬美元收入進行調整。測試服務毛利率為76%。我們第二季的患者和數位解決方案非 GAAP 毛利率為 37%，高於 2023 年第二季的 33%。不包括我們的移植藥房業務，我們的數位住院解決方案業務的毛利率較低。我們的產品業務第二季非 GAAP 毛利率為 59%，第二季非 GAAP 毛利率為 47%，低於 2023 年第二季的 59%，與上季的 46% 持平。

Moving down the P&L, non-GAAP operating expenses for the second quarter were $55.2 million, down approximately $3.7 million from the second quarter of 2023 and up $2.9 million from the previous quarter. The quarter-over-quarter increase was associated with conference [spent] and R&D spend associated with clinical trials. Reported adjusted EBITDA gain for the second quarter of 2024 was $12.9 million compared to reported adjusted EBITDA loss of $10.4 million in the second quarter of 2023 and a loss of $1.9 million in the previous quarter. Excluding the $13.2 million revenue associated with tests performed in prior periods. We were adjusted EBITDA neutral this quarter.

以損益表向下移動，第二季非 GAAP 營運費用為 5,520 萬美元，比 2023 年第二季減少約 370 萬美元，比上一季增加 290 萬美元。季度環比成長與臨床試驗相關的會議[支出]和研發支出有關。報告的 2024 年第二季調整後 EBITDA 虧損為 1,290 萬美元，而報告的 2023 年第二季調整後 EBITDA 虧損為 1,040 萬美元，上一季虧損 190 萬美元。不包括與前期測試相關的 1,320 萬美元收入。本季調整後的 EBITDA 為中性。

Turning to cash, we generated $18.9 million in cash from operations and ended the quarter in a strong position with cash, cash equivalents and marketable securities of $228.9 million and no debt.

說到現金，我們從營運中產生了 1,890 萬美元的現金，本季結束時，我們的現金、現金等價物和有價證券為 2.289 億美元，沒有債務，處於強勢地位。

Turning to guidance, based on the healthy performance across all businesses in the second quarter of 2024 and the anticipated growth in the second half of the year, we are raising our full year revenue guidance to $320 million to $328 million. The midpoint of our 2024 guidance assumes testing services volume growth in the high teens and revenue growth in the mid 20s year-over-year for the second half of 2024. The difference in our assumptions between volume and revenue growth rates is driven by ASP expansion.

談到指導意見，基於 2024 年第二季所有業務的健康表現以及下半年的預期成長，我們將全年營收指引上調至 3.2 億美元至 3.28 億美元。我們的 2024 年指引的中點假設 2024 年下半年測驗服務量年增 10 多歲，收入成長為 20 多歲。我們假設銷售成長率和收入成長率之間的差異是由平均售價的擴張所造成的。

We're assuming approximately $1,300 per test as our blended ASP for the second half of 2024, no change in medical coverage products business to grow high teens year-over-year and our patient and Digital Solutions business to grow in low double digits year-over-year. We expect our gross margin to be approximately 67% to 68%, driven by the improved testing services gross margin. Due to the improved revenue expectations and gross margin. We expect our adjusted EBITDA gain for the full year 2024 to be between $9 million and $15 million compared to the previously guided EBITDA loss of $14 million to $24 million.

我們假設每次測試約為 1,300 美元，作為 2024 年下半年我們的混合 ASP，醫療保險產品業務沒有變化，同比增長較高，而我們的患者和數位解決方案業務同比增長較低的兩位數 -超過一年。在測試服務毛利率改善的推動下，我們預計毛利率約為 67% 至 68%。由於收入預期和毛利率的改善。我們預計 2024 年全年調整後的 EBITDA 收益將在 900 萬美元至 1500 萬美元之間，而先前指導的 EBITDA 損失為 1400 萬美元至 2400 萬美元。

I would like to now turn the call over to John to deliver closing remarks.

我現在想請約翰發表閉幕詞。

Thank you, Abhishek. As we conclude our prepared remarks, I want to highlight the remarkable progress. Our team here at Care Dx has made over the past year translating into significant top line and bottom line growth. We stand in a strong position entering the second half of 2024. Prior to concluding the call, I want to share that CareDx will be hosting an Investor Day early in the fourth quarter, where we will provide insights into our long-term growth strategy of public advisory of the specific date and location will be released in the coming weeks.

謝謝你，阿布舍克。在我們結束準備好的演講時，我想強調我們取得的顯著進展。我們 Care Dx 的團隊在過去一年中取得了顯著的收入和利潤成長。進入 2024 年下半年，我們處於有利地位。在結束電話會議之前，我想告訴大家，CareDx 將在第四季度初舉辦投資者日活動，屆時我們將深入了解我們公共諮詢的長期成長策略，具體日期和地點將在未來幾週。

And with that, I would like to ask the operator to open the line for questions.

說到這裡，我想請接線生開通提問線。

(Operator Instructions)

（操作員說明）

Bill Bonello, Craig-Hallum.

比爾·博內羅，克雷格·哈勒姆。

Hey, guys. A really nice look and quarter. Congratulations. Couple of things so on the prior period collections, net-net at all surprising, given the efforts that you've been making, but last quarter, I think you had about $3.7 million and you thought maybe that was clean up and now you have another $13 million. And is there I guess you don't want to included in the guidance, but how should we think about that on a go-forward basis? I mean, is there more opportunities still to go back and and collect on prior period billing?

嘿，夥計們。一個非常漂亮的外觀和季度。恭喜。考慮到您一直在做出的努力，上一時期的收藏品確實令人驚訝，但上個季度，我認為您有大約 370 萬美元，您認為可能已經清理乾淨了，現在您有了另外1300萬美元。我想您是否不想將其納入指南中，但我們應該如何在未來的基礎上考慮這一點？我的意思是，是否還有更多機會返回並收取前期賬單？

Hi, Bill. This is Abhishek, this side. I'll take this question. So you're right that we basically had a good collection of this particular quarter and we recognized $13 million for the prior period. And from the guidance standpoint, what we have done this time around, we are including in the high end of our range of some improved collections that will help us in getting higher revenues. And that's baked in in the guidance. That's the first part. And the second part is on the overall, size of this particular opportunity. And what we are seeing that based on some of the successes that we have seen in the last one year or so. The overall pool of such opportunities are kind of decreasing. And that's the reason we decided to kind of bake in some wins from this particular area in our high end of the guidance.

嗨，比爾。這是阿布舍克，這邊。我來回答這個問題。所以你是對的，我們在這個特定季度基本上有很好的收款，並且我們確認了上一期的 1300 萬美元。從指導的角度來看，我們這次所做的，是在我們的高端產品系列中加入了一些改進的產品系列，這將幫助我們獲得更高的收入。這已納入指南中。這是第一部分。第二部分是關於這個特定機會的整體規模。我們所看到的基於我們在過去一年左右所看到的一些成功。此類機會的總體數量正在減少。這就是我們決定在指導的高端部分中加入一些來自這一特定領域的勝利的原因。

Okay. That that's really helpful. And then can you just tell us what you're seeing in terms of surveillance testing in kidney are physicians still behaving as though the draft will be XLCD is is the policy are you starting to see some reversion to increase surveillance?

好的。這真的很有幫助。然後您能否告訴我們，您在腎臟監測測試方面看到了什麼？

Hi, Bill. It's John. Thanks so much for the question. We continue to see that clinicians are using the test and being more comfortable with the scenarios in which it can be used for cause they have not changed their behaviour relative to surveillance testing in anticipation of the draft LCD finalization.

嗨，比爾。是約翰。非常感謝您的提問。我們繼續看到臨床醫生正在使用該測試，並且對可以使用該測試的場景更加滿意，因為他們在預期 LCD 最終確定草案時沒有改變相對於監視測試的行為。

Okay. And then if I can ask one last question. Just any thoughts going into BAM for this September, it possible that we could see an update to classification that references donor-derived CFDNA.

好的。然後我可以問最後一個問題嗎？只要對今年 9 月的 BAM 有任何想法，我們就有可能看到引用捐贈者來源的 CFDNA 的分類更新。

I'm going to ask Robert to respond to that.

我要請羅伯特對此做出回應。

I think that is something that they've talked about over the years. It's unclear when that might happen from as far as you have something coming out and the guidance, even if it is discussed, that would be in a future publication. So that's not short term.

我認為這是他們多年來一直在談論的事情。目前尚不清楚何時會發生這種情況，因為您已經發布了一些內容，而且即使討論過，也會在未來的出版物中提供指導。所以這不是短期的。

Okay. Thanks a lot. Appreciate it.

好的。多謝。欣賞它。

Tycho Peterson of Jefferies.

傑富瑞集團的第谷‧彼得森 (Tycho Peterson)。

This is [Kayla] on for Tycho. Thanks for taking the question. And I just wanted to start off with the IOTA program. You've mentioned potential reimbursement and can that come down the line from the program, you mean the program starts in '25 and if successful, how soon could reimbursement changes be proposed and what changes would you be hoping to see?

這是第谷的[凱拉]。感謝您提出問題。我只想從 IOTA 專案開始。您提到了潛在的報銷，這可以從該計劃中得出嗎？

Yes. And can you repeat the question you're referring to the [IOTA] program and reimbursement.

是的。您能否重複一下您提到的 [IOTA] 計劃和報銷問題。

Yeah. you've talked about some potential reimbursement model changes that could come down the line from the program. And I guess what kind of changes could we see and when.

是的。您已經談到了該計劃可能會帶來的一些潛在的報銷模式變化。我想我們會在什麼時候看到什麼樣的改變。

Yes, I'm going to ask Alex to talk about the IOTV program.

是的，我要請 Alex 談談 IOTV 節目。

Thanks. Sure. So thanks for the question. This is a long-term program for roughly half kidney transplant centers and the penalties and rewards so to speak, are really built into that program is still in discussion. And there's a lot of comments that now come in and some of those ups and ups and takes and gives inputs will happen as part of the IOTA program. That's specific to those centers that are in the IOTA program.

謝謝。當然。謝謝你的提問。這是大約一半腎臟移植中心的長期計劃，可以說，懲罰和獎勵實際上已納入該計劃仍在討論中。現在收到了很多評論，其中一些意見和建議將作為 IOTA 計劃的一部分發生。這是特定於 IOTA 計劃中的那些中心的。

Okay. That's helpful. And then all the centers that are involved be able to stick with the tests they're currently using and seemingly like AlloSure versus Prospera? Or will there be an effort to standardize private payers participating in the program and anything worth calling out, but CNA can do to defend or pick up share as the market expands.

好的。這很有幫助。然後所有參與的中心都能夠堅持他們目前使用的測試，看起來就像 AlloSure 與 Prospera 一樣？或者是否會努力標準化參與該計劃的私人付款人以及任何值得呼籲的事情，但隨著市場的擴大，CNA 可以捍衛或擴大份額。

I think what's important to realize that this program is to incentivize more utilization, Oregon's price that help patients and centers are going to make decisions on how to do that. And here Care Dx. We have tools, we have evidence driven solutions that can help them do that. And so we're thinking that we're in a very good position to help them execute on their strategies.

我認為重要的是要認識到該計劃是為了激勵更多的利用，俄勒岡州幫助患者和中心的價格將決定如何做到這一點。這裡是 Care Dx。我們有工具，有證據驅動的解決方案可以幫助他們做到這一點。因此，我們認為我們處於非常有利的位置，可以幫助他們執行他們的策略。

Yes. Thank you.

是的。謝謝。

Matt Sykes of Goldman Sachs.

高盛的馬特·賽克斯。

Hey, Guys. This is [Prashan] on for Matt, and congrats on the quarter and thanks for taking the question. So first, given how transplant volumes have trended for the first half, it seems like for kidney and heart transplant volumes are trending flattish to low single digit growth for the second half when you annualize that first half number in 2024, how are you thinking about this trend and the upside remaining for growth the remainder of the year?

嘿，夥計們。這是 [Prashan] 為 Matt 所做的發言，祝賀本季的業績，並感謝您提出問題。首先，考慮到上半年移植量的趨勢，當您將 2024 年上半年的數字按年計算時，下半年的腎臟和心臟移植量似乎呈持平至低個位數增長的趨勢，您如何看待這一趨勢以及今年剩餘時間的成長仍有上行空間嗎？

Thanks, for the question for [Prashan]. I mean, I think that we there's plenty of opportunity for us to continue to grow as a business regardless of the quarter-over-quarter trends in transplant volume in general, we see volume increasing year-over-year, and we're going to continue to monitor that. And we anticipate with the IOTA program that was addressed in the last question that we're going to continue to see the trend go and go and that upwards direction.

謝謝，對於這個問題[普拉尚]。我的意思是，我認為，無論移植量的季度環比趨勢如何，我們作為一家企業都有很多機會繼續增長，我們看到移植量逐年增加，我們將繼續繼續對此進行監測。我們預計，透過上一個問題中提到的 IOTA 計劃，我們將繼續看到趨勢不斷變化，並且呈上升趨勢。

Got it. Thanks. And then just a question on single VERSUS multimodality test. And so your main competitor in the space is involved with this approach as well. Can you just quantify the market for multimodality and how much share have you been capturing? How is that projected to evolve going forward.

知道了。謝謝。然後是關於單一與多模態測試的問題。因此，您在該領域的主要競爭對手也參與了這種方法。您能否量化多式聯運市場以及您佔據了多少份額？預計未來將如何發展。

I think we've built a strong base of evidence that supports multimodal testing in heart transplantation that dual positive AlloMap Heart and AlloSure Heart identify rejection at a higher rate than a single test, in particular, donor-derived cell-free DNA alone and then dual negative results. Patients are less likely to get biopsy and have significant fewer rejection events and so the evidence is very strong there. And the adoption of multimodal testing is high. And I think we've previously said upwards of 90% of patients that undergo a testing from Care Dx for Heart transplant, get Heart care.

我認為我們已經建立了強有力的證據基礎，支持心臟移植中的多模式測試，雙陽性AlloMap Heart 和AlloSure Heart 比單一測試識別排斥反應的比率更高，特別是單獨使用供者來源的無細胞DNA ，然後雙重陰性結果。患者接受切片的可能性較小，排斥反應事件也顯著減少，因此證據非常有力。多模式測試的採用率很高。我想我們之前說過，在接受 Care Dx 心臟移植測試的患者中，90% 以上都得到了心臟護理。

Got it. And then if I could squeeze one last one. So how does the market sizes for Histo map and Euro map compare with the market for AlloMap Kidney, given they're all gene expression profiling tests for kidney transplant, monitoring.

知道了。然後如果我能擠最後一顆的話。那麼，考慮到 Histo map 和 Euro map 的市場規模與 AlloMap Kidney 的市場相比如何，因為它們都是用於腎臟移植和監測的基因表現譜測試。

It's a great question, and we're going to be addressing future pipeline products in our investor day in the fourth quarter. So we'll hold on that question until that time.

這是一個很好的問題，我們將在第四季度的投資者日討論未來的管道產品。所以我們將保留這個問題直到那時。

Got it. Thanks.

知道了。謝謝。

Andrew Cooper, Raymond James.

安德魯庫珀，雷蒙德詹姆斯。

Hey, everybody. Thanks for the question. Maybe first, the scope for this step-up kind of quarter-over-quarter in volumes was impressive. Has anything changed? And I know you've kind of touched on it a little bit in terms of an inflection point, I think was the word used in one of the prepared remarks. I just would love kind of what you think is really driving that continued adoption from here as we see some of the noise sell down over the last year?

嘿，大家。謝謝你的提問。也許首先，這種銷售量較上季成長的幅度令人印象深刻。有什麼改變嗎？我知道你已經談到了拐點，我認為這是在準備好的發言中使用的這個詞。我只是想知道您認為真正推動這裡持續採用的是什麼，因為我們看到去年一些噪音拋售？

Yes. Thanks for the question. I'm going to ask Alex, our President of patient testing services to answer that.

是的。謝謝你的提問。我要請我們的病患檢測服務總裁 Alex 來回答這個問題。

Yes. Thanks, Andrew. We are leading through innovation and clinical evidence that hasn't changed. And I think as you look to see how our differentiation is emerging in the market are up HeartCare, we're talking talking about SHORE persistently. It's that type of evidence and us and us advocating for out of center by center approach to make sure that we're executing on our strategy. So while we see the growth and that we're pleased, this is something that is really baked into our strategy and our go to market.

是的。謝謝，安德魯。我們透過未曾改變的創新和臨床證據處於領先地位。我認為，當您看到我們的差異化在 HeartCare 市場中如何顯現時，我們正在持續談論 SHORE。正是這種類型的證據，以及我們和我們所提倡的逐中心方法，以確保我們正在執行我們的策略。因此，雖然我們看到了成長並且感到高興，但這確實已融入我們的策略和市場開拓中。

Okay. Helpful. And then maybe I think, John, you commented in response to bill something in terms of clinicians getting a little bit more comfortable on some of the Four Corners uses. Could you just elaborate a little bit more on that and kind of whether it's in regards to what the disruption really has been when it shouldn't have been or kind of what you meant by that comment and what you're seeing from that regard?

好的。有幫助。然後也許我想，約翰，您在回應法案時評論了一些關於臨床醫生對四個角落的某些用途感到更加舒適的問題。您能否詳細說明這一點，以及是否涉及到本不應該發生的干擾，或者您的評論的含義以及您從這方面看到的情況？

Yes, sure, Andrew. Thanks. Thanks for the question. I think this just reflects on what Alex was commenting on a second ago, which is and that is under the coverage criteria today in the Medicare program, there are a number of scenarios where the test can be ordered for cause it could be as a result of clinical signs and symptoms. It could be the result of another pre test that was performed such as a serum creatinine and being elevated.

是的，當然，安德魯。謝謝。謝謝你的提問。我認為這只是反映了亞歷克斯前一秒評論的內容，即今天的醫療保險計劃的承保標準下，有許多情況可以訂購測試，因為它可能是結果臨床體徵和症狀。這可能是另一項預測試的結果，例如血清肌酸酐升高。

It could be as a result of trying to monitor a change in immunosuppression levels for the patient. And so what Alex and his team have done quite successfully, it has been to educate clinicians at the centers around these scenarios in which the testing is medically. Both appropriate has utility and is considered reasonable and necessary under the policy so that they can utilize it in those settings. And that is driving to some degree, our growth as a company as they become more and more comfortable with those forecast scenarios and ordering it in those scenarios.

這可能是由於試圖監測患者免疫抑製程度的變化所致。因此，亞歷克斯和他的團隊做得相當成功，就是圍繞這些醫學測試場景對中心的臨床醫生進行教育。兩者都具有實用性，並且根據該政策被認為是合理和必要的，以便他們可以在這些情況下利用它。這在某種程度上推動了我們作為一家公司的成長，因為他們越來越適應這些預測場景並在這些場景中訂購。

Okay, helpful. Maybe just one last one I'll sneak in Abhishek. I think you said around $1,300 in terms of ASP for the rest of the year. If I back out if I'm doing the math right, backing out the 13 to this quarter, you were a little bit north of that in 2Q and you talk about the 27 million additional lives being added in terms of coverage. So any reason we shouldn't expect that number to kind of trend a little bit higher from here or maybe some of the moderating factors?

好的，有幫助。也許我會偷偷溜進阿布舍克，這是最後一件事。我認為您所說的今年剩餘時間的平均售價約為 1,300 美元。如果我計算得正確的話，如果我把 13 個數據回溯到本季度，那麼第二季度的數據就有點偏高了，而且你談論的是在保險範圍方面增加了 2700 萬人的生命。那麼，我們有什麼理由不應該期望這個數字會比現在稍微高一點，或者可能是一些調節因素呢？

Yes. The way I'm kind of thinking about this, Andrew, that I have baked in. Some of those pieces in the high end of our guide are not necessarily the midpoint of our guide. So that's how I see. I'm not seeing any kind of a step change here from Q2 is going to be more flattish at a very high level CSP assumptions.

是的。安德魯，我思考這個問題的方式是我已經習慣的。我們指南的高端部分中的一些部分不一定是我們指南的中點。我就是這麼看的。在非常高水準的 CSP 假設下，我沒有看到第二季有任何形式的階躍變化會變得更加平坦。

Okay. Great. Appreciate the thoughts and I'll stop there.

好的。偉大的。欣賞這些想法，我就到此為止。

Mason Coreco, Stephen.

梅森·科雷科、史蒂芬.

Hey, guys. Congrats on a really strong quarter how much of an impact has the SHORE data had on adoption trends? I mean, once your reps put that in front of clinicians and talk through with them, do you see utilization pick up on whether it's frequency of testing or for a ramp in new ordering clinicians? Yes, maybe I'll just leave it there.

嘿，夥計們。恭喜這個季度的表現非常強勁，SHORE 數據對採用趨勢有多大影響？我的意思是，一旦您的代表將其放在臨床醫生面前並與他們進行討論，您是否會發現利用率有所提高，無論是測試頻率還是新訂購臨床醫生的增加？是的，也許我會把它留在那裡。

Yes, thanks. This is Alex. Thanks, Mason. Ever since I think the introduction of the early data in Prague, this has been a big topic for clinicians around Heart transplant and that that has only increased I think we're in the early days of seeing the impact of SHORE. This is a 67 center study with 2,800 patients being followed for five years. The amount of data that's going to come out SHORE is tremendous. And I think we're just starting to see the early studies and the early data. So we're getting started and that's going to continue for some time.

是的，謝謝。這是亞歷克斯。謝謝，梅森。我認為自從布拉格引入早期數據以來，這一直是臨床醫生圍繞心臟移植的一個大話題，而且這一主題只會增加，我認為我們正處於看到 SHORE 影響的早期階段。這是一項 67 個中心的研究，對 2,800 名患者進行了五年的追蹤。岸上傳輸的資料量是龐大的。我認為我們才剛開始看到早期的研究和早期的數據。所以我們正在開始，這將持續一段時間。

Got it. Okay. And could you maybe give us a little bit of colour around some of the early conversations you're having with with transplant centers around the IOTA model has that driven any of the centers to increase their engagement with you guys or start to implement some sort of framework to more broadly utilize some of your offerings any broad color there, I guess.

知道了。好的。您能否給我們一些關於您與移植中心圍繞 IOTA 模型進行的一些早期對話的信息，這些對話促使任何中心增加與你們的接觸或開始實施某種形式我想，這個框架可以更廣泛地利用您的一些產品（任何廣泛的顏色）。

I think there is certainly increased interest centers notices coming out. They're trying to organize themselves and there's certainly many more questions we're receiving on areas that we are well-positioned to help them.

我認為興趣中心的通知肯定會增加。他們正在努力組織起來，我們確實收到了更多關於我們有能力幫助他們的領域的問題。

Okay. And last one here. I may have missed this, but did you guys call out volume trends across Oregon type during the quarter? Would you be willing to.

好的。最後一張在這裡。我可能錯過了這一點，但是你們有沒有指出本季俄勒岡州類型的銷售趨勢？你願意嗎。

No, we have not called out the volume growth at the organ level. But what we can say, Mason, that we are seeing growth across all the organs.

不，我們還沒有提到器官層面的體積增長。但我們可以說，梅森，我們看到所有器官都在生長。

Perfect. Okay. Thank you.

完美的。好的。謝謝。

Mark Massaro, BTIG.

馬克·馬薩羅，BTIG。

Hey guys, this is [Vini] on for Mark. Thanks for taking the question. I'm trying to understand that we're waiting for a CMS update in the coming weeks? And could you just give us a sense for how you're thinking about what the range of outcomes might look in the final LCD? I'm particularly given that the interim short data is out there and just any dialogue you've had with them since that data read out. Thanks.

大家好，我是馬克的 [Vini]。感謝您提出問題。我試圖了解我們正在等待未來幾週內的 CMS 更新？您能否告訴我們您是如何考慮最終 LCD 中可能出現的結果範圍的？我特別注意到臨時短期數據就在那裡，以及自該數據讀出以來您與他們進行的任何對話。謝謝。

And we appreciate the question. As I shared in the prepared remarks, we have observed CMS, I publicly state that they continue to want to provide will be access to monitoring assays for solid organ transplant rejection. And we anticipate that policy will be updated here in the coming months. And so we're monitoring for that. We, as you asked, we do regularly communicate with the agency and with our [MACs]. And of course, I've shared with them both assure data as well as our Nature Medicine Publication around kidney transplant management. So they are diligent about reviewing the literature and the positive results there. And so we'll just continue to await their final policy.

我們很欣賞這個問題。正如我在準備好的演講中分享的那樣，我們觀察了 CMS，我公開聲明他們繼續希望提供實體器官移植排斥監測檢測的機會。我們預計該政策將在未來幾個月內更新。所以我們正在對此進行監控。正如您所問的，我們確實定期與該機構和我們的[MAC]。當然，我與他們分享了有關腎臟移植管理的保證數據以及我們的《自然醫學》出版物。因此，他們非常努力地回顧文獻和其中的正面結果。因此，我們將繼續等待他們的最終政策。

Okay, perfect. Understood. And just one on just wanted to dig in a little bit more on the prior period collections and was pretty substantial number. And I typically you say that it is contemplated in the high end of the guide to some degree. But yes, should we think about a tapering off sequentially for the remainder of the year? And do the collections include tests just from the prior year? Or do they go back up further than that?

好的，完美。明白了。其中只有一個只是想深入了解之前的系列，而且數量相當可觀。我通常會說，指南的高端部分在某種程度上考慮了這一點。但是，是的，我們是否應該考慮在今年剩餘時間內逐步減少？這些集合是否僅包含前一年的測試？或者他們會比這更進一步嗎？

So these tests that we're calling out they definitely go back prior periods. We're not including any test that we've done in the current quarter in that $13 million number. And as I was referencing of previously, we have seen quite a few wins up based on a lot of effort that you have done the past many quarters. But you believe that now the available pool of these kind of wins is kind of shrinking. And that's the reason we decided to begin. Part of that's kind of our expectation on what it may kind of pan out in our high end of the guidance.

因此，我們提出的這些測試肯定可以追溯到之前的時期。我們沒有將本季所做的任何測試納入這 1300 萬美元的數字中。正如我之前提到的，基於你們在過去幾個季度所做的大量努力，我們已經看到了相當多的勝利。但你認為現在此類勝利的可用池正在縮小。這就是我們決定開始的原因。部分原因是我們對它在我們的高端指導中可能取得的成果的期望。

Understood, I'll leave it there.

明白了，我就把它留在那裡。

Yi Chen, H.C. Wainwright.

陳毅, H.C.溫賴特。

Yes, thank you for taking my questions on my first questions is when you talk about those tests performed in prior periods, are you primarily talking about maybe one, two or three quarters in the back or maybe one to three years in back?

是的，謝謝您回答我的問題，我的第一個問題是，當您談論之前進行的那些測試時，您主要是在談論過去的一個、兩個或三個季度，或者可能是過去的一到三年嗎？

Yes. So there are a couple of components on these tests are each and one is, of course, what we typically have called out around the Medicare Advantage where we have been working with these fairs. And these tests generally go back multiple years, not necessarily just a few quarters. So that's the first part. And the second part is that based on that of how we are seeing these increased collections and based on our discussions with the payers and everybody, we are kind of recognizing the revenue on certain tests, which is actually helping us improving our ASPs in the current quarter and on a go-forward basis. So there are two components there.

是的。因此，這些測試有幾個組成部分，其中一個當然是我們在與這些博覽會合作時通常圍繞著醫療保險優勢所提出的內容。這些測試通常可以追溯到幾年前，不一定只是幾個季度。這是第一部分。第二部分是，根據我們對這些增加的收款的看法以及我們與付款人和每個人的討論，我們在某種程度上認識到某些測試的收入，這實際上有助於我們提高當前的平均售價季度和未來的基礎上。所以那裡有兩個組成部分。

So sir, in the near term for the next two or three quarters, do you expect the top line growth could be primarily driven by test volume growth in the current quarter or better collection of tests performed in prior periods or maybe equally, they could contribute equally to [Talkline]

因此，先生，在接下來的兩到三個季度的短期內，您是否預計營收成長主要是由本季度的測試量增長或之前時期進行的更好的測試收集推動的，或者也許同樣，它們可能會做出貢獻同等於[通話專線]

The way we are guiding for the second half [each and churn out]. We are basically saying that our volume growth is going to be in the high teens and our revenue growth is going to be mid 20s. So you can basically say that majority of the revenue growth is still driven by the volume. But still there is a pretty a decent piece because of the ASP expansion, which is baked in our revenue guidance now.

我們下半年的指導方式[每個並大量生產]。我們基本上是說我們的銷售成長將達到十幾歲，我們的收入成長將達到二十多歲。因此，基本上可以說，大部分的收入成長仍然是由銷售推動。但由於平均售價的擴張，仍然有相當不錯的部分，這已納入我們的收入指導中。

Thank you for the clarification.

謝謝您的澄清。

Thomas DeBourcy, Nephron Research.

托馬斯·德布西，腎單位研究。

Hello. Thanks for taking the question. I guess still back to the prior period question. So I just maybe just want to clarify around the incremental coverage? And are you getting a look-back period from either [MA plans] or commercial plans? You know, I guess as you negotiate network reimbursement part of what's helping this?

你好。感謝您提出問題。我想還是回到了上一期的問題。所以我可能只是想澄清一下增量覆蓋範圍？您是否從 [MA 計劃] 或商業計劃中獲得了回顧期？你知道，我猜當你協商網路報銷時，部分原因是什麼？

Yeah. No, that's a good question, Tom. And let me give you an example here of that. We were we have been having these negotiations with the Medicare Advantage payers and one large national payer actually decided to process many of these unpaid claims starting January of 2022. So that's just an example as to sometimes we are able to kind of negotiate with these payers, some of the claims that we were not being paid in the past, and we're able to get that payment now.

是的。不，這是個好問題，湯姆。讓我在這裡舉個例子。我們一直在與 Medicare Advantage 付款人進行這些談判，一家大型國家付款人實際上決定從 2022 年 1 月開始處理其中許多未付索賠。這只是一個例子，有時我們能夠與這些付款人進行談判，有些人聲稱我們過去沒有得到付款，但現在我們能夠得到付款。

Understood. And then maybe just as a I'd related follow-up around you know, faster volume growth, obviously impressive you know. Is it relative to last quarter of it? Just you mentioned some of it is related to I guess, doctors understanding the various situations where they can order the test. Do you think overall maybe across top transplant centers that and there's a greater recognition or just more and more of, I guess, maybe from early adopters, it's shifting towards like maybe the little or the majority in terms of transplant doctors adopting, you know, [Bodadoric acid].

明白了。然後也許就像我周圍的相關後續行動一樣，銷量增長更快，顯然令人印象深刻。是相對於上季而言嗎？剛才你提到其中一些與我想醫生了解他們可以安排測試的各種情況有關。你認為總體而言，也許在頂級移植中心，人們對這一點有更大的認可，或者只是越來越多，我想，也許來自早期採用者，在移植醫生採用方面，它正在轉向可能很少或大多數，你知道，[波達多酸]。

Yes, hi. This is Alex, but I think it lessens the factors of multiple, right? So one is clinicians are getting more comfortable with ordering for costs, and that's clearly an area of value they want to use these technologies to help their patients. And but the bigger picture is we are early in this adoption cycle of these technologies. If you think about it, Alistair for kidney was launched six years ago, right? Majority of patients have never had a molecular test to help monitor their transplant. And so when you think about both those trends coming in place. It's certainly a factor, but we have a long way to go in this adoption cycle, and that's really what gets us excited about helping patients every day.

是的，嗨。這是亞歷克斯，但我認為它減少了多重因素，對吧？因此，臨床醫生越來越願意接受以成本訂購，這顯然是他們希望使用這些技術來幫助患者的一個有價值的領域。但更重要的是，我們正處於這些技術採用週期的早期。如果你想一想，Alistair for腎臟是六年前推出的，對吧？大多數患者從未進行過分子測試來幫助監測他們的移植。因此，當您考慮這兩種趨勢的出現時。這當然是一個因素，但在這個採用週期中我們還有很長的路要走，這確實讓我們對每天幫助患者感到興奮。

Thank you very much.

非常感謝。

Thank you. This does conclude our question-and-answer session as well as our conference for today. You may now disconnect your lines, and everyone have a great day.

謝謝。我們的問答環節和今天的會議到此結束。現在您可以斷開線路了，祝大家有個愉快的一天。