Scott: 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 creates 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: Thank you. As a reminder, to ask a question, please press star 11 on your telephone and wait for your name to be announced. To withdraw your question, please press star 11 again. Please stand by while we compile the Q&A roster. And our first question comes from Kyle Mixon of Canaccord Genuity. Your line is open.
Kyle Mixon: Hey, guys. Thanks for the questions. Congrats on a great year. I WANT TO GO BACK TO THE FIRST QUARTER COMMENTS AND JUST TRY TO UNDERSTAND HOW MUCH OF A STEP DOWN WE SHOULD EXPECT WITH REVENUE AND VOLUME WITH RESPECT TO THE I GUESS IT'S RELATIVE TO THE FOURTH QUARTER BECAUSE YOU KNOW THERE'S 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 IF YOU COULD TALK ABOUT
Robin: know how we should take them at the step down um for volume and then pricing and especially given the deductible dynamics and then um the weather too i mean i know you referenced that but there's obviously been some you know 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 um 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 um increased collections in the fourth quarter, about a million dollars of collections from claims over one 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 volumes. So we're anticipating that the volume dynamics and the ASP dynamics are consistent with our historic seasonality.
Kyle Mixon: All right, great. Thanks for that. And maybe just one on the pipeline as well. I think I heard, Scott, you were mentioning going to some of these other tests. Could you, you know, maybe just to the extent that you have not already shared on the call, could you talk a little bit more and elaborate on on those new tests, what you're developing, what you aim to launch in the next, you know, 12 to 18 months, let's say. And ultimately, like, what are you the most excited about in the, you know, kind of future portfolio for the company?
Scott: Yeah, thanks, Kyle. Great question. You may recall at AMP, Dr. Gary Postano led an R&D day representing Biodesics where we had other participants from BioRad, 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 since 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, reimbursement timing, and the appropriate studies that will 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 asked 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.
Kyle Mixon: Perfect. And finally, on the primary care kind of rep cohort that you've been building, I think now that almost all of them are probably up to speed and mature and, you know, 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 the primary care rep base? Is it, you know, 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, you know, throughout 26 as a year, you've had the proving ground in 25 and now 26 as a year to kind of, you know, that will pay dividends, I guess.
Scott: Yeah, it's a great question. We continue to see the primary care focus, you know, 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 honored 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'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 and 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 in doing so. We'll see a state shift over time.
Kyle Mixon: Awesome. Okay. Thanks, Kyle. Thanks, Robin. Appreciate it.
Thomas Flatton: Thanks, Kyle.
Operator: Thank you. And our next question comes from William Ruby of TD Cal, and your line is open.
William Ruby: Hi, thanks for the questions. First question is just, you reached adjusted EBITDA 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.
Robin: Thanks, William. Appreciate the questions. Yeah, we feel very good about the cash position. We not only showed the operational improvement, strong growth 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.
William Ruby: Gotcha. And then also just on the guy that came in above the street, just wondering, what do you see as some of the most likely upside levers this year to guidance?
Robin: 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 really in the last part of the year. they're really just getting their feet under them. And for most of the, 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 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 its volume, ASP, and development services funnel.
William Ruby: Gotcha. If I could just ask one more, actually. I think you mentioned on the Q1 call, and I think Scott mentioned earlier, and Susan Garwood's presentation mentioned as well, that you seem to see some stage shift by referring through primary care. I'm 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 for your shifting stage earlier.
Scott: Yeah, thanks, William. It's a great question. We have. The way it usually transpires is physicians will share with us what they're seeing, some of their performance. We've encouraged those individual physicians and 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, You know we want to encourage those physicians that are seeing the positive impact of utilizing notify 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.
William Ruby: Thank you very much.
Scott: Thanks, William.
Moderator: Thank you.
Operator: And our next question comes from Andrew Brackman of William Blair. Your line is open.
Andrew Brackman: Hey, Scott. Hey, Robin. Good afternoon. Thanks for taking the question. Maybe I'll pick up on that last question there, sort of around the data readouts that you expect. I think, you know, you've been making some good progress on CLARIFY over the last couple of quarters. So anything new to share there on 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.
Scott: Yeah, thanks, Andrew. Great questions. With CLARIFY, we're going to continue to look at different interim analysis and kind of subgroups, if you will, With Clarify, we're not going to wait for CHEST, so we'll continue 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 regards 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 two years. So for 2026, we won't hit the one-year endpoints. until third quarter. So 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.
Andrew Brackman: Perfect. Thanks for all that color. And then I want to go back to 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.
Scott: 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 is 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 notify 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 XL2, 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 in to 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 weekly and monthly basis. Those positive stories really reinforce 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. There's sharing of best practices. And they're excited to possibly impact patients first and foremost. And so we are seeing it work exceptionally well. And we continue to anticipate broader adoption as we progress through 2026. Very helpful. Appreciate all the color. Thanks, Andrew.
Operator: Thank you. And our next question comes from Thomas Flatton of Lake Street Capital Markets. Your line is open.
Thomas Flatton: 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 sales force in 2026, Can you just help us understand what that allocation is going to be between PCP and pulmonology?
Scott: Yeah, thanks, Thomas. You know, 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 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 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.
Thomas Flatton: And maybe just playing that out, you probably won't be able to share anything quantitative, but maybe qualitative. How do you see the differential growth rates through 2026 between the two channels?
Scott: Yeah, again, can't really be that – you know, 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 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.
Thomas Flatton: And then just a quick one. Any insight to share on the HEDIS guidelines?
Scott: Oh, yeah, nothing new on HEDIS. I think it was September timeframe 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 still will remain. And we know that once they make those statements, it will create a different change than we're able to facilitate ourselves. And so we've referenced the example in breast cancer historically. You know, we're eager and supportive of this. It will benefit us and help, but most importantly, it will 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 HEDIS and guidelines, no material updates. Both parties just continue to state that they will continue to prioritize it and provide updates in 2026.
Thomas Flatton: That's great. Thank you. Thank you, Thomas.
Moderator: Thank you.
Operator: And our next question comes from John Wilkin of Craig Hallam. Your line is open.
John Wilkin: Hi, guys. Congrats on hitting the Bada milestone in Q4. Wanted 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?
Robin: Yeah, absolutely. We track everything very, 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 tests.
John Wilkin: Got it. And then for the, I don't know, 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.
Robin: Yeah, we've been very, very pleased with the caliber of reps that have been hired and brought in. We historically have seen that it takes two to three 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 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 first 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.
John Wilkin: Perfect. Thank you so much. Thanks, John.
Operator: Thank you. This concludes our question and answer session and today's conference call. Thank you for participating and you may now disconnect.
