Q1 2021 Vivos Therapeutics Inc Earnings Call
Yeah.
[music].
Good afternoon, and welcome to the vivo Therapeutics incorporated second quarter 2021 earnings Conference call.
All participants will be in listen only mode.
Should you need assistance. Please signal of a conference specialist by pressing the star key followed by zero.
After today's presentation there'll be an opportunity to ask questions to ask a question you May Press Star then one on your telephone keypad to withdraw your question. Please press Star then two please note. This event is being recorded.
I would now like to turn the conference over the Edward load Investor Relations Officer of please go ahead.
Thank you operator, Hello, everyone and welcome to the both Therapeutics first quarter 2021 earnings conference call a copy of the company's earnings press release is available on the Investor Relations section of our website at Www Dot vivo slight dot com with us on today's call are Curt Hunter.
Spin vivo, chairman and Chief Executive Officer, and Brad <unk>, Chief Financial Officer Today, We will review the highlights and financial results for the first quarter 2021, as well as recent developments. Following the formal remarks, we will be prepared to answer your questions.
I would also like to remind everyone that today's call will contain certain forward looking statements from our management made within the meaning of section 27, a of the Securities Act of 1933 as amended and section 21 E of the Securities and Exchange Act of 1934 as amended concerning future events.
Words, such as May should project.
Expects intends plans believes anticipates hopes estimates and variations of such words and similar expressions are intended to identify forward looking statements. These statements involve known and unknown risks and are based upon a number of assumptions and estimates which are inherently subject to significant uncertainty.
<unk> and contingencies, many of which are beyond the company's control.
Actual results, including the results of the votes as growth strategies operational plans results of operations and other matters to be addressed by the books management. In this conference call may differ materially from those expressed or implied by such forward looking statements factors that could cause actual results to differ materially include but are not limited to.
The risk factors described in the other disclosures contained in <unk> filings with the securities and.
Exchange Commission, including our first quarter, 2021, 10-Q, which is being filed today, except to the extent required by law. The host of assumes no obligation to update statements as circumstances changed now at this time. It is my pleasure to introduce Kirk Huntsman, Chairman and CEO of the loss Kirk.
Please go ahead.
Thanks, Ed and thank you everyone for joining us today on our first quarter 2021 earnings Conference call. This is our second quarterly call as a public company and I'm excited to provide you with an update on our progress afterwards, our chief Financial Officer Brad.
We will review the highlights of our first quarter financial results followed following that we will be happy to take your questions for the.
Those of you not familiar with either of US we are of growing revenue stage medical technology company focused on developing and commercializing innovative diagnostic products and therapeutic treatment for adult patients suffering from sleep disordered breathing, including obstructive sleep apnea or OSA.
OSA is a chronic illness affecting nearly 1 billion people worldwide and over $54 million in the U S alone OSA can also lead to many other debilitating and deadly health conditions, such as high blood pressure heart failure stroke diabetes dementia, and other debilitating or life through.
The diseases this creates substantial societal and healthcare system costs not to mention the personal toll it inflicts on people and their families.
At <unk>, our mission is to rid the world of obstructive sleep apnea.
The market and sell two primary innovative products, one diagnostic and the other therapeutic each of which represents what we believe to be a best in class technology together, we believe they give us a great competitive advantage in the market for the identification and treatment of OSA consistent with our <unk>.
FDA approvals of.
Our flagship therapeutic product is the vivo system, a multi disciplinary set of clinical therapies and protocols, featuring our patented and customized M RNA oral appliance.
Studies have shown that treatment with the vivo system can reduce OSA severity as measured by apnea Hypopnea index scores by 67, 4% on average our vivo score product, which we gained access to and launched in the first quarter is a comprehensive home sleep apnea test.
To which we have exclusive distribution rights to the dental sleep markets in the United States and Canada.
Score consists of a single sensor ring recorder that works with a mobile phone application and proprietary cloud based algorithms to evaluate the sleep quality and clinically diagnosed sleep apnea.
The primary market channel for the vivo system in vivo score or the estimated 165000 general dentists and dental specialists in the United States and Canada to date, we have trained over 1200 dentists across North America and internationally in the use and application of the vivo system. Our dentist are enrolled in our.
The most integrated practice or VIP program, which offers training and other value added services in connection with using the vivo system.
Turning now to the first quarter, we continued to advance our strategic initiatives to benefit to the introduced the benefits of the vivo system treatment to members of the medical and dental communities.
This includes the Finalization of our licensee marketing and distribution agreement for and the launch of vivo score for home sleep testing in children and adults the.
The opening of our first new Somnial centre in del Mar and del Mar, California, and the launch of a new service called mile. Correct were trained therapists will provide the most trained providers access to oral facial mile functional therapy, otherwise known as <unk> via telemedicine technology before.
A review of our first quarter highlights I want to talk a little about the tip of the typical kind of activity. We see this time of year and perhaps more importantly, what we've been seeing here more recently.
As you may recall during the fourth quarter, we saw an uptick in both VIP enrollment as well as higher sales of our therapeutic products and services. The fourth quarter is typically a strong quarter for us. In addition to our continued organic growth in 2020 during the Q4, we usually experienced some seasonal activity activity.
Related to people utilizing their dental insurance benefits prior to the calendar year end.
In line with our forecast our revenue recognition policies the gradual post pandemic reopening of our economy and the timing of our sales cycle. We did not expect to realize the full impact of the capital deployed from our December 2020, IPO and accelerated growth actions in the first quarter of 2020.
One this is consistent with what we've shared with the analysts who cover us and why we beat the consensus revenue numbers for the quarter.
Related to this during the first quarter, we typically see a sequential slowdown in product sales activity. This reflects a slight lull that often follows the higher activity. We usually see in Q4 as dental offices overall are typically slower following the year end rush when people are trying to utilize the remainder of the dental insurance benefits to their fullest extent.
As a result of these factors I've discussed while our VIP enrollment was up quarter over quarter for the first quarter. The overall growth was slower than what we'd seen in Q4.
Having said that I am happy to report that following the typical seasonality of the first quarter. We have been very pleased by the strong interest in our products and services within the dental community, which has increased our VIP sales funnel.
This momentum has continued throughout may to date as many Dennis have reopened their offices more Americans get vaccinated and we of all move forward from this the disruptions of the COVID-19 pandemic. The second quarter has been off to a very strong start with enrollments by new VIP dentists, along with increased levels of daily appliance sales.
Demand for our new vivo score diagnostic product and <unk> therapy service available via telemedicine. During Q2 have also exceeded our expectations, although any material impact on our overall revenue from those two products is not expected to begin to be realized until the second half of 2021.
We are very pleased with this recent momentum and expect it will continue throughout the remainder of the second quarter and for the rest of 2021.
With that let me provide some highlights from our first quarter results I am pleased to report that for the first quarter of 2021, we generated revenue of $3 4 million, an 8% increase compared to $3 2 million for the first quarter of 2020, we.
We achieved gross profit of $2 7 million, an 11% increase compared to gross profit of $2 4 million for the same period in 2020.
The increase we also increased gross margin to 78% compared to the gross margin of 76% for the first quarter of 2020, we surpassed seven we surpassed 17000 in total cases treated with the vivo system and we ended the first quarter of 2021 with cash and cash equivalents of 14.
The $1 million as of March 31, 2021.
Brad will review our financial results with you shortly in more detail.
Im very pleased with the results, we're reflecting so far which reflect the most this quarter over quarter growth notwithstanding the onset of the view of the.
COVID-19 pandemic more than that I'm, particularly satisfied with our more recent performance.
As I noted earlier, our business began to pick up considerably in April and this has continued to date given the drivers which include continued adoption of the vivo system as well as accelerated growth in VIP enrollment and where we are now in mid May we expect this momentum momentum will continue throughout the balance of the second.
<unk>, we continue to be encouraged by our recent activity and look forward to updating you further when we have our next quarterly call in.
In addition to these results during the first quarter and in the weeks that of followed we continued making considerable progress in advancing a number of our strategic initiatives designed to both increase awareness of our therapeutic products and services and adoption of the vivo system throughout both the medical and dental communities as well as to broaden our.
Our scope of activities and potential revenue streams.
To briefly recap some first quarter achievements I discussed on our last call in January we commercially launch our arrow to software a new patient and sleek practice management software platform that will enable our VIP doctors to more effectively manage schedule monitor and process their patients with OSA and it's really.
<unk> conditions the <unk>.
<unk> in collaboration with Lyondell Aero. Two contains features that enhance our health care professionals medical building services and more including practice management systems, We believe our arrow to patient and practice management platform represents a significant improvement in how medical and dental professionals can effectively treat sleep disorders.
We look forward to continuing to market <unk> is a key value added component along with our existing building intelligence service and to actively pursue arrow to as of revenue source from other OSA focused health care providers that are not affiliated with vivo.
I would note that we like the Lion dental technology. So much that this past April relatively small spend we acquired from line of dental certain medical billing and practice management software licenses and contracts pertaining to the software underlying <unk>, thus, eliminating all of the middleman expenses to us.
In February we submitted a 500 10-K class II application to the U S food and drug administration for our Mmm RNA oral appliance with indications to treat the mild to moderate OSA sleep disordered breathing and snoring in adults are mrna oral appliance as a new version of our.
<unk> mrna appliance, which is an FDA cleared class II oral appliance, assuming the <unk> received.
500 10-K.
Class II approval, we would expect the <unk> RNA to be added to the centers for medical in Medicaid Medicare and Medicaid services list of approved sleep apnea appliances. This achievement will allow our vips to bill Medicare and the reimbursed for their patients aged 63% up.
That want the vivo system, while the process with the FDA is sometimes uncertain, we anticipate having this class II approval. Later this year. This would be an important development for us and we will keep you updated as this process continues.
Later in February as mentioned earlier, we gained access to and then launched our vivo score diagnostic product. It is important to note. The vivo scores core technology from our partner sleep image is the only FDA cleared software as a medical device for establishing sleep quality and diagnosing and managing OSA.
In both children and adults.
We believe this new technology will open the door for more patients to be diagnosed and eventually treated for sleep apnea.
Further we expect to generate increased revenue from vivo score due to anticipated rise in total patients being tested for sleep apnea with this translated into a corresponding increase in patients enrolling in the vivo system treatment.
This conclusion is based on the results of an informal pilot study conducted with independent dealers trained dentists and other vivo as provider feedback, which may or may not prove reliable on a broader scale, but in the public or in the pilot study 12, Devos trained dentists performed approximately 900.
The 38 sleep tests over a three month period using vivo score.
56% of the patients in the pilot study tested positive for obstructive sleep apnea and received a confirming diagnosis from a physician.
50% of those patients who tested positive then entered into treatment for OSA with the vivo system.
We believe these pilot study results indicate that vivo score may enable healthcare providers to more effectively efficiently screen diagnose and initiate treatment for OSA and their patients, which could result in more patients being treated with the <unk> system.
In addition to vivo score during the first quarter, we continued to make advancements through our medical integration Division with March opening our first new Somnial Center, our medical integration Division or MIP was launched in 2020 with the goal of creating strategic alliances between the medical and dental communities.
So more medical doctors could work directly with vivo has trained dentists for treating sleep disorders.
Disorders in patients with <unk>.
The lead this will further the diagnosis and treatment of OSA with the vivo system.
This first new some new center is located in del Mar, California and is the owned and operated by an assorted group of local physicians led by Dr. <unk>, a renowned cardiologist and founder and.
And president of the Academy of integrated Health and Medicine, and an award winning physician and researcher additional.
The additional new some of these centers are currently being developed in Nevada, and Nevada, Colorado, California, and New Jersey later in March we announced the launch of the new therapeutic service called mile. Correct were trained therapists will provide our VIP doctors and their patients with access to oral <unk>.
So Michael functional therapy or <unk>.
Utilizing telemedicine technology as a component to OSA treatment for their patients using the vivo system.
<unk> therapists work with patients to strengthen and improve function in the muscles of the lips tongue cheeks and face and their related roles in breathing sucky chewing swallowing and some aspects of speech clinic.
Clinical research has shown <unk> to be an effective component of OSA treatment further the most trained dentists, who are actively incorporating <unk> vivo system. The treatment protocols report four primary benefits one higher case acceptance for vivo system therapy.
To better patient compliance three shorter treatment times and for improved clinical outcomes. Despite these benefits due to the scarcity of trained <unk> therapists in many areas of the country and other factors too few dentists and patients have been able to access this important adjunct of.
Therapy.
<unk> will provide every vivo dentists and their patients with immediate and easy access via telemedicine to this valuable clinical resource at an attractive price point.
Over time, we expect to see additional revenue from this new <unk> service in the form of increased vivo system case starts and direct therapeutic fees charged for the service. We expect this <unk> service will become an important value added component in the treatment of OSA as it is more fully integrated into the vivo system.
We further believe that offering a scalable and cost effective OMD service via telemedicine will improve patient compliance shorten the overall treatment times and further improve clinical outcomes, thus, providing the most with a further competitive advantage in the marketplace.
More recently in April we announced the appointment of Dr. <unk> as an independent consultant serving in the role of medical director of clinical education.
As I mentioned earlier Dr. <unk> is one of several physician owners of the Eagle <unk> first New Somnus Center in del Mar, California in her newly created role of her duties for our company will include the promotion and expansion of our medical integration Division to her extensive network of medical colleagues.
We are extremely excited to welcome Dr coronary to vivo.
As a leading integrated cardiologist in North America. She is an incredibly valuable addition to our team her vast experience and expertise is an award winning physician and researcher make her a logical choice to help inform other physicians about our breakthrough diagnostic and treatment technologies. We are happy to have her with us and look forward to her.
Contributions to our rapidly growing organization.
In summary during the first quarter, we began to strategically deploy the capital from our IPO laying the foundation for accelerated growth and performance throughout 2021 and beyond at the same time, we achieved several significant milestones, including the commercial launch of <unk>.
Our 500 10-K class II application submission to the FDA for our mrna the oral appliance the finalization of our exclusive license marketing and distribution agreement for our vivo score sleep testing product and service.
The opening of our first new Somnus Center and the recent introduction of a new <unk> service for oral facial mile functional therapy.
Looking ahead as I noted earlier in April we began to see a substantial increase in activity throughout all facets of our business. This uptick has continued to date in may and we believe it is further proof of the continued adoption of of ecosystem and the accelerating growth impact due to our vivo score of diagnostic products.
And Mike correct therapy services.
This recent activity in the drivers of our business. We are hopeful that this momentum will persist throughout the remainder of the second quarter the.
The last month has also seen the publication of two important peer reviewed papers, adding further value of validation and support to our core therapeutic technology, along with the long anticipated publication and the arrival of a new textbook by our founder and Chief Medical Officer, Dr. Dave Singh called <unk>.
And cranial facial epigenetics with.
With the forward written by Dr. Clean sheet of the Division Chief and medical director at Stanford Sleep Medicine, and the Stanford Center for Human Sleep Research at Stanford University Medical Center.
So with these achievements so far during our brief time as a public company and our current business momentum. We are extremely excited about our prospects. We look forward to updating you on our continued progress as we execute on our strategic initiatives to expand market share and increase awareness of our therapeutic products and services through our mark.
Can you the initiatives and medical integration Division.
This concludes my opening remarks, now I'll pass the call onto Brad who will review our financial results Bret.
Thank you Kirk and good afternoon, everyone. Today I'll review, our first quarter 2021 financial results. We reported total revenue of $3 $4 million for the first quarter of 2021 compared to $3 2 million for the first quarter of 2020, the 8% quarter over quarter increase was.
Related to revenue from VIP enrollments.
Intelligence service subscriptions and a small amount of initial management fees from our medical integration division or <unk> program.
During the first quarter, we enrolled 53, Vips and recognized revenue of approximately $1 8 million compared to 32, Vips and recognized revenue of $1 5 million during the same period last year.
Additionally, our billing intelligence service revenues increased from $156000 in the first quarter of 2000 $20 million to $203 million are just the $203000 for the first quarter of 2021 during the first quarter of 2021, we sold 2500.
70, oral appliance arches compared to 2099 total oral oral appliance arches during the last year's first quarter with revenue slightly higher in 2021 due to volume increases.
<unk> profit was $2 7 million for the first quarter of 2021 after the 11% compared to gross profit of $2 4 million for the first quarter of 2020 for the first quarter of 2021 gross margin was 78% an increase of two percentage points compared to 76% for the first.
Of 2020.
We continue to see improvement as our business continues to be driven by high margin service revenues, including VIP enrollments and billing intelligence service revenues during the period.
General administrative expenses were $5 1 million for the first quarter of 2021 compared to $4 2 million for.
For the first quarter of 2020. This increase was due to additional personnel that were higher during the course of 2020 and early 2021 to support our continued growth and new status as a public company.
The net loss was $3 4 million for the first quarter of 2021 compared to $2 6 million for the first quarter of 2020 the quarter over quarter increase was mainly due to higher G&A expenses due to the factors that I discussed earlier.
Turning to our balance sheet at March 31, 2021, our cash and cash equivalents were $14 1 million compared to cash and cash equivalents of $18 2 million at December 31, 2020.
To strengthen our balance sheet, we recently closed a follow on public offering of four point.
6 million shares of common stock at a public offering price of $6 per share aggregate gross proceeds from this offering were $27 6 million prior to deducting underwriting discounts commissions and other operating expenses.
These proceeds in addition to the proceeds from our December IPO should give us the considerable financial flexibility to continue executing on our growth strategy.
As for the reasons for this raise our board of directors and management, we're pleased by the initial demand of.
Of our vivo score of <unk> products and services and concluded that the additional capital could be highly beneficial, allowing Venus vivo to staff up significantly to meet the demand and potentially accelerate revenue growth.
Before I go to Q&A I want to provide an update on the coronavirus.
Pandemic as it relates to our company as we noted on our last conference call. The COVID-19 pandemic created a global disruption in economic activity.
Due to this decrease in global economic activity as well as local restrictions temporary business shutdowns and social distancing practices, many of our vips and potential of Vips closed their offices during 2020, while revenues growth flattened during March and April of 2020 are.
Texas were also reduced due to our disciplined management of expenses.
At the same time, we aggressively expanded our network of healthcare providers familiar with our products by offering online continuing education courses, which introduced many in the medical and dental communities.
To our product line.
<unk> businesses and the general economy have continued to reopen during 2021 the impact of COVID-19 on our business continues to diminish our VIP program continues to grow while sales of <unk> appliances have steadily increased. Additionally, we have continued to work to improve cash flow.
<unk> and manage our working capital.
Given these factors as well as our recently price secondary offering we believe our existing cash resources will be sufficient to meet our capital requirements and fund our operations for at least the next 24 months.
Moving forward, we will continue to aggressively expand our network of healthcare providers familiar with veeva products by offering online continuing education courses, which have proven to be both successful as well as cost effective in introducing new members of the medical and dental communities to our services and products.
We continue to see greater awareness and adoption of the vivo system throughout both the dental and larger health care communities.
Given our continued momentum in 2021, we expect this trend will continue throughout 2021 and into next year.
That concludes our prepared remarks, now I would like to open the call for questions off.
Operator, Please go ahead.
We will now begin the question and answer session.
To ask a question you May press Star then one on your telephone keypad.
If you are using a speakerphone. Please pick up your handset before pressing the keys to withdraw your question. Please press Star then two at this time, we will pause momentarily to assemble our roster.
The first question comes from Alex Nowak with Craig Hallum Capital. Please go ahead.
Greg Good afternoon, everyone just over the last six months or so we've seen veeva has built out a pretty nice portfolio of cross trading I would say of the dental office, you've got the new solvency of clinics the V.
The score of the telemedicine App and then the patient management software are there any other areas you'd like to bring on to round out that portfolio.
So thanks, Alex good question there.
We are always looking opportunistically for the right kind of platform to leverage.
Whether it's the technology or some other means of accessing.
The marketplace so.
I would say there is not anything directly we pretty well assembled what we have.
Today, and now it's a matter of execution, but we're always looking.
At the different platforms and other opportunities to extend the reach.
Okay that makes sense and perhaps expand the ways to leverage the investment dollars from the IPO to expand the sales and marketing strategy here for vivo is the press release today of mentioned it looks like there is a new marketing firm. So just expand how youre looking to change the marketing of the appliances. How are you going to change the.
Marketing or expand the marketing for the VIP enrollments and.
Yes, I guess I'll leave it there I'll ask a separate question.
Yes, another good question so.
We validated our model for our our sales force prior to the IPO, where we took rather than having of series of of independent sales reps that were out there sort of operating on their own we actually formed teams and the team we had one fully constituted team.
That had a variety of different functions and people playing different roles on the team and what we've done now is since the IPO, we've actually replicated our second team and now of 13, so, whereas we were we had.
Sort of of limited capacity prior to the IPO and limited resources to be able to accelerate and add more marketing people. We are now scaling up by replicating these teams across the country. So we have.
We have a second team and of 13 that will be fully constituted by the first of June and then we will add additional teams as needed throughout the balance of the year and Thats how were approaching the enrollment side of things on the on the.
Vivo score side, we've had we've had the basically put an entire department together of the demand that we saw once we announced the vivo score product the demand came fast and furious and frankly caught us a little bit by surprise is just the nature of it was global we had people calling us.
Around the World I didn't know if anybody is reading our press releases quite frankly, but but they did and apparently they had interest and so we feel we were fielding calls from all over and so we knew we needed to gear up.
The company make sure we had a robust division led by people that have experience in these things. So we've made some new hires we've constituted the vivo score division. We've got programs put in place I just got back from a conference in Dallas, We had another conference down in Florida, where we had some amazing results.
Leading I've referred to the vivo score product as the tip of the spear.
And I think that's really what's happening. It's the first exposure that these doctors have to us and it works, so well and so seamlessly.
We gave a bunch of doctors the devices to go sleep with overnight and they came back the next morning.
I don't remember too many doctors that didn't have some.
<unk> of varying levels with the sleep that they had it was just it was really eye opening experience for these doctors and it opened the dialogue for us to really to really have a conversation with the Dennis about the need for this in their practices and the opportunity that <unk> represents so by leading with vivo score we're opening up the dialogue with me.
More professionals, both on the dental side and the medical side and they're able to have the conversation is more readily with their patients.
No that's great and just the path of the sales point on those teams.
Stablish here.
Is there a focus as well to improve same store sales and I guess, what I'm trying to get that you have some vips that are doing a high number of cases, you mentioned those in the prepared remarks, but then the average is lower so just curious.
Where are you focusing the sales side to improve the same store sales performance.
Okay, Yes, so down of down of parallel track to our enrollment teams. We also have what we call practice.
Analysts and so these these practice of analysts are actually.
Experienced people from within the dental the dental space, who have lots of lots of experience in rolling out products within the dental offices. They are dispatched to the new enrollees. So what happened was with COVID-19 a lot of these dental practices shut down for a period of time last year and a lot of them took the.
To get enrolled but they couldnt get in they can get they can start their training, but they couldnt quite get everything done to get on boarded and to get really get that first the first few cases are always the hardest. So what what we've done is we've hired and continue to hire people on our practice advisor level and they have ridden.
<unk> the number of of practices that have yet to engage by a significant amount I don't have that number off top of my head, but I remember the really pleased with it.
As the number of doctors that have actually started cases with US is now it was over 88%. The last number that I looked at so whereas during the middle of COVID-19. It was down around 50%. It's actually come up is that come up quite a bit. So we're actually seeing a much greater engagement level from our doctors as they.
Come out of COVID-19, they get the full measure of the training. There is there is a a part of their training that we ask them to come to Denver for it's now mostly online it used to be all in Denver now, it's mostly online with some of it in Denver, but they have to get the Denver to see the the field the.
The appliances to actually get there their minds around what this is and how it works and to get comfortable enough that they're going to they're going to tell the patient, let's do this and that's actually where we feel really good about what's going on so we're running down parallel tracks. There. In addition to the new enrollments, we have a whole another initiative from that division.
That is working on the same store sales.
Okay understood that makes sense and then just last question just an update on the Stanford study and then any other data readouts, we should be watching for.
Yes, the Stanford I think Brad.
We sign and this week, we should be signing.
It's ready to be launched yes, it's ready to be executed. So the final documents that we were back and forth of little bit with Stanford on we've resolved all of those issues and so I think we're ready to sign the deal and get started so that the.
The.
The Stanford study will start right away. So very excited about that there's other studies that we are that we have underway I'll remind you that other IRB studies that.
That have been underway or about to conclude in the next few months and we will be.
The reporting on the results and publishing those.
Of those papers later this year.
Alright, Thats great I appreciate the update thank you.
You bet. Thank you. Thank you Alex.
The next question is from Scott Henry with Roth Capital. Please go ahead.
Thank you and good afternoon.
Apple of questions first.
You recently brought in that second sales force team.
Can you talk about where they are in the cycle are they productive at this point are they generating new VIP.
Yes, they are so.
Yes, I'll just tell you that.
We're very happy with the way that they are they are ramping up and they're not quite to the same productivity level as our as our first team but.
I think we are really happy with the way that's come along so yes. The answer is yes.
Hey, Greg it sounds like a lot of positive leading indicators.
In this first quarter would you expect to see sequential upticks throughout the year on a kind of quarter to quarter basis.
Total revenues in and perhaps on the VIP front as well, although you might get some choppiness here of that.
Well I would tell you that our forecast as you well know our forecast call for us to see acceleration in enrollments as well as appliance sales throughout the year. So there's nothing that's happening now that dissuades us from that.
We're seeing we're seeing daily record set in the number of appliance orders. So we're very excited about the recurring revenue streams as well as the the new enrollments.
Yes.
Target given the current momentum that we're that we talked about today.
Excellent.
And G&A a little higher in Q1 do you think Q1 is representative of what we should expect throughout the year.
On G&A, yes, we do have some infrastructure type of expenditures, we have an ERP system that we're planning on bringing on here later this quarter.
And we do have certainly sales and marketing expenditures are planned to increase to help drive top line revenue.
So what happens here, though is that and I think this is true of most businesses but.
And our business in particular, we have to hire in advance of when people start generating revenue so for for the.
The add on of marketing expenses et cetera.
In the current quarter, we're not going to see the benefit of that we're just going to be sinking cost into the marketing assets that we need the the personnel that we need the vivo score department hires that have to be hired up of trained up and dispatched all of those things require capital to the to go.
<unk> and expenses to be incurred in advance of when you start to see the ROI. That's why as I sit here today, we're making a lot of those investments the.
The IPO and secondary offering capital is being very.
<unk>.
Judiciously applied to these areas, where we can see in the second half of this year from Q3 for we're going to start to see we're going to see some of it in Q2, but it's going to be mostly of Q3 Q4 that we're going to see the results of some of these.
Capital deployment and investments in that so I would say, yes, we are experiencing some higher slightly higher.
G&A, but its all with the eye towards seeing future near term growth in the business.
Okay. Thank you for that color of final question, just with regards to the mrna, let's say you get that approval later this year.
How long does it take from approval to being able to get Medicare reimbursement and one of the steps in that process to make that happen.
Well there is several steps associated with that so we have to we have to get.
CMS too.
To approve it that requires a.
P deck, what's called <unk>.
Clearance, so theres a step of involved in sort of of third party looking at the actual mechanics of it that shouldnt be of probably already completed all of the bio mechanical work that needed to be done. It's a hinge basically that we went back to the FDA with it.
There's no <unk>.
<unk> of the changes or anything it's basically the switching out of one type of hinge for another tight. It's the other type is what is required by Medicare why they would do that we don't know nobody can tell us but it is what it is.
So so we have several steps along the way and.
We can't say with certainty what the timing looks like or how all of these people are going to respond, but it should be fairly straightforward to get this approval and to get it through this process and then we could we could be if we can get the FDA to release it in the next.
Say month or two.
Three.
We should be six to eight weeks after that we should be able to get the clearance and go forward.
Okay. Thank you for the color of thank you for taking the questions.
You bet.
This concludes our question and answer session I would like to turn the conference back over to Kirk Huntsman for any closing remarks.
Thank you operator.
We feel like with the with the capital of the much needed capital that we obtained through our IPO and our secondary that we have positioned this company to be a disruptive force in the market as we move forward as we begin to get the the name Devos.
And our brand out there using osman marketing our new.
Marketing group that we have they have just embraced this full full tilt and they are aggressively creative marketing assets and helping us with the rollout. We're very pleased with that we're very pleased of the way our medical division is rolling out and the exposure that we have seen some of these new papers that I've referenced here.
That of come to market. The doctors seeing is published and others have published.
Give us great hope for being able to continue to make the case that vivo has.
Has a a game changing technology.
From a therapeutic standpoint, and certainly from the diagnostic standpoint, something thats already showing some disruptive capabilities in the market. So I think we've positioned us very well I always say if the world knew what we really had here it would be a much different story for us, but but we are gradually and and Judy.
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Putting this thing together and put it into the out in a way that that we think will optimize the the growth opportunities that we have and maximize shareholder value. So with that we'll close this out I appreciate everybody's support of the company and our our team here and we look forward to.
Having you onboard and see you again next quarter. Thank you.
Thanks, everybody the car.
France has now concluded. Thank you for attending today's presentation you may now disconnect.
Okay.
[music].
Okay.