Q4 2021 Exagen Inc Earnings Call

Greetings, ladies and gentlemen, and welcome to the Exigent, Inc. Fourth quarter 2021 earnings conference call. At this time all participants are in a listen only mode. A question and answer session will follow the formal presentation. If anyone should require operator assistance. During the conference. Please press star zero on your telephone keypad.

Please note that this conference is being recorded I would now like to turn this conference over to your host Brian Douglas Investor Relations for oxygen. Thank you you may begin your presentation.

Good afternoon, and thank you for joining us today earlier today <unk> released financial results for the quarter and fiscal year ended December 31 2021.

Or at least is currently available on the company's website at Www Dot extra Gen Dot com.

Ron Rocca, President and Chief Executive Officer, Kemal Dowie, Chief Financial Officer, and Mark Hazeltine, Chief operating Officer will host this afternoon's call.

Before we get started I'd like to remind everyone that management will be making statements. During this call that include forward looking statements within the meaning of federal Securities laws, which are made pursuant to the safe Harbor provisions of the private Securities Litigation Reform Act of 1095.

Any statements contained in this call that are not statements of historical fact should be deemed forward looking statements. All forward looking statements, including without limitation statements regarding our business strategy and future financial and operating performance, including 2022 guidance the impact of COVID-19 pandemic on our business are.

Current and future product offerings and reimbursement and coverage are based upon current estimates and various assumptions. 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 these risks and uncertainties associated with our business. Please see our filings with the Securities and Exchange Commission, including our Form 10-K and subsequent filings the information.

Provided in this conference call speaks only to the live broadcast today March 22022 extra Gen disclaims any intention or obligation except as required by law to update or revise any information financial projections or forward looking statements, whether because of new information future events or otherwise.

I'll now turn the call over to Ron Rocca, President and CEO of extra thanks.

Thanks, Ryan and thank you to everyone joining the call today I will discuss our fourth quarter and 2021 highlights as well as give updates on our payors pipeline and growth plans I'll, then hand, it over to come all our CFO for details on our financial results and as always we appreciate your continued support.

Of extra.

2021 was another record breaking year for action and one we're extremely proud of we.

We had record revenues of $48 3 million for the year with $12 7 million coming in the fourth quarter.

Our strong performance throughout the year was fueled by growth in our flagship advise CTD test, including advised lupus, which set a record of over 128000 tests delivered for the year and a record of over 34000 tests delivered in the fourth quarter.

From inception through 2020 , one we have delivered over 615000 test. We also achieved a record of 2126 total ordering health care providers in the fourth quarter and a record of 739 adopters for our flagship advise CTD.

And advised lupus test.

We again saw very high retention rate of 99% among adopting health care providers from the prior quarter we.

We believe this high retention rate and the continued increase in the number of ordering health care providers speaks volumes to the value our customers recognize and using advised testing.

I'm very proud of our team as these records continues to show our sustained success in delivering autoimmune testing solutions that help accelerate the historically slow and frustrating process of clinically diagnosing auto immune disorders.

I'd like to point out that these record milestones were achieved in a year that solve various waves of COVID-19 outbreak that impacted patient flow, which resulted in diminished testing volume.

The omicron variant impact persisted through mid Q1, 2022, where we saw the worst January in the past three years in regards to volume.

This onto crime subsided in February in the United States. The sequential six week total volume demand was an all time record for advise CTD and advised lupus test.

We continue to make progress on the reimbursement front and are happy to announce the signing of a covered in network agreement with the National plan Wellcare Centene.

This agreement adds over $22 million in network lives any payers continues to be a high priority for X gene and brings our total in network lives to over 91 billion.

Signing these contracts is immensely helpful to both patients and physicians, we look forward to continuing this momentum in 2022 as our payer dossier continues to strengthen and payers are currently not inundated with reviewing Covid test.

Turning now to our R&D efforts, a key strategic focus of ours is to drive multiple sources of innovation and strengthen our IP portfolio to solidify <unk> as a premier autoimmune testing company.

In doing so we added a second platform to our testing portfolio with the addition of advisor radar.

Advise radar, which stands for rheumatoid arthritis drug response will bring oncology style precision medicine to rheumatology.

We exclusively licensed worldwide IP rights from Queen Mary University of London for technologies that will utilize RNA gene expression testing through Sanofi old tissue biopsies to predict patient response prior to the selection of commonly prescribed biological therapies.

We expect this platform will significantly benefit both patients and payers approximately 2 million people in the United States currently suffer from our a and are prescribed a multitude of different high cost therapeutics.

Unfortunately, only about 20% of those patients reach a low disease activity state, which implies a waste of approximately $18 billion in therapeutics spending in the United States alone.

We believe with our advisor radar platform Rheumatologists, we'll have the precision testing that will add clarity to their clinical evaluation of therapies.

We are developing advised radar to reduce the trial and error of empirical therapeutic selection and the resulting odyssey that patients experience. We recently formed a new scientific advisory board comprised of top thought leaders in the field. We are targeting our clinical experience program for Kols in late Q4.

We believe this new platform is a perfect fit for <unk>, because it allows us to leverage our existing rheumatology infrastructure to address one of the largest therapeutic markets and unmet needs.

Continuing with our pipeline, we are addressing another large market with unmet needs with our advisor fibro insight test.

We are happy to announce the fiber patients enrollment in our better study is now complete.

The study covers 10 sites and will take approximately a year to complete.

Further the advice MTX trial with Cvs Aetna has officially launched we look forward to providing you with additional updates on both topics throughout the year.

Before I hand, the call over to come all I think it's important to note that we are delivering on our plan to own the rheumatology hilltop by executing across all verticals.

Our growth strategy is to continue to execute commercially expand our coverage of payors and develop a robust pipeline.

The mission of X gene is extremely important.

Our opportunities have never been greater.

With that I will now turn the call over to come off.

Thank you Ron and good afternoon, everyone Q4, 2021 casting revenues, which are derived from our core products grew to $12 5 million. This represents a 14, 2% year over year growth total revenues in Q4 were $12 7 million, which were consistent with Q4 2020.

Total revenues for the full year 2021 were $48 3 million, which was a 15, 1% year over year increase from 2020, despite the impact from the ongoing COVID-19 pandemic.

Total revenues were driven primarily by helping volumes from buying DTD, including a by Blue Paas for a record 34147 in the fourth quarter and 128240 <unk> for the full year.

As Ron mentioned the record number of ordering health care providers was 2120 <unk> for Q4 2021, compared with 1690 for Q4 2020.

Our buying CTD test revenue was $10 4 million in the quarter and other testing revenue was $2 1 million.

<unk> CTD revenue for the full year was $39 2 million and other testing revenue was $7 9 million.

Revenue for Symphony was <unk> 2 million for Q4, 2021, and conclude all revenue we will recognize from the agreement. Once again, we're pleased where the performance of our core testing franchise in spite of the headwinds from the ongoing COVID-19 pandemic.

Cost of revenue were $4 9 million in Q4 2021, resulting in a gross margin of 61, 1% compared to 65, 8% in Q4 2020.

For full year 2021 cost of revenue were $26 million with a gross margin of 57, 4% compared to $16 6 million and gross margin of 55% for the full year 2020.

The decrease in gross margin was driven by a decrease in high margin non core revenue, resulting from the Janssen agreement passed in gross margin represents the gross margin of our tap and excludes the effect of the Janssen agreement testing gross margin was a record at 65% in Q4 2021.

<unk> compared to 64% in Q4 2020.

<unk> gross margin for the full year 2021 was also a record at 36, 3% compared with 55, 1% for the full year 2020.

Operating expenses in Q4, 2021 were $18 9 million compared with $15 4 million in Q4 2020.

Operating expenses for the full year 2021 were $72 4 million compared with $57 2 million in 2020. The increase was primarily due to the expansion of our decentralized sales force and the creation of an inside sales team further costs were incurred from the build out of an R&D team to support the advisory.

Our platform and cost of revenue due to the increase in testing volumes.

The net loss in Q4, 2021, with $7 1 million compared with $3 5 million in Q4 2020 for full year 2021, the net loss was $26 9 million compared to $16 7 million in 2020.

Looking at our balance sheet, we remain well capitalized for growth cash and cash equivalents as of December 31, 2021 were approximately $99 4 million.

For full year 2022, we expect total revenue to be in the $51 million to $53 million range.

January and first half of February were negatively impacted due to the surge in the omicron variant.

As Ron previously mentioned since omicron subsided in the United States in mid Q1, we have seen the sequential six week total volume demand for buying CTD and advised lupus have reached an all time record.

We will now open the call for questions.

At this time, we'll be conducting a question and answer session. If you would like to ask a question. Please press star one on your telephone keypad, a confirmation tone will indicate your line is in the question queue. You May press star to cheer them move your question from the queue.

<unk> is using speaker equipment and may be necessary for you to pick up your handset before pressing the star keys, one moment, while we poll for questions. Our first question comes from the line of Max Masucci with Cowen You May proceed with your question.

Hi, guys. Thanks for taking the question, it's Stephanie on for Max Masucci, Congrats on the 17 payer wins.

My first question is do you think that the <unk> reimbursement win could play a role in your conversations with other payers and if you could give a little more color on specifically the Sweden for instance, what did you find out the final hurdle or factor that you needed to address in order to secure coverage with <unk>.

Yeah, Thanks, Stephanie and welcome.

This is an important one for us and it's a big National plan, obviously over $22 million. What happens now is as you gain momentum and are approaching a third of the country being covered is it puts it put it does put pressure on the other national payers.

We feel that that along with the studies and the dossier, we have as well as other materials. We have is going to continue to push for coverage in network status.

So yes to answer your first question. It should absolutely helped you gain momentum there's a tipping point, where you just become part of the of the criteria for payers to enable the doctors to take care of these patients. We do have the kols support we have over 35 papers that were published in top journals. So we feel really good about that.

As far as your second question I actually think the disparity in treatment has really reached a fever pitch with these payers and they're aware of it.

Lupus nine out of 10 lupus patients are women and it affects women of color disproportionately and they need to take care of that they know there's an issue with that and by the way we do too we run thousands of samples and we can see that the people that really need this women of color. Hispanic African American and Indian American Indian who get lupus disproportion.

<unk> really need a test like this keep in mind that the stable test that they used to use a N a which developed in the late forties and NTT CNA in the early forties. So they didn't have a lot to choose from in the past, which is why it took six years to get correctly diagnosed with this potentially deadly disorders. So.

This has been a big breakthrough as far as testing and making sure that the patient does have the disorder and you can put them on the proper treatment.

Awesome. Thanks, so much for that color.

If I could also ask about your guidance. So could you walk us through what your core assumptions for your guidance range, both at the low and high and any color that you can provide around volume and Isps would be great.

Sure Stephanie similar to last year, we'd love to $2 million range on the guidance and it's similar to what made the decision a year ago as the uncertainties with Covid.

As we said in the prepared remarks January was a very rough month for us and while we did and.

With very strong housing volume or the six weeks, leading up to this call. There is a delay with us.

The patient has to go through the primary care physician to get to the Rheumatologists. So when we have the rising COVID-19 . It can cause a delay for the patient to get our task.

And with the uncertainty of EBITDA, two in Europe , and Asia, and potentially coming to the U S. We wanted to make sure that we're pragmatic with our guidance that we're providing and that led to that similar range that we had a year ago.

Got it thanks, so much.

And then if I could sneak in one last question.

Are there any updates that you can provide on your pilot agreement with Cvs to supply a buys MTX.

Yeah, absolutely. So it's kicked off its started we like working with Aetna Cvs, It's obviously their marquee institutions.

And we're excited to see the outcome of this we're confident that our advised methotrexate tests can give the information necessary to keep people on the correct therapy at the right therapeutic range. So.

It just kicked off we're really excited about it so are they end up as we get more information, we'll be more than happy to share with you.

Got it understood. Thanks again for taking my questions.

Sure. Thanks, Thanks, Stephanie.

Our next question comes from the line of Brian Weinstein with William Blair. You May proceed with your question.

Hey, good afternoon. This is griffin on for Brian . Thank you for the questions.

Just two on radar to start can you talk about the patient journey, a little bit more and where this test comes into play because your expectation for radar to be given multiple times over this journey to answer a few clinical questions and just want to better understand that.

Sure sure Griffith So right now what happens is you have something called the Das 28. This is where they feel the 28 joints to see whether or not you have rheumatoid arthritis, obviously, a big Tam huge area.

And the journey goes usually with methotrexate type product and usually from there. The doctor really tries to get you to an anti TNF that is just the way. It is now and these anti TNF. So very expensive what is shocking to a lot of people that are spending 30 to $40000 a year for a therapy is it doesn't always work and a lot of times those.

<unk> failed to reach.

What they called the ACR, 50%, they're doing you would get 50% better and the reason for that quite frankly Griffin as the way. They use. These therapeutics is very empirical Lee I believe this would work for you so having a guided diagnostic like ours and Thats. The key here is changing imperative to guided.

We can add real clarity to that clinical diagnosis radar can inform of which therapy through molecular testing would would work best for that patient.

And there's really this is a platform more than a test so theres two tests coming out of your radar one and radar to radar won the way. It's informing right now is it'll tell a naive patient it'll tell the doctor whether naive patient could metabolized methotrexate if they can obviously they want to use our second test to make sure they're in a therapeutic range.

Radar too is after they built up some resistance maybe immunogenicity, maybe if for some reason that therapy is not working so well instead of using the same class of products you take a radar to and because we are looking at Sanofi youll tissue keep in mind. This is not a blood test we can look at the actual look at the site of where the infection as <unk>.

Happening we can then inform a whether they are better off with an anti TNF or with the be depleting or with the IL six and eventually even with the JAK inhibitor. So the key here is we're moving from empirical treatment to treatment with a scientific test that can inform based by looking at the actual.

Tissue.

And letting the doctor pick the right therapy for that patient.

That will save a lot of money there is $18 billion wasted in this area. So payers are very interested in our tests. They are very engaged with us at this point, we're really looking forward to launching both radar and radar to as soon as possible.

That's great. Thank you for that.

And just in terms of timelines here I mean, you talked about the late Q4 'twenty two.

Launch kept some EU European proof of concept studies out there but.

Evidence generation do you think should we need ahead of those launches.

Yeah, we're on that right now we got our AD Board, which was terrific. They gave US a lot of good information and we are going to look to have an experienced program at the end of this year and experienced programs, where you have your kols used to test for a couple of reasons. One is there'll be our future speakers to as they get to.

Inform us of how that test is working in the real world before you do an actual launch as far as the evidence there is a lot of evidence out of a Queen University out of London, but we are duplicating that in we're actually adding additional studies, we will have a complete dossier on illness product clinical utility clinical validation health care economics were.

Putting all that together.

And we're really excited with the enthusiasm we're hearing from Rheumatologists that want to participate in our scientific endeavor.

Yeah.

Okay. Thank you.

One quick one in on <unk>.

<unk> growth expectations.

Would you characterize the growth is the expectation for more of an increase in utilization among existing ordering clinicians are.

Do you expect that the majority of that to come from just growing the ordering base can you talk about that mix a little bit.

Sure the volume growth.

Let's do it this way Griffin, we rarely get any dot ever get any doctor, saying that this isn't the superior way to do a work up with somebody with autoimmune and a rheumatologist office. They all agree it's the best Lupus test and it's with the overlapping markers that gives them the best information the only hindrance to volume, where there's really the payers so getting.

Payers on board is a key initiative of ours, because that lets the guard Dennis is not a scientific reason they don't use it. It's the reason is that the payers will usually object to it until you have a contract with them. So that's what makes the the 90 over 91 million patients that we have under covered it so important to us and why we have to continue to push for that.

It's not the doctors as the issue. They agree this is the way to go so not the Kols. It's not the 35 papers that we have published it's whether or not is covered so the patient does have to pay out of pocket. So that's what we're working on as we knock these down I do anticipate volume will increase and keep in mind. This test covers.

Most of the autoimmune infections that rheumatologists see on a daily basis.

Great. Thanks for the question Scott Thanks Griffin.

Griffin.

Our next question comes from the line of Mark Massaro with BTG. You May proceed with your question.

Thank you Sandy.

Hey, Mike Thanks for taking the question so.

So just getting that conclusion of distinct <unk> co promote.

Speak to your commitment to a dual.

Diagnostics and therapeutics and Shell's strategy.

Maybe also how you've been exploring options to other places.

Sure absolutely so I've done the combination in my past life, we've done it here.

And it's very important to do those when they make sense from a standpoint of this does it fit with their current infrastructure in other words autoimmune rheumatology. So I can leverage what I have are the economics, such that there is sufficient that I willing to do it and not lose any opportunity cost with our other assets and three is the type of partner we have in.

The asset is it an asset that's appreciated by our customers if it hits those criterias, we're more than willing to take a look at it we have turned down quite a few because they didn't hit those criteria.

So I'm not opposed to it I think that precision medicine lens to it I actually think that radar may open up the door to some of these conversations down the road.

We were happy with Symphony remember, we sign that Symphony agreement with a lot of accolades from Janssen as well as us before Covid a month. After we signed it COVID-19 hit a worldwide pandemic in it really caused a lot of issues with the.

With a lot of things the relationship with Janssen is still absolutely strong we still talk to them. We still talk about possible initiatives. So that relationship is really strong it was nothing to do with that but from here on out they would be and we're going to look at assets to fulfill those three criteria as I mentioned early as far as options one of the great things about owning the hill.

Top if you will in rheumatology anybody who wants to enter this space usually ends up calling us and having discussions. So we have multiple options to discuss as far as that's concerned. The key here is right now I have terrific assets that are currently commercialized and when I look at my pipeline with fibromyalgia radar as well as other assets.

I have I have plenty to do here to continue the growth of the company in a very meaningful way.

If and when the right therapeutic pumps and fits our criteria then we'll take a look at it and if it works we'll put it in there if it fits with their criteria, we will put it in our bag.

Okay perfect. Thank you.

Just a quick follow up.

If you could provide a multiyear mix R&D.

Milestones that we should be looking out for there.

If you could also remind us on the Tam for that and how it could help you expand it to earlier diagnosis.

Okay, multi omics, where the lab is now just about complete we have.

Advised radar that will be our first multi omics test that will run through there. It is a RNA test base test.

And the Tam for that is huge.

Look at especially on the therapeutic side with Humira Remicade Cimzia all those tests, it's just a big market and are a.

I think it's got to be one of the biggest testing tabs that possibly out there that we're gonna be addressing and again with the $18 billion wasted every year in the United States alone, we do have the payers.

Focus on this area. So that's the Tam the multi omics, it's definitely something we're interested in we have a lot of great proteins and adding markers like for example on interferon Alpha does make sense for us as these products that are being developed by companies Astrazeneca just launched a product that has a interferon alpha type.

Lucas tests, it makes sense for us to meet them, there and give the quality tests. So that we can find out if those new therapeutics are in fact effective.

Okay, great. Thanks for taking the questions.

Thanks Vivian.

Our next question comes from the line of Kyle <unk> with Canaccord Genuity you May proceed with your question.

Great. Thanks, guys for the questions. Congrats on the quarter. Congrats on Centene I guess I had like a multi part question on <unk>. So it looks like Youre getting all the lives excluding the PDP lives I guess first could you just confirm that and also that includes includes strike. Your west just kind of curious I know, obviously, you had tricare east already and the second like <unk>.

Part of this question was basically just like the kind of implications on the 'twenty two guide and maybe your 'twenty three sort of outlook based on just given the extent in all of these lives here.

And specifically I guess, you could talk about the rate that you negotiated like how does that compare to your current list price of ASP are you overall.

Overall, just to kind of pleased with already negotiated.

Okay.

Great call. Thank you I'm going to answer the first two questions and then <unk> is going to answer the question as far as the rate.

On the ISP.

Tricare West is different Tricare east as its own entity Tricare west as its own entity and they're both basically military military families.

Centene really isn't Centene wellcare really isn't that we cover the 22 over 22 million lives that they have and it does exclude some areas, but that's why we already took that down that's why the numbers that we gave you is the right number.

So there are some plants that don't participate that they do cover but it's not the majority. It's a rounding error. If you will so you want to look at Centene Wellcare is covered and in network, which is which is what we need again tricare west as different as far as the HP and the rates are going to kick it over to small yes, Kyle we've never for.

Abided pricing details on any of the agreements that we've signed but I can tell you based on the history of the testing.

From this payer this would be accretive to revenue and to margins.

Alright, great. Thanks, guys. It sounds that sounds good and then maybe a few on like kind of already in the radar. So radar can be the first rule and therapy selection desperate alright, there is already a like a blood based test that can rule out already is there anything about maybe the physiology of blood or just kind of leave technology available today.

Including you know whats out there in the academic institutions that kind of like precludes a blood based <unk> test from being developed.

Yes, a couple of thing is liquid biopsies are popular because they are convenient you don't have to do surgery and thats. The real reason that that people like those I don't have to.

I don't have to surgically remove a thyroid if you will with a blood test that's not the case here there's not a.

Something thats demonstrative like that like a surgical procedure to show convenience too.

Our test of radar elevates the Rheumatologists, it's a procedure that the rheumatologists, who are basically exclusively half and rheumatologist did not go through their fellowship and become a rheumatologist to act like a primary care doctor. So they liked the sophistication of something that's a procedure solely for them that they could add value to the medical.

Community above and beyond what a primary care Doctor can do that's one thing its just themselves and so forth. The second piece is this when you're looking at blood blood is dirty blood as white blood cells blip Red blood cells platelets has all kinds of things in it but when you are picking us know youll tissue at the site of infection you are getting a raw information that's not there.

Diluted that's the key and that's what the advisers were telling US just recently at a meeting our scientific advisors are saying, that's the purest way to get the most <unk>.

Accurate answer is to actually look at the Sanofi youll tissue the site of infection before it gets diluted in the bloodstream and so forth. So a rule in test as critical a rule in test the doctors feel like they can command and get a hold of because its a medical procedure. They do is important and the accuracy of tissue versus blood.

<unk> is going to be critical down the road and we have no problem improving that as we continue to develop the asset.

Great that sounds good and then Ron or maybe actually like Mark have you guys decided on using mgs or PCR for the radar test your EDA and actually.

Encounter was possibly an option.

Have you decided on like the instrumentation yesterday on the test.

Hi, Kyle this is mark we do use encounter for discovery work and we also have.

Illumina next week 2000, and for discovery work as well, which might make its way into our clinical operation. We are evaluating the gene count and for the optimization LNG count for our radar and radar to Kyle if it's if it's low enough and provides the right performance characteristics and we might go with the PCR platform. So as we stand right.

Now we are looking at RNA gene expression with Ngls, but there is an opportunity for optimization for the clinical lab.

Okay, Yeah that makes sense and then last one for me on I guess, alright. So congrats on the scientific Advisory Board appointments you had one new board member that has.

It has a pretty solid background, unlike AI and machine learning and computational methods could you talk about how like AI and big data can be integrated into the radar test over time as you kind of develop the product and maybe optimize the assay our algorithm.

Yeah. It is already being implemented there we have we use data robot, which so we use AI quite extensively now with radar so.

It has proven to be very valuable I can't get into the details, but it has been very informative to us.

Data from our big data the way, we're getting it through AI through data robot. So yes, absolutely called that's been a very important part of this development.

Okay interesting I'll leave it there thanks for asking the questions Congrats again.

Great. Thank you Paul.

Our next.

Question comes from the line of Ross Osborne with Cantor Fitzgerald you May proceed with your question.

Hi, Congrats on the quarter just a couple quick ones for me maybe regarding gross margin.

Typically had some gross margin could you walk through some of that headwind tailwind in during the fourth quarter.

Shape out encounter at 'twenty, two given that gross margin theme.

Yeah, Ross I'll take that question first I'll say in Q4, with our ASP increased 2% year over year to $304 on a revised DTD task.

Last year fourth quarter was $299 ASP is always going to be the biggest driver of our gross margins going forward Thats why these deals like Wellcare centene are so important to us.

As a driver of gross margins north other areas that helped us to expand our gross margins and have a record on our accounting gross margins. This quarter include efficiencies in the lab, we've done a lot to automate.

As we see our volumes increase we got purchasing discounts and sometimes those perfect purchasing discounts.

And the ended the year and we get bigger credits at the end of the year. We also have that royalty of 10% and CB caps.

That's almost completely off the books in 2021, so looking at full year year over year that was a 10% royalty on Seabee character was paid to royalty pharma that ended in January 2020, but it takes about 12 months for that to completely come off of the P&L.

Sometimes it takes a payer 12 months to pay us and that's how the royalty is calculated.

Yes.

Okay got it.

And then maybe just on the sales force now how would you describe the performance during the fourth quarter.

Are there any metrics that you can provide and then I'll have it can perform year to date.

And then just kind of a quick follow up.

What is the hiring plan look like for calendar 'twenty.

Sure.

I'm very proud of the performance.

I was I started my career as a rep and in the middle of a pandemic to be enable to continue to drive sales is as tough as daunting the jobs hard without a pandemic, but I'm very proud of them hitting the 128000 orders for the year of 34000 for the quarter a record adopters of 739 those are metrics that are very.

Meaningful, especially in the face of a pandemic so very proud of the team they're highly educated we train them like crazy.

We make sure that they are absolutely sharp and understand autoimmune as well as any person could so the time and effort we spend in training is paying off and their ability to continue to grow even in the face of all of these waves of the pandemic that keeps hitting the country as far as the future while I can't disclose it right now we will do what's necessary.

To get the reach and frequency on our assets and we'd look at it constantly sit here with Mark and come all in we run metrics and if and when we need to add reps in a territory. We have no problem doing that I will add this we're finding and maybe it's a pandemic effect that in house salespeople can be very effective. So we continue to grow that team is.

Well along with the decentralized team.

And I don't think that's going to go away I think Ross I think companies have learned that it is a very cost effective way to add to your to your frequency and reach I don't think I'd use it to launch a new product, but to augment an existing customer with new data. It does seem to be an effective way to go.

Got it sounds great and then.

Last one for me would you walk through the dynamics that drove the decline in either taking volume during the quarter.

Yes, I don't think we dipped all that much in those but we do use or assets that we don't put a lot of marketing our sales effort.

A lot of those assets or what we call one the hilltop assets. This is something I learned in my prior life instead of just offering one product offer multiple products that keeps the doctor engaged across the board. So some of these products ebb and flow probably a lot because of the pandemic there theyre going to concentrate on the most important disorders will obviously.

Lupus being one of them for Rheumatologists, where some of these other assets.

While important and they like them.

That's what they are really more focused on I'm not not too concerned about it I think they'll rebound very quickly as patient flow continues to come back post pandemic.

Okay sounds great. Thanks for taking my questions and congrats on the quarter.

Thanks Ross.

Ladies and gentlemen, we have reached the end of today's question and answer session I would like to turn this call back over to Mr. Ron Rocco for closing remarks.

Yes, thanks for everyone and your supportive action and we really do appreciate it we do feel we're taking on the challenges.

Autoimmune when these are the tough challenges with testing I'm very proud of our team and there's three things we're absolutely focused on one commercial excellence to the development of our elaborate extensive pipeline and three the payers adoption of our tests for in network coverage those are at commercial excellence pipeline development.

Your adoption.

That's what keeps us focused and that's what keeps us driven so we can help more patients with autoimmune disorders with that I want to thank you for your support and I look forward to our next call.

This concludes today's conference you may disconnect. Your lines at this time. Thank you for your participation or the rest of your day.

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