Q1 2024 Myriad Genetics Inc Earnings Call

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Operator: Thank you for standing by, and welcome to Myriad Genetics' first quarter 2024 earnings conference call. At this time, all participants are in a listen only mode.

Yeah.

Operator: After the speaker's presentation, there will be a question and answer session. To ask a question during this session, you will need to press star 11 on your telephone. To remove yourself from the queue, you may press star 1 1 again.

Thank you for standing by and welcome to myriad genetics first quarter 'twenty 'twenty four earnings conference call. At this time, all participants are in a listen only mode.

Operator: After the speaker presentation, there will be a question and answer session to ask a question. During this session you will need to press star one on your telephone to remove yourself from the queue. You May Press Star one one again I would now like to hand, the call over to Matt Scala. Please go ahead.

Operator: I would now like to hand the call over to Matt Scalo. Please go ahead. Thanks Lateef, and good afternoon and welcome to the Myriad Genetics first quarter 2024 earnings call. During the call, we will review the financial results we released today. And afterwards, we will host a question and answer session. Our quarterly earnings release was issued this afternoon on form 8k and can be found on our website at investor.myriad.com. I'm Matt Scowell, Senior Vice President of Investor Relations, and on the call with me today are Paul Diaz, our President and Chief Executive Officer, Scott Leffler, our Chief Financial Officer. Sam Raha, our Chief Operating Officer, and Mark Verratti, our Chief Commercial Officer.

Speaker Change: Thanks, Latif and good afternoon, and welcome to the Mary Genetics first quarter 2024 earnings call. During the call. We will review the financial results released today and afterwards.

Operator: A question answer session.

Operator: Our quarterly earnings release was issued this afternoon.

Operator: It can be found on our website at Investor day.

Operator: Yes.

Matthew Scalo: And then Scott <unk> Senior Vice President of Investor Relations and on the call with me today, albeit president and Chief Executive Officer.

Operator: John Leffler, Chief Financial Officer, Sam Rob <unk>, our Chief operating officer, and Mark variety, our Chief commercial officer.

Matthew Scalo: This call can be heard live via webcast at Investor.Myriad.com, and a recording will be archived in the investor section of our website along with this slide presentation. Please note that some of the information presented today contains projections or other forward-looking statements regarding future events or the future financial performance of the company. These statements are based on management's current expectations, and the actual events or results may differ materially and adversely from these expectations for a variety of reasons.

Matthew Scalo: Paul can be heard live.

Matthew Scalo: Industrial about marine.

Matthew Scalo: And a recording will be archived in the investors section of our website along with the slide presentation.

Matthew Scalo: Please note that some of the information presented today, James projections or other forward looking statements regarding future events or the future financial performance.

Matthew Scalo: These statements are based on management's current expectations and the actual events or results may differ materially and adversely from these expectations for a variety of reasons.

Matthew Scalo: We refer you to the documents the company files from time to time with the Securities and Exchange Commission, specifically the company's annual report on Form 10-K, its quarterly reports on Form 10-Q, and its current reports on Form 8-K. These documents identify important risk factors that could cause actual results to differ materially from those contained in our projections for forward development. I will now turn the call over to Matt. Good afternoon, everyone.

Matthew Scalo: We refer you to the documents the company files from time to time.

Matt: <unk> and exchange Commission, specifically the company's Andrew.

Matt: Sanjay it's.

Matt: Its quarterly reports on Form 10-Q.

Matt: And its current reports on form 8-K.

Matt: Documents identify important risk factors that could cause the actual results to differ materially from those contained in our projections.

Matthew Scalo: David.

Matt: I will now turn the call over to Paul.

Paul J. Diaz: And thank you for joining us. On today's call, we'll discuss the highlights of our strong first quarter performance. I will provide an update on the progress to continue to make decelerating profitable revenue growth. First, I want to thank my Myriad teammates and our provider partners for their continued support and commitment to advancing our mission and vision to make genetic testing and precision medicine more accessible and help people take more control of their health. Now turn to slide four and talk about our Highlights Order.

Speaker Change: Thanks, Matt Good afternoon, everyone and thank you for joining us on today's call to discuss highlights of our strong first quarter performance.

Paul J. Diaz: An update of our progress to date.

Paul J. Diaz: Accelerating profitable revenue growth.

Paul J. Diaz: First wanted to thank my teammates to our provider partners.

Paul J. Diaz: Can you support commitment to advancing our mission.

Paul J. Diaz: To make genetic testing.

Paul J. Diaz: More accessible is helping people take more control of their economy.

Paul J. Diaz: Now, let's turn to slide four talking about our highlights quarter.

Paul J. Diaz: We continue to deliver on our commitment to shareholders as we achieve double-digit revenue growth in the first quarter compared to last year, achieving both volume growth and ASP improvements across the portfolio. Our focus on profitable growth continues into 2024 as we reported positive adjusted EBITDA, and we're close to breakeven on an adjusted EPS basis. We are excited about the ongoing execution of our near-term strategic priorities that are driving growth and efficiency across the enterprise.

Paul J. Diaz: We continue to deliver on our commitment to shareholders as we achieved double digit revenue growth in the first quarter compared to last year.

Paul J. Diaz: So I think both volume growth and AFP improvements across the portfolio.

Paul J. Diaz: Our focus on profitable growth continues into 2024.

Paul J. Diaz: Positive adjusted EBITDA.

Paul J. Diaz: Close to breakeven on an adjusted yes.

Paul J. Diaz: First quarter.

Paul J. Diaz: We are excited about the ongoing execution of our near term strategic priorities.

Paul J. Diaz: Driving growth and efficiency across the enterprise.

Paul J. Diaz: You are seeing early wins in both oncology and women's health related to recent market dislocation as we continue to reinforce our oncology offerings precisely and soon liquid, currently being integrated into orange cloud. This morning we announced the reorganization of our international operations, so I will provide more detail on that as well. So it's progress standing up, Mark. I'm glad.

Paul J. Diaz: We are seeing early wins in both oncology women's health related to recent market dislocation as we continue to reinforce our oncology offering precise timber.

Paul J. Diaz: Liquid currently being integrated.

Paul J. Diaz: This morning, we announced the reorganization of our international operations.

Paul J. Diaz: Slide more detail on as well.

Paul J. Diaz: Progress standing up margin flat.

Paul J. Diaz: We continue to accelerate investments in clinical validation studies and EMR integration. A large part of our transformation journey has been addressing our clinical validation data deficit. In 2024, we'll see Myriad go to ASTHO and stay in touch with more publications. Abstracts and posters don't get to skate in the fall.

Paul J. Diaz: We continue to accelerate investments clinical validation studies that EMR integrations large part of our transformation journey, that's been addressed at our clinical validation data deficit.

Paul J. Diaz: 24 mill scenario go to App.

Paul J. Diaz: No.

Paul J. Diaz: More publications and abstracts and posters that we've seen.

Paul J. Diaz: Mark and Sam will speak about these and other strategic priorities on the call, as well as important updates on an upcoming product launch. Next slide. Our strategic areas of focus are directly aligned with our customer expectations and the pillars we believe will drive long-term growth, innovation, and profitability for shareholders. Every provider survey we do, every customer interaction I have, always points back to five things that providers and patients expect. Our customers want tests that have strong clinical utility and validity, as well as a lab partner with the most comprehensive testing menu that meets their needs. And they care about fast turnaround time. Unknown Speaker, place unnecessary burdens on their steps.

Paul J. Diaz: Paul.

Paul J. Diaz: Carpet sales for these and other strategic priorities on the call as well as important updates.

Paul J. Diaz: Product launch.

Paul J. Diaz: Yes.

Paul J. Diaz: Next slide please.

Paul J. Diaz: Our strategic areas of focus are directly aligned with our customer indications and the pillars. We believe will drive long term growth.

Paul J. Diaz: Sure.

Paul J. Diaz: <unk> ability for shareholders.

Paul J. Diaz: Every provider surveys.

Paul J. Diaz: Every customer interaction.

Paul J. Diaz: All these points back to five day provided patients back from us.

Paul J. Diaz: Customers want tests that are strong.

Paul J. Diaz: Utility.

Paul J. Diaz: Liberty as well as the last partner with the most comprehensive testing menu that meets their needs.

Paul J. Diaz: Our customers care about fast turnaround time.

Paul J. Diaz: Did not.

Paul J. Diaz: Unnecessary burdens on their staff.

Paul J. Diaz: Also on tests that are important for their patients.

Paul J. Diaz: They also want tests that are affordable. Our four strategic pillars, addressed to, will be discussed on the next slide. Top tier science and innovation are at the foundation. We deliver products that are clinically validated and use real-world clinical studies. We've invested heavily in technology-enabled lab operations, automated, scalable, and cost-effective labs that are compliant with FDA quality management system requirements. Our team continues to make it easier to do business with Myriad by testing new platforms and results delivery.

Speaker Change: Four strategic pillars address customer needs and Jeff will discuss on the next slide.

Paul J. Diaz: Top tier science and innovation are at the foundation Barry genetics.

Paul J. Diaz: To deliver products that are clinically validated.

Paul J. Diaz: Well correct.

Paul J. Diaz: We've invested heavily in technology lab operations automated scalable and cost effective lab that are compliant at Jake quality management.

Paul J. Diaz: Mark.

Paul J. Diaz: Our teams continue to make it easier to do business with period of testing.

Paul J. Diaz: Forbes results delivery.

Paul J. Diaz: Supported by our ongoing investment in EMR integrations, our new universal order management activities, and our patient-provider portal. Combining these pillars with expertise across regulatory, compliance, and revenue cycle management, we find ourselves in a position to serve our customers at scale and profit. Next slide. Today we announce the reorganization of our European operations to better align company resources to our domestic operations, while continuing to serve key biopharmaceutical partners. Patients Outside the United States, As part of the reorganization here, we will sign an agreement to sell our endopredictiveness to your bioscientists, who will license the right to continue to produce and sell endocrine tics as an LBT in the United States as part of Precise's college program, who also license her via the right to self-health.

Paul J. Diaz: Ordered by our ongoing investment in EMR integration.

Paul J. Diaz: New Universal order management activities, and our patient provider portals.

Paul J. Diaz: These pillars with expertise fast regulatory compliance and revenue cycle management, we find ourselves in a position to serve our customers.

Paul J. Diaz: Scale.

Paul J. Diaz: Next slide please.

Paul J. Diaz: Jamie we announced the reorganization of our European operations, better aligns somebody resources, so our domestic opportunity.

Paul J. Diaz: Continuing to serve key Biopharma partners.

Paul J. Diaz: Patients outside the United States.

Paul J. Diaz: As far as the reorganization here to sign it.

Paul J. Diaz: Net seller Endo predicts business.

Paul J. Diaz: <unk> bioscience.

Paul J. Diaz: We will license Youre right to continue to produce and sell endo per day as an LDC in the United States as part of precise color solutions.

Paul J. Diaz: We will also license via the right to sell Polaris future diagnostic kit outside investors.

Paul J. Diaz: These were diagnosed in kids outside the U.S. [inaudible] This also allows us to better position Myriad to grow its other global businesses more effectively through strategic partnerships, including licensing, and I would also call out that this does not affect Japan, which has been and remains an important market. The transaction is expected to close in the second or third quarter. Last quarter, we announced the acquisition of precise tumor and liquid from Intermountain Persistent Tumor.

Paul J. Diaz: The rationale for this part of our continued effort to accelerate profitable growth.

Paul J. Diaz: Our biopharma partners more efficient.

Paul J. Diaz: This also allows us to better position <unk> relative to other global business more effectively through strategic partnerships.

Paul J. Diaz: Licensing and distribution.

Paul J. Diaz: I would also call out that this does not affect Japan, which has been and remains an important market.

Paul J. Diaz: Yes.

Paul J. Diaz: Transaction is expected to close in the second or third quarter.

Paul J. Diaz: Last quarter, we announced the acquisition of precise tumors liquid Premier Mountain resistance.

Paul J. Diaz: Sam will provide an update on the integration of Associated Labs into our new Salt Lake facility, which is making steady progress. Together, these transactions represent very capital-efficient ways to optimize and enhance pharmacology proposals. Transactions are expected to be accretive to earnings and cash flow in 2025. I will close with comments on the FDA's final rule regarding the regulation of lab-developed tests. While we share many of the concerns raised by the industry regarding the use of the medical device framework for this industry oversight, we do view the final rule as generally positive for Mary. All of our clinical tests, CAPA, CLIA, and New York State requirements.

Paul J. Diaz: Sam will provide an update on the integration and the associated <unk> Salt Lake facility, which is making steady progress.

Paul J. Diaz: Together these transactions represent very capital efficient ways to optimize.

Paul J. Diaz: Okay.

Paul J. Diaz: These transactions are expected to be accretive to earnings and cash flow in 2025.

Paul J. Diaz: I will close with comments on the Fda's final rule regarding regulation with lab developed tests.

Paul J. Diaz: While we share many of the concerns raised by the industry regarding the use.

Paul J. Diaz: Device framework. This industry oversight, we do view the final rule is generally positive married with all of our clinical chassis Capa leader in New York State requirements.

Paul J. Diaz: We have a strong quality assurance of regulatory fairness team who have a long history of complying with FDA quality standards. We plan to be proactive and working with K, and ensure that our products come to meet and use the regulatory requirements. Sam will cover this in more detail later on the call. Thanks, Paul.

Paul J. Diaz: Strong quality assurance <unk> guarantee as well as the long history of compliance.

Paul J. Diaz: Yes.

Paul J. Diaz: We plan to be proactive in working with HP sure that our products meet.

Paul J. Diaz: Regulatory requirements.

Speaker Change: Sam will cover this in more detail later on the call now I'll turn it over.

Mark S. Verratti: I will begin on slide 9 to talk about our commercial strategy. We continue to invest in tools and analytics that enable our commercial teams to better segment their territories and identify clinicians that could benefit from Merriest's testing portfolio. We have seen positive results from the use of these analytic tools as our commercial teams continue to drive new and sustainable revenue growth. In the second half of 2023, we realigned our commercial sales force incentives from volume-based targets to revenue-based. Overall, the shift better aligns our commercial team's goals with the company's focus on reducing no-goes.

Sam: Thanks, Paul I'll begin on slide nine to talk about our commercial teams, we continue to invest in tools and analytics that enable our commercial teams to better segment their territories and identify.

Mark S. Verratti: Conditions that could benefit from heritage testing.

Mark S. Verratti: Portfolio, we are seeing positive results from the use of deep analytic tools as our commercial teams continue to drive sustainable.

Mark S. Verratti: Sustainable revenue growth in the second half of 2023, we realigned our commercial sales force.

Mark S. Verratti: Scientists from volume based targets to revenue based targets overall, the shift better aligns our commercial team's goals with the company's focus on reducing our guys.

Mark S. Verratti: We believe that the 12% revenue growth and positive ASP trend in the first quarter, in part, reflect our investment in these analytical tools and the realignment of our commercial team incentives and our ongoing focus on revenue cycle management, which Scott will talk about in more detail. Most importantly, these efforts position us as well for continued positive momentum throughout 2024. Next slide.

Mark S. Verratti: We believe that the 12% revenue growth and positive ASP trend in the first quarter in part reflect our investment in these analytical tools and the right alignment of our commercial team incentives and our ongoing focus on revenue cycle management, which Scott will talk about in more detail. Most importantly, these efforts position us well for <unk>.

Mark S. Verratti: <unk> positive momentum throughout 2024 next slide.

Mark S. Verratti: Myriad continues to lead with differentiated insights offered by our MyRisk Risk Score for hereditary cancer. In the first quarter, hereditary cancer testing revenue grew 16% compared to last year, with volumes up 9% year-over-year. We believe this consistent growth reflects a combination of our reputation as a leader in this area, the commercial team doing a better job driving home our differentiated messaging, improving relationships with genetic counselors, along with Looking forward, we are excited about the omnichannel opportunity to drive my risk growth across all of our businesses.

Mark S. Verratti: <unk> continues to lead with differentiated insights offered by our virus risk score hereditary cancer tests.

Mark S. Verratti: The first quarter hereditary cancer testing revenue grew 16% compared to last year with volumes up 9% year over year. We believe this consistent growth reflects the combination of our reputation as a leader in this area. The commercial team doing a better job driving home, our differentiated messaging improving relationships with genetic counselors.

Mark S. Verratti: Along with early competitive dislocation.

Mark S. Verratti: Looking forward, we are excited about the omnichannel opportunity to drive my risk growth across all of our businesses.

Mark S. Verratti: And we continue to accelerate our investment in clinical validation studies and EMR integration to address recent market dislocation with the most recent, clinically differentiated, heterotory cancer test on the market. Next slide. As mentioned, no part of our portfolio has more upside potential than a hereditary cancer. Just for the unaffected population, there are an estimated 50 million women in the United States that meet guidelines for hereditary cancer testing.

Mark S. Verratti: And we continue to accelerate our investment in clinical validation studies and EMR integration to address recent market dislocation with the most recent with the most clinically differentiated editor territories cancer test on the market.

Mark S. Verratti: Excellent.

Mark S. Verratti: As mentioned no part of our portfolio has more upside potential in our hereditary cancer testing.

Mark S. Verratti: Just for the unaffected population there are an estimated 50 million women in the United States. The <unk> guidelines for hereditary cancer testing, we are making good use of the analytical tools as mentioned previously to better identify and serve those patients. Additionally through partnerships with Lightfoot knifepoint hospitals some of that.

Mark S. Verratti: We're making good use of the analytical tools, as mentioned previously, to better identify and serve those patients. Additionally, through partnerships with Lifepoint Hospitals and SimonVet, we are expanding our reach even further. In the first quarter of this year, our women's health team grew hereditary cancer testing revenue by 12% compared to last year, while our oncology team grew hereditary cancer testing revenue by 20% over the same period. Our ability to serve more patients in both the unaffected and affected markets reflects these consistent results, and there is so much more upside for us to realize. Next slide.

Mark S. Verratti: We are expanding our reach even further in the first quarter of this year, our women's health team grew hereditary cancer testing revenue by 12% compared to last year, while our oncology team grew hereditary cancer testing revenue by 20% over the same period.

Mark S. Verratti: Our ability to serve more patients in both the unaffected.

Mark S. Verratti: Markets reflect these consistent results and there is so much more upside for us to realize.

Mark S. Verratti: Here at Mary, we focus on ways to expand access to genetic testing. MyRisk with RiskScore is one of the best examples of how we are changing staff. RiskScore is the component of MyRisk that expands its benefits for people of all ancestries and is the only polygenic risk score in breast cancer validated for women of any demographic.

Mark S. Verratti: Next slide.

Mark S. Verratti: Alright, Barry we focus on ways to expand access to genetic testing my risk with risk score is one of the best examples of how we can reduce that risk or is the component of my risk that expand its benefits for people of all ancestry and is the only apologetic risk score and breast cancer validated for women of any demographic.

Mark S. Verratti: Not only is this a major differentiator for MyRIS, but RISC-CoR is an example of our commitment to expanding access to genetic testing and increasing equity in care for all. Next slide. MyRisk has been in the news a lot.

Mark S. Verratti: Not only exist a major differentiator from Iris a risk score is an example of our commitment to expanding access to genetic testing and increasing equity for care for all people.

Speaker Change: Thanks, a lot.

Mark S. Verratti: <unk> has been in the news a lot recently as more people become aware of the importance of genetic testing in the preventative care market.

Mark S. Verratti: More People are becoming aware of the importance of genetic testing in the preventative care market. In today's patient-centered health care ecosystem, many patients want to drive their own health care journey, which is why we have invested in resources like My Gene History for patients to determine their breast cancer risk online for free and why we continue to provide free genetic counseling to anyone who takes a virus test. Myriad is not just a lab partner; we're also a women's health company whose objective is to provide insights that help people take control of their health and increase access to genetic testing.

Mark S. Verratti: Today's patient centric health care ecosystem, many patients want to drive their own health care journey.

Mark S. Verratti: Which is why we have invested in resources like IGT history for patients to determine their breast cancer risk online for.

Mark S. Verratti: Airframe and why we continue to provide free genetic counseling to anyone who takes a virus test.

Mark S. Verratti: Barry It is not just a lab partner. We are also women's health advocate, whose objective is to provide insights that help people take control of their health and increased access to genetic testing.

Mark S. Verratti: I want to now turn to slide 14 and talk about our prenatal... In the first quarter, our prenatal revenue increased 22% and volumes increased 9% compared to last year, reflecting market share gains and ongoing initiatives to improve ASP. Our commitment to support providers negatively affected by the market dislocation continues to drive volume for this business, while our disciplined approach to adding quality accounts to the franchise has resulted in strong ASPs for both prequel and foursome.

Mark S. Verratti: Now turning to slide 14, and talk about our prenatal business.

Mark S. Verratti: In the first quarter, our prenatal revenue increased 22% and volumes increased 9% compared to last year, reflecting market share gains and ongoing initiatives to improve asps.

Mark S. Verratti: Our commitment to support providers negatively affected by the market dislocation continues to drive volume for this business, while our disciplined approach in adding already account for the franchise has resulted in strong asps.

Mark S. Verratti: For both <unk> and foresight.

Mark S. Verratti: We see even more upside for this business as we await ACOG guideline expansion this year. We believe the expanded guidelines will improve patient health and expand the market opportunity for carrier screening as clinicians are already ordering larger panels from us. Once ACOG moves, we believe the rest of the market and payers will adapt as well, which will likely result in ASP improvement, considering the large number of expanded panels that we currently run that are often not reimbursed. We look forward to ACOG guideline updates and the launch of Foresight Universal Plus later this year. Next slide. In the first quarter, gene site revenue increased 21% year-over-year, as we reported approximately 124,000 tests.

Mark S. Verratti: We see even more upside for this business as we wait a car guideline expansion. This year. We believe the expanded guidelines will prove patient health and expand the market opportunity for carrier screening as clinicians are already ordering larger panels from us.

Mark S. Verratti: Once a cog moves we believe the rest of the market and payers will adapt as well, which will likely result in ASP improvement considering large number of expanded panels and we currently Brian that are often operating burst.

Mark S. Verratti: We look forward to <unk> guideline update and the launch of foresight Universal plus later this year.

Mark S. Verratti: Next slide and.

Mark S. Verratti: In the first quarter <unk> revenue increased 21% year over year as we reported approximately 124000 test coupon.

Mark S. Verratti: ASPs improved both year-over-year and quarter-over-quarter in the first quarter, reflecting improved revenue cycle management activity. I want to end on slide 16 and share what is in the pipeline for our products. I would remind investors of our upcoming launch, Foresight Universal Plus Expanded Carrier Screening Test, in the context of anticipated ACOG expanded guidelines. This new test will feature an expanded panel, as well as more efficient and cost-effective work. These guideline expansions would also support our multiple prenatal screening test, FIRST gene, which we hope to launch later this year.

Mark S. Verratti: Asps improved both year over year and quarter over quarter in the first quarter, reflecting improved revenue cycle management activities.

Mark S. Verratti: I want to end on slide 16, and Sherwood is in the pipeline for our products I would remind investors of our upcoming launch foresight Universal plus expanded carrier screening test in the context of anticipated expanded guidelines.

Mark S. Verratti: To add more feature and expanded panel as well as more efficient and cost effective workflows. These.

Mark S. Verratti: These guideline expansion would also support our multiple prenatal screening test first gene, which we hope to launch later this year.

Mark S. Verratti: We continue to add depth to our oncology offering with the addition of precise tumor and precise liquid from our recent acquisition. Sam will speak about the progress we are making integrating both these tests into a new lab. We're making tremendous strides in the development of PRECISE-MRD. Last quarter, we announced a research collaboration with the National Cancer Center Hospital East in Japan to use our highly sensitive PRECISE-MRD test.

Mark S. Verratti: We continue to adapt to our oncology offering with the addition of precise tumor and precise liquid from our recent acquisition Sam will speak towards the progress we are making integrating both these test into the labs.

Mark S. Verratti: We're making tremendous strides in the development of precise MRV last quarter, we announced the research collaboration with the National Cancer Center Hospital East Japan. He is our highly sensitive precise MRV test.

Mark S. Verratti: Yes.

Samraat S. Raha: We look forward to speaking more on MRD at ASCO this year, as well as Myriad's other areas of research included in the seven abstracts accepted by ASCO across HRD, Polygenic Risk Scores, Germline Registry Studies, and our Tumor-Informed Approach to Whole-Genome. Now, I will turn the call over to our Chief Operating Officer, Sam Ross. Thanks, Mark. Let me start on slide 18 and provide an update on our labs in the future. A quick reminder that the overall objective of this program is to drive innovation and operational excellence to continue delivering high-quality testing results at scale that meet regulatory requirements while shortening turnaround time in support of our ongoing focus to improve patient-provider relationships, all of which continue to differentiate us from other As you may recall, we completed construction of our new lab snowdies in South San Francisco and Salt Lake

Sam: We look forward to speaking more on MLD at Astro this year as well as myriad other areas research included seven abstracts accepted by <unk> across HRD polygenic risk scores Germline registry studies and our tumor informed approach the whole genome sequencing now I will turn the call over to our chief.

Sam Ross: Operating officer Sandra.

Sam Ross: Thanks, Mark let.

Sam Ross: Let me start on slide 18, and provide an update of our labs and the future program.

Sam Ross: A quick reminder, the overall objective of this program is to drive innovation and operational excellence to continue delivering high quality testing results at scale.

Sam Ross: Meet regulatory requirements, while shorter turnaround time and support of our ongoing focus improve patient and provider experience all of which continue to differentiate us from other labs.

Sam Ross: As you May recall, we completed construction of our new lab facilities in South San Francisco and Salt Lake City in 2023.

Samraat S. Raha: Highlights from Q1 of this year include completing and passing critical inspections in New York State and Salt Lake City by the State of California and CLIA in South. We also completed the validation of PREQOL, our NITS assay, in South San Francisco and completed the first phase of bringing up precise MRD assay workflow in Salt Lake City.

Samraat S. Raha: Highlights from Q1 of this year include completing in passing critical inspection and <unk>.

Samraat S. Raha: Your state and Salt Lake City by the state of California in Korea, and South San Francisco, We also completed the validation of prequel.

Samraat S. Raha: Assay, South San Francisco and completed the first phase of bringing up <unk>.

Samraat S. Raha: <unk> workflow and Salt Lake City.

Samraat S. Raha: Our plan for South San Francisco remains to complete the move-in, workflow validation, and full-scale prenatal lab operations by the end of 2024. For our new Salt Lake City lab, we remain focused on completing the move-in process, as well as the validation of sample processing, for most of our oncology assays by the end of 2024 and running those assays at scale by the end of Q3 in 2020. We are also in the process of integrating a recently acquired precise tumor, precise liquid test into our new Salt Lake City facility.

Samraat S. Raha: Our plan for South San Francisco remains.

Samraat S. Raha: The move in workflow validation and full scale Fernando lab operations by the end of 2024.

Samraat S. Raha: Our new Salt Lake City Lab, we remain focused on completing the move in process as well as the validation of sample processing for most of our oncology assays by the end of 2024 and running those assays at scale by the end of Q3 in 2025, we.

Samraat S. Raha: We are also in the process of integrating the recently acquired <unk> tumor precise liquid test into our new Salt Lake City facility.

Samraat S. Raha: Let me talk more about that now. You may recall that we completed the acquisition of select assets in our mountain precision genomics last quarter, including lab instrumentation, workflows, precise tumor, and precision, which together are genomic profiling tests for therapy selection that are part of our overall precision oncology. Our immediate focus has been on retaining employees associated with the acquisition, as well as testing continuity for providers as we move these operations to our new Salt Lake City facility.

Samraat S. Raha: Let me talk more about that now on the next slide.

Samraat S. Raha: You may recall that we completed the acquisition of select assets Intermountain precision genomics last quarter, including lab instrumentation workflows and precise tumor resection of liquid assets.

Samraat S. Raha: Which together these two our genomic profiling test for therapy selection and are part of our overall precise oncology solutions portfolio our.

Samraat S. Raha: Our immediate focus has been on retaining employees associated with the acquisition as well as testing continuity providers as we move these operations to our new Salt Lake City facility.

Samraat S. Raha: I'm happy to share that we have seen great engagement from our new team members and that turnaround time has already been reduced under our direction. We've advanced our lab transition planning and started moving some instrumentation to Salt Lake City within the quarter. We expect to start processing precise tumor samples in Salt Lake City in Q3 of this year, as we also advance our work on precise liquids, and by the end of 2024, we expect to have completed the lab move entirely and to fully be operational for sample processing reporting in Salt Lake City.

Samraat S. Raha: Im happy to share that we have seen great engagement from our new team members and that turnaround time at all.

Samraat S. Raha: Already been reduced under our direct oversight.

Samraat S. Raha: Advanced our labs transition planning and started moving some instrumentation Salt Lake City.

Samraat S. Raha: Within the quarter.

Samraat S. Raha: We expect to start processing precise tumor samples in Salt Lake City in Q3 of this year as we also advanced our work on precise liquid by the end of 2020 or we expect to have completed the lab move entirely and to fully be operational for sample processing reporting in Salt Lake City.

Speaker Change: Next slide please.

Samraat S. Raha: Next slide. Building on what Paul shared last week, the FDA released a final rule regarding the oversight of lab-developed tests or LB... Adding to Paul's comments earlier, our current view is that this finalized version of the rule is more favorable than the preliminary guidance. We believe that Myriad is in a good position to work within the new framework. First of all, the rule provides a continued path for LBTs approved by New York State Department of Health to serve the market without requiring immediate additional analytical or clinical validation through the FDA.

Samraat S. Raha: Building on what Paul shared last week, the FDA released its.

Samraat S. Raha: Final rule regarding the ultra site of lab developed tests or <unk>.

Samraat S. Raha: Adding to Pauls comments earlier, our current view that this fine lines version of the rule is more favorable than the preliminary guidance. We believe that myriad is in a good position to work within the new framework first of all the rule provides a continued path for <unk> approved by New York State.

Samraat S. Raha: One of the help to serve the market without requiring immediate additional analytical clinical validation through the FDA.

Samraat S. Raha: And again, all of our on-market tests meet CAP, CLIA, and New York State requirements. Second, we have a strong quality assurance regulatory affairs organization with over a decade of meaningful experience collaborating with the FDA on regulatory issues, including two FDA-approved Mitrate CDX and the Bracken Alpha CDX. We've also built and maintain a robust quality management system, which is the foundational element for all the patient samples that we process. While we are optimistic about the FDA's new new rule, we are also aware that the FDA intends to review labeling associated with LVT. You could review the sufficiency of analytical and clinical validation data for LVTs that are approved by New York State.

Samraat S. Raha: And again all of our on market tests meet cap.

Samraat S. Raha: New York State requirements.

Samraat S. Raha: We have a strong quality assurance regulatory affairs organization over a decade of meaningful experience collaborating with the FDA regulatory submissions, including two FDA approved tests.

Samraat S. Raha: <unk> Pdx, Nebraska analysis CTX, we've also built and maintain a robust quality management system, which is the foundational elements all the patient samples that we process and report on.

Samraat S. Raha: While we are optimistic about the fda's, new new rule.

Samraat S. Raha: Are also aware that the FDA intends to review, enabling associated with Lvg's and could review the sufficiency of analytical and clinical validation data for <unk> that are approved by New York State.

Samraat S. Raha: Finally, I have personal experience running a business that is regulated by the FDA, and since joining Myriad, I've been working closely with our teams to prepare and plan for increased FDA oversight and how we can use the LVQ rule as a competitive differentiator for Myriad. Turning to the next slide, I'd like to end with an update on select operational highlights. We are proud to have a high level of organizational engagement across the company, reflected in a single-digit employee turnover level. In terms of market penetration, healthcare providers are among our most important customers.

Samraat S. Raha: Finally, I have personal experience running a business that is regulated by the FDA and since joining period I've been working closely with our teams to prepare and plan for increased FDA oversight and how we can use the <unk> rule is a competitor competitive differentiator period.

Samraat S. Raha: Turning to the next slide I'd like to end.

Samraat S. Raha: With an update on select operational highlights from the first quarter.

Samraat S. Raha: We are proud to have a high level of organizational engagement across the company reflected in a single digit employee turnover level.

Samraat S. Raha: In terms of market penetration health care providers are among our most important constituents their satisfaction with myriad genetics led to NPS or net promoter score of 74.

Scott J. Leffler: Their satisfaction with Myriad Genetics led to an MPS, or Net Promoter, score of 74 in the first quarter, up from 70 for the full year, a figure that has continued to improve over the past few years. This is a testament to the focus and investments we continue to make in patient providers. In terms of efficiency and productivity, this quarter, we increased commercial productivity by 11.5% compared to the last quarter as a result of the continued execution of our commercial transformation that Mark and his team are leading, including improved sales planning and process optimization. With that, let me turn it over to Scott Leffler, CFO. Thanks, and I'll start on five.

Scott J. Leffler: First quarter up from 70 for the full year 2023, a figure that has continued to improve over the past few years and this is a testament to the focus and the investments we continue to make in the patient provider experience.

Scott J. Leffler: In terms of efficiency and productivity this quarter, we increased commercial productivity by 11, 5% compared to the last quarter. As a result of the continued execution of our commercial transformation that Ark and his team are leading including improved sales planning and process optimization.

Scott J. Leffler: With that let me turn it over to our CFO Scott.

Scott J. Leffler: Thanks, Tom I'll start on slide 23.

Scott J. Leffler: We delivered a strong overall performance in Q1, led by 12% of Rho-Mnucrose Zero. This growth was primarily driven by hereditary cancer testing, prenatal testing, and pharmacogenomics and speaks to internal initiatives such as an improving customer experience and continued execution by our commercial partners. Mark provided commentary as to how the company, with an analytical approach, is addressing the health care provider and more effectively generating growth. We believe these activities, in addition to ongoing progress in revenue cycle management, are important drivers of our Q1 AFP growth of 2% over the year-ago period. Historically, ASBs in the first quarter tend to be soft due to the reset of deductibles and other adjustments.

Scott J. Leffler: We delivered a strong overall performance in Q1 led by a 12% revenue growth year over year.

Scott J. Leffler: This growth was primarily driven by a hereditary cancer update prenatal testing.

Scott J. Leffler: Okay.

Scott J. Leffler: Speaks to internal initiatives, such as an improving customer experience and continued execution by our commercial.

Scott J. Leffler: Mark provided commentary as to how the commercial television with enhanced analytical tools are addressing health care provider needs and more effectively generating revenue growth.

Scott J. Leffler: We believe these activities in addition to ongoing progress in revenue cycle management.

Scott J. Leffler: Drivers of our Q1.

Scott J. Leffler: Movement up 2% over the year ago period.

Scott J. Leffler: Historically asp's in the first quarter tends to be soft due to resetting of deductibles and other adjustments.

Scott J. Leffler: The fact that we are starting off 2024 with such a strong ASP performance bodes well for the rest of the year. On slide 24, we revisit some of the revenue cycle initiatives discussed at our September 2023 investor. We have made progress on multiple fronts, including ramping up GMR. Improving prior all, automating our billing process, and expanding payer coverage. Myriad has seen a number of payers recently expand coverage of average risk populations that could benefit CAR Tests.

Scott J. Leffler: So the fact that we're starting off 2024.

Scott J. Leffler: For such a strong ASP performance bodes well for the rest of Asia.

Scott J. Leffler: Next slide.

Scott J. Leffler: On slide 24, we revisit some of the revenue cycle lenders there.

Scott J. Leffler: Our September 2023 Investor event.

Scott J. Leffler: We have made progress on multiple fronts, including ramping up EMR integration.

Scott J. Leffler: Proving prior art.

Scott J. Leffler: Automating, our billing process and expanded payer coverage.

Scott J. Leffler: <unk> seen a number of Peter's recently expanded coverage of average risk population.

Scott J. Leffler: First quarter revenue reflects approximately $3 billion from a single payer who expanded coverage of these averages, as well as other immaterial favorability from out-of-period justice. We are pleased with the continued progress against our long-term goal to reduce our no pay rate, complementing the volume generating potential. Moving to slide 25, I want to highlight our financial performance by quarter. The adjusted growth margin of 68.5%, improved 80 basis points compared to last year, overcoming headwinds associated with the IBG lab and precise tumor and liquid assets, which were acquired in February of this year and are still being. First quarter 2024, adjusted OPEX 139, increased sequentially from the fourth quarter of 2020, but decreased by 4% year over year.

Scott J. Leffler: The current tough.

Scott J. Leffler: First quarter revenue reflects approximately $3 million from a single payer expanded coverage for average risk patients.

Scott J. Leffler: Well as other immaterial in variability.

Scott J. Leffler: Chuckles.

Scott J. Leffler: We are pleased with the continued progress against our long term goal to reduce our nuclear rate complementing the volume generating potential.

Scott J. Leffler: Moving to slide 25, I want to highlight our financial performance.

Scott J. Leffler: Quarter great.

Scott J. Leffler: First quarter adjusted gross margin.

Scott J. Leffler: Right.

Scott J. Leffler: So improved 80 basis points compared to last year overcoming headwinds associated with the <unk> lab.

Scott J. Leffler: Cheaper and liquid assets, which were acquired in February of this year and are still being in agreement.

Scott J. Leffler: First quarter 2024, adjusted Opex of 139 months to increase sequentially from the fourth quarter.

Scott J. Leffler: But decreased by 4% year over year.

Scott J. Leffler: As reflected in our full year 2024 guidance, we expect our full year OPEX run rate to be higher than Q1 amount as we ramp up spending to accommodate growth and strength, for strong revenue growth and more, for a significant improvement in overall profitability, including an adjusted EPS loss of only one penny versus a loss of 21 cents in the first quarter, as well as $4 million of positive adjusted EBITDA compared to a loss of $19 million in the prior year period. Regarding financial flexibility on 526, We finished Q1 in a solid position with approximately $104 million in cash, cash equivalents and marketable investments, and have $41 million in credibility under our credit. The first quarter is typically a high-task person. University of Utah Faculty.

Scott J. Leffler: Reflected in our full year 2024 guidance, we expect our full year opex run rate to be higher coupon amount as we ramp up spending to accommodate growth and strategic.

Scott J. Leffler: Our strong revenue growth and margins in Q1 drove significant improvement in overall profitability, including an adjusted EPS loss of.

Scott J. Leffler: Chris is a loss of 21.

Scott J. Leffler: First quarter of 2023, as well as $4 million of positive adjusted EBITDA compared to a loss of $19 million prior year period.

Scott J. Leffler: Regarding financial flexibility on slide 26.

Scott J. Leffler: We finished Q1 in a solid position with approximately $104 million in cash cash equivalents and marketable investments to contribute and how $41 million.

Scott J. Leffler: Under our credit facility.

Scott J. Leffler: The first quarter is typically a higher cash burn.

Scott J. Leffler: However, we saw a meaningful year-over-year improvement in adjusted operating cash flow, with an outflow of only approximately $9 million in the first quarter of 2024 versus an outflow of $25 million in the first quarter of. Importantly, adjusted operating cash flow is expected to be positive for the remainder of the year. On slide 27, we reiterate our full year 2024 financial guidance for revenue between $820 million and $840 million, representing annual growth between 9% and 11%.

Scott J. Leffler: The detailed back.

Scott J. Leffler: However, we saw a meaningful year over year improvement in adjusted operating cash flow with an outflow of only approximately $9 million from the first quarter of 2024 versus an outflow of $25 million.

Scott J. Leffler: The first quarter of 2020.

Scott J. Leffler: Importantly, adjusted operating cash flow positive for the remainder of 2014.

Scott J. Leffler: On slide 27, we reiterated our full year 2024 financial guidance with revenue between $105 million.

Scott J. Leffler: <unk> billion dollars, representing annual growth of 9% and 11%.

Scott J. Leffler: Our strong Q1 performance positions us well to meet or exceed our revenue guidance range, but I would also note that there are areas where we look to accelerate actionable commercial opportunities in a changing competitive landscape and further drive the top line on that part. An example of that accelerated spin would be our EMR integration, where new customer wins are often dependent upon our ability to meet the IT requirements of prospective customers. Overall, we're optimistic regarding the business trend and the company's ability to grow at or above industry level. We remain comfortable with a full-year gross margin range of 69.5 to 70.5, with adjusted operating expense growth between 5% and 7%, and adjusted EPS between break-even and 5%. Now, let me turn the call back.

Scott J. Leffler: Strong performance positions us well to meet or exceed our revenue guidance range.

Scott J. Leffler: Also note that there are areas, where we can.

Scott J. Leffler: Increased.

Scott J. Leffler: To accelerate actionable commercial opportunities in a changing competitive landscape to further drive the topline at Barclays.

Scott J. Leffler: An example of that accelerated spend would be our EMR integration efforts were new customer wins are often dependent upon our ability to meet the requirements of perspective.

Scott J. Leffler: Overall, we are optimistic regarding the business trends and the company's ability to grow at or above industry footprint.

Scott J. Leffler: We remain comfortable with full year gross margin rate.

Scott J. Leffler: 70%.

Scott J. Leffler: Adjusted operating expense growth between 5%, 7% and adjusted EPS between breakeven and five.

Scott J. Leffler: Now, let me turn the call back.

Paul J. Diaz: Thanks, Scott. We continue to build on the pillars of long-term growth and profitability, delivered our strong results in 2023 and the first quarter of this year, are clinically differentiated products supported by technology, have value in real world clinical settings, and enable early detection and better treatment decisions for providers and their patients. For modernized laboratories, commercial engines are examples where investments in automation and advanced technology are yielding improved workflows, faster turnaround times, and reduced operating costs.

Speaker Change: Thanks, Scott, we continue to build on the pillars long term growth and profitability.

Paul J. Diaz: Delivered our strong results in 2023, and the first quarter of this year are.

Paul J. Diaz: Our clinically differentiated products supported by technology.

Paul J. Diaz: Book value of real World clinical settings.

Paul J. Diaz: And enable early detection and better treatment decisions for providers and their patients.

Paul J. Diaz: Modernized lab virtual mentioned, our example, where investments in automation and advanced technology are yielding improved workflows faster turnaround times and reduced operating costs.

Paul J. Diaz: All of this is reinforcing our position as a trusted, differentiated lab. [inaudible] Thank you for following. Strong, Scalable, Perfluent, Underpinned by Data, Research, and Technology. Industry Leading Markets and Business Panel We continue to energize the enterprise around our shared mission and vision to make genetic testing and precision medicine more accessible, helping people take more control of their health, and enabling providers to better treat and prevent cancer. I'd like to now turn it back over to Matt for your two questions.

Matt: All of this reinforcing our position as a trusted differentiated lap specialized expertise.

Matt: <unk> quality.

Matt: The strong scalable commercially.

Paul J. Diaz: By data research and technology.

Matt: With industry, leading margins in business spend.

Matt: We continue to energize the enterprise around our shared vision.

Paul J. Diaz: Kinetic testing of precision medicine, or acceptable, helping people take more control of their health.

Matt: I will provide us to better treat and prevent disease.

Paul J. Diaz: I'd like to now turn it back over to Matt for your two questions.

Paul J. Diaz: Thanks, Paul. As a reminder, during today's call, we used certain non-GAAP financial measures for reconciliation of the GAAP to non-GAAP financial results. Non-GAAP Financial Guidance can be found in our findings folder and under the Investor Relations section of our website.

Matt: Thanks, Paul as a reminder, during today's call we use certain non-GAAP financial measures a reconciliation of the GAAP to non-GAAP financial results.

Matt: <unk> non-GAAP guidance can be found in our earnings release.

Matt: Under the Investor Relations section of our website.

Matthew Scalo: Now we're ready to begin our Q&A session. To ensure broad participation, we're asking participants to ask only one question and one follow-up. So Chief, we are now ready for the Q&A portion. Thank you. As a reminder, to ask a question, you will need to press star 1 1 on your telephone. To remove yourself from the queue, you may press star 1 1 again.

Matthew Scalo: Now we're ready to begin our Q&A session to ensure broad participation. We are asking participants. Please ask only one question with one model.

Matthew Scalo: We are now ready for the Q&A portion of the call.

Matthew Scalo: Thank you and as a reminder to ask a question Youre running to press star one on your telephone to remove yourself from the queue. You May press star one again.

Operator: Please stand by while we compile the Q&A roster, and our first question comes from the line of Matt Sykes of Goldman Sachs. Hi, good afternoon. Thanks for taking my questions. Congratulations on the quarter. Maybe, Paul, or maybe Mark, just talk a little bit about the runway that you see for future market share gains in both hereditary cancer and prenatal. You made some comments that it's sort of just at the beginning. So we'd love to know kind of where you see that runway and how long and then how sticky are the new relationships that you're building? I'd assume if you get those relationships, it's probably easier to keep them over time, post-winning them. I just want to get some color around that.

Matthew Scalo: Please standby, while we compile the Q&A roster.

Operator: And our first question.

Paul J. Diaz: Thanks. Yeah, Matt. First, it's in the early phase of this. You know, particularly for large accounts, these institutions take a while to make changes. I would say what's happened, and Mark will elaborate here, is that we're in the room now, certainly with, you know, two or three other competitors, and people are revisiting their choices. And as I said earlier, we really focus on the things that they tell us they care about, ease of use, clinically differentiated products, you know, and that's where EMR and the other point of care things really matter, but you're absolutely right Yeah, I would agree with that.

Operator: Comes from the line of Matt <unk> of Goldman Sachs.

Speaker Change: Hi, good afternoon, thanks for taking my questions congrats on the quarter.

Paul J. Diaz: Maybe.

Speaker Change: Paul or maybe Mark just talk a little bit about the runway that you see.

Paul J. Diaz: For future market share gains in both hereditary cancer and prenatal.

Paul J. Diaz: Made some comments that it sort of just at the beginning.

Paul J. Diaz: So we'd love to know kind of where you see that runway.

Paul J. Diaz: And how long and then how sticky are the new relationships ships that Youre building I would assume if you get those relationships.

Mark: It's probably easier to keep them over time.

Speaker Change: Post winning them I just wanted to get some color around that thanks.

Mark: Yes, Matt.

Paul J. Diaz: It's sort of early stage.

Paul J. Diaz: This.

Speaker Change: Particularly for large accounts these institutions take wallet to make changes I would say whats happened and Mark will elaborate here is that we are in the room now certainly with two or three other competitors as people are revisiting their choices and as I said earlier really folk.

Paul J. Diaz: Based on the things that they tell us they care about ease of use clinically differentiated products.

Paul J. Diaz: And Thats, where EMR and and the other point of care things really matter, but youre absolutely right.

Paul J. Diaz: Net.

Paul J. Diaz: These relationships I think it will be stickier.

Paul J. Diaz: Come from large hospital system World that once these institutions base changes without the disruptions that we're seeing now it's very hard to kind of get it now that being said of genomic testing is not number 123 or chat on the list of a hospital system priority.

Paul J. Diaz: But.

Paul J. Diaz: Pretty excited I think that expectations should be though that the.

Paul J. Diaz: The business, we hope to sign in the back half of the year, certainly could give us a lot of momentum going into 'twenty, five, but you really won't see.

Mark: Well I think it's a big opportunity fully come through those 25 markets.

Mark S. Verratti: And thanks for the question, Matt. I think now, too, the benefit is that we are at the table. Myriad is perceived as best in class, so I think we are at the table. These providers, even though there is dislocation, they've got lots of other priorities, and so we think of it as it's going to take a couple of quarters for us to really accelerate. But as Paul mentioned, and as I mentioned during my comments, for the MyRisk business, with EMR integration and all the investments we are making, that really suits us well for the back half of the year and going into 2025.

Mark: Yes, I would agree with that and thanks for the question Matt.

Mark S. Verratti: Not to speak of our poll here.

Mark S. Verratti: I think the benefit is as we are at the table b oriented is perceived.

Mark S. Verratti: Best in class. So I think we are at the table.

Mark S. Verratti: These providers, even though there is dislocation they've got lots of other priorities and so we think of it as it's going to take a couple of quarters for us to really accelerate.

Mark S. Verratti: But as Paul mentioned and as I mentioned during my comments.

Mark S. Verratti: For the virus business with EMR integration and all the investments we are making that really suits us well for the back half of the year and going into FY 'twenty five.

Mark S. Verratti: And then maybe just as my follow-up to that related question, perhaps, again, for you, Mark, just given the change in incentives for the commercial team to revenue from volume, does that help salespeople target the right customers? I'm sure in this market dislocation, there are a number of customers that might not be economically viable.

Matt: Great and then maybe just as my follow up unrelated question, perhaps again for you Mark just given the change in incentives for the commercial team to revenue from volume.

Mark S. Verratti: Does that help sales, we will target the right customers I'm sure in this market dislocation there is a number of customers.

Mark S. Verratti: It might not be economically viable and this change in incentives does it focus your salespeople on attracting the right customers and what has the reception been from your commercial team to this change in incentives.

Mark S. Verratti: And this change in incentive, does it focus your salespeople on attracting the right customers? And what has the reception been from your commercial team to this change in incentives? Yeah, Matt, you are spot on, right? I think when we make those changes, it just allows our team to focus their attention. It isn't that we're excluding any particular patient or any particular provider, but from a point of focus, and even to Scott's comment, Just all of our efforts around revenue cycle management, making sure that the order, making sure that the provider knows what's in guidelines, making sure the provider has an understanding of what the specific payer coverage is, and making sure that at the time of ordering, we're collecting as much information as we can, absolutely And that's something that I think in this space, Matt, just really wasn't...

Mark S. Verratti: Yes, Matt you're you're spot on Brian I think.

Mark S. Verratti: When we make those changes at it it just allows our team to focus their attention. It isn't that we're excluding any any particular patient or any particular provider, but from a point of focus and even to Scott's comments.

Mark S. Verratti: It just all of our efforts around revenue cycle management, making sure that the order, making sure that the provider knows what's the guidelines, making sure. The provider has an understanding that what the specific payer coverage is making sure that at time of ordering we're collecting as much information as Mccann <unk>.

Mark S. Verratti: Absolutely allows us to be able to pull through increased asps.

Mark S. Verratti: And Thats something that I think in this space not just really was not up.

Mark S. Verratti: Teams just really didn't have that type of focus, so I would definitely agree with you there, and I would say the acceptance from the sales force has been 100% aligned. You know, obviously that's how they get paid, that's how they get compensated, but it's also about the way that they spend their time in the field, right? Where they're not wasting time focusing on areas that aren't going to benefit the company, and they're certainly not going to benefit the company.

Mark S. Verratti: Team is just really didn't have that type of focus so I would definitely agree with you there and I would say the the acceptance from the sales force has been 100% of line.

Mark S. Verratti: Yes.

Mark S. Verratti: Obviously, that's how they get paid until they get compensated, but it's also about the way that they spend their time in the field right, where they are not wasting time, focusing in areas that arent going to benefit the company and they are certainly not going to mess with that.

Mark S. Verratti: And we're perfectly fine; I've talked to the sales teams about this. They understand now that, you know, maybe a point of volume was given up to get, you know, three or four points for brevity. So we are just much better aligned now, and I think you started seeing that inflection and that change in the border because they are very much now aligned with the revenue cycle management initiative. And again, as Mark said, at our different national sales meetings and stuff, we have not gotten pushback because we really helped them embrace this as part of the change.

Mark S. Verratti: Were perfectly I mean, I've talked to the sales teams about this.

Mark S. Verratti: They understand now that maybe a point of volume.

Mark S. Verratti: It's worth giving up to get three or four points of revenue.

Mark S. Verratti: So Peter just much better and why now.

Mark S. Verratti: You started seeing that inflection in that change in order because they are very much now aligned with the revenue cycle management initiatives and again as Mark said at our National sales meeting. So we have not got pushed back because we really help them embraces barb changed it so thank you.

Mark S. Verratti: So I think you'll see that net benefit play out over the course of the year and accelerate it to a five. Thank you. Thank you. Our next question comes from the line of Douglas Schenkel, of Wolf Research. Please go ahead, Douglas. You've got it. Thank you. Good afternoon. Thank you for taking my question. I want to start with a high level one.

Douglas Anthony Schenkel: You'll see that net.

Douglas Anthony Schenkel: Play out over the course of the year it accelerated.

Douglas Anthony Schenkel: Thank you.

Douglas Anthony Schenkel: Thank you.

Douglas Anthony Schenkel: Our next question.

Mark S. Verratti: Comes from the line of Douglas Schenkel.

Douglas Anthony Schenkel: Now for research.

Douglas Anthony Schenkel: Hey, guys.

Douglas Anthony Schenkel: Thank you good afternoon, and thank you for taking my questions.

Scott J. Leffler: Scott and Sam, it's now been a few months since you joined the company, and I'm curious where you are in the process of, you know, essentially, evaluating the firm, evaluating your teams, you know, essentially, what's better, and what's worse. It just would be interesting to get an update on kind of your, you know, your early learnings and kind of where you think you are and, you know, essentially starting to play offense in your leadership roles at the new firm. Sure, I'll start out and then hand it over to Stan.

Speaker Change: I want to start with a high level one.

Speaker Change: Scott and Sam It's now been a few months since you joined the company.

Scott J. Leffler: I'm curious where you are in the process of essentially evaluating the firm evaluating your teams.

Speaker Change: Essentially what's better what's worse.

Stan: Just would be interesting to get an update on kind of your your early learnings and kind of what where you think you are in essentially starting to play offense.

Speaker Change: Your leadership roles at the new firm.

Scott J. Leffler: First of all, thanks very much for the question. You know, I could not be more thrilled to be at Myriad, but also with everything that I've seen and learned, both about the company itself and the momentum that it has, but also in terms of the overall broader market opportunity that we see in front of us. I just feel privileged to have joined the company at what is a very special inflection point, where so much great work and so much great investment have already been done.

Stan: Sure I'll start off and then hand it over to Scott first of all thank you very much for the question.

Scott J. Leffler: Even more thrilled to be at area, but also with everything.

Scott J. Leffler: And learn about the company itself and the momentum it out also.

Scott J. Leffler: Also in terms of the overall broader market opportunity that we see in front of us.

Scott J. Leffler: Fruitless to join the company, but it is a very special inflection point.

Scott J. Leffler: So much creative work so much credit investment already been done.

Scott J. Leffler: And yeah, I think you can see a lot of the fruits of that effort in our results from Q1, but also to now see the landscape in front of us in terms of the ability to accelerate growth throughout 2024 and beyond. So if there is any learning that I've had in the last three months at the company, it is how extraordinary the progress that has been made, Unknown Speaker...

Scott J. Leffler: I think you see a lot of the fruits of that effort in our in our results from Q1, but also to now do the landscape in front of us in terms of the ability to accelerate growth correct.

Scott J. Leffler: Going forward. So if there is any learnings.

Scott J. Leffler: A lot of three months of the company.

Gordon: Gordon or progress.

Scott J. Leffler: Asia Pacific.

Scott J. Leffler: So.

Speaker Change: Of course.

Samraat S. Raha: Yeah, thanks, Scott. Thanks for the question, Doug. I concur with what you said.

Scott J. Leffler: Sure.

Speaker Change: Yes, Thanks, Scott Thanks for the question Doug.

Speaker Change: Concur with what you said Scott I'll tell you that I have a vantage point are coming from Sun.

Speaker Change: Other larger companies that you are aware of and I would put our team on.

Speaker Change: On par with any of them.

Samraat S. Raha: I'll tell you that I have a vantage point of coming from some larger companies that you're aware of, and I would put our team, you know, on par with any. It is a focus on, as Paul was mentioning, understanding the patient first, the science, but the operational execution to deliver timely results, quality results. I think all of those things are exactly what is needed for this next phase of our journey. I also have; it's taken time. It's not as obvious, It wasn't to be coming from the outside.

Samraat S. Raha: It is a focus on as Paul was mentioning understanding patient first science, but the operational execution to deliver timely result audio results.

Samraat S. Raha: I think all of those things are exactly what is needed for this next phase of our journey.

Samraat S. Raha: I also it's taken time out of the obvious it wasn't to be coming from the outside is the level of transformation on so many different fronts.

Paul J. Diaz: It's the level of transformation on so many different fronts. This company has really executed in the last two years, and I think there's a lot of return yet to be seen from that, and of course, now Scott and I have joined this great organization, we have an opportunity to help be part of taking us to the next level. So not only do I have no regrets, but this is exactly what I wanted to do.

Paul J. Diaz: That this company has really executed on the last two years and it's.

Paul J. Diaz: There is a lot lot of return yet to be seen from that and of course now Scott and I join.

Paul J. Diaz: Joining.

Paul J. Diaz: Thats Great organization, we have an opportunity to help be part of taking us to the next level. So not only do I have no regrets. This is exactly what I wanted to scan thrilled.

Paul J. Diaz: Thrilled to be here. And Doug, I'd only add that Dr. George Daneker has just been an incredible addition. You know, an oncologist, physician, who led a large health system oncology business. I mean, he has had such an impact just over the last couple months.

Paul J. Diaz: Thrilled to be here.

Paul J. Diaz: Doug I would only add that Dr. <unk> has just been a incredible addition element colleges physician led to large health systems oncology business. I mean, he has had such an impact just over the last couple of months.

Paul J. Diaz: And <unk>.

Paul J. Diaz: Dallas feed at our equipment outside so the company built the team build as many.

Paul J. Diaz: Many different levels.

Paul J. Diaz: These two guys have just been great there framed the ups do lots and lots of other day, you saw a little bit of that this quarter with some of the strategic stuff. So I couldnt be more pleased with our new partnership.

Paul J. Diaz: And Dr. Dallas Reed on our women's health side. So, you know, the company build, the team build is happening on many different levels. And these two guys have just been great. You know, they're freeing me up to do lots and lots of other things. And you saw a little bit of that this quarter with some of the strategic stuff. So I couldn't be more pleased with our new partner. That's fantastic.

Paul J. Diaz: Thank you for all that detail. And maybe I'll just try to sneak in one more on an unrelated front. Regarding the LDT final rule, I appreciate what you shared in your prepared remarks. For whatever it's worth, my take was, Yeah, this actually kind of turned out to potentially be a pretty big advantage for Myriad. I'm just wondering if, by and large, you guys agree and, as we look forward, recognizing this is going to take a few years to phase in, does this change anything as you think about how you develop assays, how you go to market, you know, how you think about things competitively?

Speaker Change: That's fantastic. Thank you for all that detail.

Speaker Change: Maybe I'll just try to sneak in one more.

Paul J. Diaz: On an unrelated front.

Paul J. Diaz: Regarding the <unk> final rule.

Paul J. Diaz: I appreciate what you shared in your prepared remarks.

Paul J. Diaz: For whatever it's worth.

Paul J. Diaz: It was yes.

Paul J. Diaz: It's actually kind of turned out to potentially be a pretty big advantage for myriad I'm just wondering if.

Paul J. Diaz: You guys buy and large agree.

Paul J. Diaz: As we look forward recognizing this is going to take a few years to phase and does this change anything as you think about.

Paul J. Diaz: How do you develop assays, how your go to market.

Paul J. Diaz: You know, again, I think this increases barriers to entry for others, and this may even boost your position as a consolidator. So I'd love to get any comments on where you agree or disagree with my initial thoughts on this. Thank you. Yeah, I'll start, and Doug and Sam can add later. You know, I agree, Doug. I think that this is going to be very difficult for subscale operators.

Paul J. Diaz: How you think about things competitively again, I think this increases barriers to entry for others and this.

Speaker Change: Maybe even boost your position as a consolidator so I'd love to get any comments on whether you agree or disagree with my initial thoughts on that thank you.

Speaker Change: Yes, I'll start and Doug.

Paul J. Diaz: Yes.

Speaker Change: I agree.

Speaker Change: That is.

Speaker Change: There would be very difficult for subscale operators, we have been preparing for this.

Paul J. Diaz: We have been preparing for this, though, for years. Quite frankly, when we began to develop our plans to lab the future, it was not just a real estate play. It was an automation strategy. It was to have the quality management system with full knowledge that this was coming. We feel lucky, you know, and that the investments we've made over the last decade in those quality management systems can now be leveraged, both in our existing products, modifications to our existing products, and future products.

Paul J. Diaz: For years quite frankly, but we began to develop our plans to lap future. It was not just a real estate play. It was an automation strategy. It was to have the quality management system.

Paul J. Diaz: With full knowledge that this was coming.

Paul J. Diaz: We feel lucky.

Paul J. Diaz: And that the investments we've made over the last decade, and the quality management systems now compete leverage both at our existing products.

Paul J. Diaz: Vacations to our existing products and future products. So.

Paul J. Diaz: So, clearly, we think this is going to be a competitive advantage, and the capital markets taken together with this, I think it's going to put a lot of pressure on folks, whether they're health systems, up-and-coming lab operators, or others. Sam's doing a great job of pulling the team together, and he can talk a little bit about every single one of our products. Every single one of our products is going through product management with respect to these rules, and we've been working on that for a while. Yeah, I mean, I concur with everything Paul said.

Paul J. Diaz: Clearly, we think this is going to be a competitive advantage.

Paul J. Diaz: Yes.

Paul J. Diaz: The capital markets taken together with this I think is going to put a lot of pressure on folks.

Paul J. Diaz: Their health system.

Paul J. Diaz: Up and coming lap operators or others, Sam showed a brake job. Both teams together you could talk a little bit about every single one of our products is going through the product management with respect to these rules. We can work it out for one yes, I concur with everything Paul said that'd be really answers your question.

Samraat S. Raha: I mean, it really answers your question, Doug. But just to build on what Paul was saying, we have been preparing for, you know, very diligently going through every single product we have both on the market, and we're preparing to launch some of the things that Mark talked about with an eye to all those critical elements, right? Not only quality management systems, but you know, what are the studies that need to be done? What is the labeling approach?

Samraat S. Raha: Let's just build on what Paul is saying we have been preparing for very diligently going through every single product both on market and that we are preparing to launch some of the things that mark talked about with an eye to all of the critical elements right not only quality management systems, but what are the what are the studies that need to be done.

Samraat S. Raha: And all of that while we meet the five most important things, five that you've heard Paul and myself talk about over and over again, right? We have to make sure the quality standards are there, that the tests are relevant, quality is there, that the turnaround time is there, and we make the tests accessible. So I think this is going to be, you know... Yeah, I don't know how folks that are outsourcing their lab operations can get a 70% growth margin, do it consistently, and meet these new requirements all at the same time. So I think it'll be quite a challenge. Thank you. Standby for our next question, which comes from the line of Dan Brennan of T.D. Cohen. Your question, please, Dan.

Daniel Gregory Brennan: Labeling approach.

Daniel Gregory Brennan: And all doing that while we beat most important thing for all Michelle talk about over and over again.

Daniel Gregory Brennan: We have to make sure the quality standards, there, but the tests are relevant quality of their turnaround time, there and we make the topics festivals.

Daniel Gregory Brennan: I think this is going to be.

Samraat S. Raha: Yes.

Daniel Gregory Brennan: I don't know how folks that are outsourcing their lab operation.

Daniel Gregory Brennan: The 70% gross margins and do it specifically to meet you.

Daniel Gregory Brennan: Requirements. All the same time, so I think it'll be quite a challenge.

Daniel Gregory Brennan: Thank you.

Daniel Gregory Brennan: Our next question.

Samraat S. Raha: When it comes from the line of Dan Brennan of TD Cohen.

Daniel Gregory Brennan: Question. Please.

Paul J. Diaz: Great, thank you. Thank you very much for the question here. Congratulations on a strong quarter, guys. Maybe the first one, you obviously had a really solid start to the year, you maintained a full year guide, you know, you talked about, I think, just prudence, but could you speak to, didn't sound like there were, I think you called out 3 million, maybe, in prior period benefits. So most of the beat was all organic. So is there anything that would prevent you from seeing this strength continue? Just wondering why not kind of raise the guy now?

Daniel Gregory Brennan: Great. Thank you. Thank you very much for the question here and congrats on a strong quarter guys.

Paul J. Diaz: Maybe first one obviously you had a really solid start to the year you maintained the full year guide you talked about I think just prudence, but could you speak to it didn't sound like there were I think you called out 3 million maybe.

Paul J. Diaz: <unk>.

Paul J. Diaz: Prior period benefit so most of the beat was all organic so is there anything that would prevent you from seeing this strength continue just wondering why not kind of raised the guide now.

Paul J. Diaz: Yes.

Paul J. Diaz: You're right. We agree, Cam. We're just putting one foot in front of the other here. It's a really strong start to the year, particularly on the ASP side, which we will see run through the year. And we certainly can build on that, hopefully exceed guidance as we go through the rest of the year, but it just didn't seem prudent to get ahead of ourselves, really beat our forecast. Women's health was strong, but more in line.

Speaker Change: We agree Dan.

Paul J. Diaz: Just put in one way or the other here.

Paul J. Diaz: So really strong.

Paul J. Diaz: Start to the year, particularly on the ASP side that you run through the year.

Paul J. Diaz: And we certainly can build all of that hopefully exceed guidance.

Paul J. Diaz: As we go through the rest of the year, but just didn't seem prudent to get ahead of ourselves at this point.

Speaker Change: Got it.

Paul J. Diaz: Thanks, Paul and maybe on the hereditary cancer side.

Paul J. Diaz: The oncology side really beat our forecast women's health was strong but more in line just could you elaborate a bit more.

Mark S. Verratti: Just could you elaborate a bit more on kind of how much the benefit was from, you know, the share gains that you're seeing from the dislocation versus some of the ongoing initiatives that you have? And, you know, presumably, there's still a lot more share gains ahead, given the size of that business that went bankrupt. So just a little more color on kind of, you know, what you saw this quarter, teasing it out and kind of what's assumed in the guidance going forward.

Mark S. Verratti: And kind of how much the benefit was from the share gains that youre seeing from the dislocation versus some of the ongoing initiatives that.

Mark S. Verratti: You have and presumably there is still a lot more share gains ahead, given the size of that business.

Mark S. Verratti: That one bank that went bankrupt so just a little more color on kind of what you saw this quarter teasing it out and kind of what's assumed in the guidance going forward.

Mark S. Verratti: Yeah, this is Mark, and I think we called it out that in Q1, most of it was just our ongoing blocking and tackling. You know, I think we're always winning share back and forth. So we would expect, as we mentioned earlier, that any incremental gains would happen in the back half of the year. Got it. Okay, great, guys. I'll get back in the queue.

Mark S. Verratti: Yes.

Mark S. Verratti: This is mark and I think we called it out in Q1 most of it was just our ongoing blocking and tackling.

Mark S. Verratti: I think we're always winning share back from Florida, So we would expect that.

Mark S. Verratti: We mentioned earlier that any incremental gains what happened in the back half of the year.

Speaker Change: Got it.

Speaker Change: Okay, great guys I'll get back in the queue.

Operator: Well, thank you. Thank you. Our next question comes from the line of Puneet Souda of Lyrinc Partners; please go ahead. Yeah, hi guys.

Speaker Change: Thanks, David.

Puneet Souda: Thank you.

Puneet Souda: Our next question comes from the line Puneet Sudan of Leerink partners. Please go ahead.

Paul J. Diaz: Thanks for taking my questions. I just want to clarify the European end-of-predict business, if there was anything for that in the guide, and just wondering. I know you have reiterated the guide, but just wanted to clarify that point. And then I'll follow up. Yeah, no, um, I would say that both of the strategic transactions, the way we were serving that market pretty expensively, and, you know, to put a little more cash back on the balance sheet.

Speaker Change: Yeah, Hi, guys. Thanks for taking my questions.

Paul J. Diaz: I just wanted to clarify the <unk>.

Paul J. Diaz: European and to predict the business and if there was anything that for that in the guide and.

Paul J. Diaz: Just wondering I know you have reiterated the guide, but just wanted to clarify that point.

Speaker Change: And then I have follow up.

Speaker Change: Yes no.

Paul J. Diaz: I would say that both of the strategic transaction with <unk>.

Paul J. Diaz: Our incorporating within the guide.

Paul J. Diaz: And so and being able to reposition the portfolio with the additions of precise tumor sites liquid.

Paul J. Diaz: <unk> reorganized our European operations.

Paul J. Diaz: And become much more efficient.

Paul J. Diaz: And the way we were serving that market.

Paul J. Diaz: Recently.

Paul J. Diaz: And.

Paul J. Diaz: Yes.

Paul J. Diaz: But a little more cash back on the balance sheet.

Paul J. Diaz: These are both very capital-efficient transactions, and whether it's on the revenue or the profitability side, within our guidance for 24, and accretive earnings and cash flow in 25. So, we are really excited in this market that we are picking and choosing our opportunities, and we think there'll be more in terms of bolt-ons and strategic acquisitions going forward. But this is the kind of stuff that we want to keep doing, you know, mainstream pearls or different philosophies around those kinds of things.

Paul J. Diaz: These are both very capital efficient transactions.

Paul J. Diaz: Whether it is on the revenue and the profitability side within our guidance for 'twenty, four and accretive to earnings and cash flow. Its 45. So we are really excited at this market that we are picking and choosing our opportunities.

Paul J. Diaz: We think there'll be more.

Paul J. Diaz: In terms of bolt ons and strategic acquisitions going forward, but this is a kind of stuff.

Paul J. Diaz: We want to keep doing.

Paul J. Diaz: <unk>.

Paul J. Diaz: Thanks strict hurdles.

Paul J. Diaz: Plus.

Paul J. Diaz: Okay. And then just following up on that, I mean, when you look at the portfolio optimizations that you have done, the focus on precise liquid and expansion into therapy management and also MRD, sort of, Paul, just walk us through, you know, further either trimming of the portfolio or, you know, as you said, potential expansion, other strategic options that you might pursue, given sort of where this data is coming from.

Paul J. Diaz: <unk>.

Speaker Change: Got it Okay and then just following up on that I mean.

Paul J. Diaz: When you look at the portfolio optimizations that you have done.

Paul J. Diaz: The focus on precise liquid and expansion into therapy management and also MRV sort of Paul just walk us through how you think about further either trimming of the portfolio or.

Paul J. Diaz: As you said potential expansion and other strategic options that you might pursue given sort of where the state of the market is right now in diagnostics.

Paul J. Diaz: Yeah, you know, when I pushed George, you know, and the physician, and we're certainly going to ask him these questions for everyone like, what are the key precision medicine tools you need to treat a cancer patient, a breast cancer patient, etc. Hereditary cancer always comes up first.

Paul J. Diaz: Yes.

Paul J. Diaz: Then push towards and physician.

Paul J. Diaz: And we're certainly going to ask these questions rather than like what are the key precision benefit tools, you need to treat a cancer patient breast cancer based et cetera, hereditary cancer always comes up first.

Paul J. Diaz: You know, Sabbath, second. Liquid, third, and MRD, an interesting new novel technology board. So we're just very excited that in the next couple of years, we're going to have a place where you get those primary key tools and monitor the progression of patients in one place in an EMR with consolidated reports. And I think that is going to be a big differentiator from others who are trying to string together this. And all of a sudden, regulatory cancer seems to be interesting. When I got here, everybody thought it was, you know, it's a dead bounce kind of thing.

Paul J. Diaz: Somatic second lift.

Paul J. Diaz: Liquid third and have Marty interesting new novel Technology, Florida.

Paul J. Diaz: So we're just very excited over the next couple of years, we're going to have a place where you can get those primary key tools to treat and monitor the progression of patients.

Paul J. Diaz: One place and any MLR.

Paul J. Diaz: Solid data reports.

Paul J. Diaz: That is going to be a big differentiator from others, we're trying to string together.

Paul J. Diaz: And all of a sudden hereditary cancer can be interesting when I got here everybody thought it was.

Paul J. Diaz: So we kind of like the portfolio position. That being said, Tiffany, you know, we are investing in innovation. We're building more studies, as we referred to on the call. That's a place where we have to play catch-up, going to ASCO and ACOG with more studies and more readouts than we've had in years. And we'll certainly be watching the marketplace for great science and innovation that fits within our portfolio, but we're going to stay pretty disciplined on the indications that we're focusing on and the channels where we think we have luck.

Paul J. Diaz: Yes.

Paul J. Diaz: So.

Paul J. Diaz: We kind of like the portfolio position.

Paul J. Diaz: Stephanie.

Paul J. Diaz: We are investing in innovation, we're investing in building more studies system first of all it Paul that's a place where we have been playing catch up but wanted to ask on a cogs more studies and more readouts.

Paul J. Diaz: Years.

Paul J. Diaz: We'll certainly be watching the marketplace right client innovation is fit.

Paul J. Diaz: Within our portfolio, but we're going to stay pretty disciplined on the indications that we're focusing on and the channels, where we think we have lunch.

Operator: Super helpful, guys. Thank you. Thank you. Our next question comes from the line of Andrew Cooper of Raymond James. Hey, everyone.

Speaker Change: Got it.

Andrew Harris Cooper: Super helpful guys. Thank you.

Andrew Harris Cooper: Thank you.

Andrew Harris Cooper: Thank you.

Andrew Harris Cooper: Our next question.

Operator: It comes from the line of Andrew Cooper of Raymond James.

Andrew Harris Cooper: Hey, Andrew Hey, everyone. Thanks, so much.

Operator: Thanks for the question. Um, maybe just first kind of sticking with the US transaction, maybe just give us a little bit more of the thinking on sort of circling the wagons here on the US opportunity. And, you know, what our takeaways from that should be? Is it, Hey, we're just really excited about the opportunity here and don't need to worry about European efforts in the same way we have before? Like, what should our real takeaway be from that decision? Yeah, I would say that, you know, the thesis is generally that complexity is the killer of growth. Accountability, and operating in Europe is both complicated and expensive; every single country has its own requirements.

Andrew Harris Cooper: Thanks for the question.

Operator: Maybe just first kind of sticking with the.

Operator: Our U S transaction can you, maybe just give us a little bit more of the thinking on sort of circling the wagons on the.

Operator: A U S opportunity and what our takeaways from that should be in it.

Operator: We're just really excited about the opportunity here and don't need to worry about the European efforts and the same way we have before like what should our takeaway really be on that decision.

Speaker Change: Yes, I would say that.

Operator: The thesis is generally that.

Operator: <unk> is the killer growth and accountability and operating in Europe is both complicated and expensive.

Paul J. Diaz: We were going to be forced to set up satellite laboratories everywhere to go through their regulatory IVDR process, and the juice just wasn't worth the squeeze. For the Urbio folks, that's where they live, that's where they do business, they're great at kits. And so for us to continue to serve through distribution arrangements at our LDP operations in Salt Lake City, to continue to expand in Japan, where we have a growing and very profitable business.

Paul J. Diaz: Every single country has its own requirements we were.

Paul J. Diaz: Before some set of satellite labs everywhere to go through their regulatory process.

Paul J. Diaz: And as you've just wasn't worth suites for the Euro bio folks that's where they live that's what they do business day or greater kits.

Paul J. Diaz: And so for us to continue to serve through distribution arrangements at our LDP operations Salt Lake.

Paul J. Diaz: Continue to expand in Japan, where we have a growing and very profitable business.

Paul J. Diaz: And yes, you know, resources, you know, we have to be very efficient. So investing in studies, investing in EMR has higher returns on bringing in this new business, and new opportunity we see in terms of consolidating the market, whereas Europe is a much longer term and a more complicated process. So that was really what went into it. Okay, that's helpful. And then maybe just shifting to the T&L a little bit; I would love a little bit of flavor.

Paul J. Diaz: And yes resources.

Paul J. Diaz: To be very efficient so investing in study the vesting in EMR.

Speaker Change: Higher returns.

Paul J. Diaz: Bringing in this new business opportunity, we see in terms of consolidated market, where Europe is a much longer term.

Paul J. Diaz: At a more complicated process, so that was really about.

Paul J. Diaz: Thanks.

Scott J. Leffler: I know you shared a little bit, but on some of the ASP dynamic, maybe across some of the different areas of the portfolio. And then also, just if we think about the ramp and OPEX through the year, you know, can you give us a breakout of how much of that we should think about as true? kind of new product growth that you're trying to drive and new efforts versus sort of maintaining the growing base that you have. I'll take the second one; let Scott take the first one.

Speaker Change: Okay. That's helpful.

Speaker Change: And then maybe just shifting to the P&L, a little bit would love a little bit of flavor.

Speaker Change: I know you shared a little bit but on some of the ASP dynamic maybe across some of the decline.

Speaker Change: Areas of the portfolio and then also just if we think about the ramp in opex through the year.

Scott: Can you give us a breakout of how much of that would you think about it is true.

Scott: Kind of new product growth that youre trying to drive and new efforts versus sort of maintaining the growing base that you have.

Speaker Change: I'll take the second one let Scott take first one.

Paul J. Diaz: You know, we're continuing to try to get productivity gains across all OPEX, whether it's commercial, be, you know, replay in the support center, um, and, and, and trying to repatriate dollars to our end, clinical studies, and to I. T. Well, we know we have very quick returns on investment. So we expect to stay within that 5% to 7% growth. I just want to remind everybody, over the last couple years, we've done exactly what we said we were going to do, and we've done it again this quarter.

Paul J. Diaz: So we're continuing to try to get productivity gains across all of Opex, whether it's commercial.

Paul J. Diaz: A replay of the support center.

Paul J. Diaz: And trying to repatriate dollars to R&D clinical.

Paul J. Diaz: Clinical studies and to what.

Paul J. Diaz: What we know we have very quick returns on investment.

Paul J. Diaz: <unk>.

Paul J. Diaz: We expect to stay within that 5% to 7% growth.

Paul J. Diaz: Just to remind everybody over the last couple of years has done exactly what we said.

Paul J. Diaz: And you're really starting to see the leverage of this operating model this quarter. And so we maintain that we can manage within a five to seven. But within that, you know, we may push the 7% growth in OPEX, but a higher percentage of that, call it 10 to 15% growth in R&D and tech spend, while the other areas, it's really wages and benefit costs that are in the 4 to 5% range for all of them.

Paul J. Diaz: We've done that again this quarter and you're really starting to see the leverage of this operating model this quarter.

Paul J. Diaz: So we we maintain that we can manage within that five to seven but within that we may push the 7% growth in opex, but a higher percentage of that call it 10% to 15% growth in the R&D and tech spend while the other areas, it's really wages and benefit costs that are in the 4% to 5% range all in.

Paul J. Diaz: So that's how I would think about that. No big investments beyond, you know, that five to 7% range in our OPEX. You'll see some ramp-up over the course of the year, and just a great job by the team starting this year in terms of actually meeting budget in the first quarter, so you will see a little bit of a ramp each quarter as we invest, getting ahead of the launches of the studies that were Yeah, so I'll take that here. What was your first question on ASP?

Paul J. Diaz: So that's how I would think about that no big investments beyond that 5% to 7% range of our Opex, you'll see some ramp up over the course of the year.

Paul J. Diaz: And just a great job by the team starting this year in terms of actually beating budget in the first quarter. So you will see a little bit ramp each quarter as we invest in getting ahead of the launches of the studies that were frankly.

Scott J. Leffler: And I'll just remind you that on the last earnings call, we did talk a little bit about the fact that, looking back on 2023, our overall ASP performance for 2023 actually was a little bit worse than we would typically expect. And so coming into the year, we already saw that there was an opportunity to really perform even better than we would typically hope for, just given the ability to recover some of what was lost last year, along with incremental organic improvement from the various initiatives that we've talked about.

Paul J. Diaz: Okay.

Speaker Change: Yes, so I'll take the Europe, what was your first question on <unk>.

Scott J. Leffler: And I'll just remind you been on the last earnings call. We did talk a little bit about the fact that looking back on 2023, our overall.

Scott J. Leffler: Performance for 2023 execute with a little bit worse.

Scott J. Leffler: Ladies expect and so coming into the year, we already saw that there was an opportunity to really perform even better than we would typically hope towards driven the ability to recover some of it with cloth blocks here along with incremental organic improvement from the various initiatives that we've talked about.

Scott J. Leffler: But really, I would say that it's just been an extraordinary success so far this year, and more or less across the board at the individual product level, outside ASP gains. And when you look at the blended performance, where I think we call that a 2% contribution from ASPs, in some ways, that high-significance ASP improvement has been at the individual product level, because you have a little bit of product mix that is impacting that blended number.

Scott J. Leffler: Really I would say.

Scott J. Leffler: It's just been an extraordinary so far this year.

Scott J. Leffler: Sure.

Scott J. Leffler: Okay.

Scott J. Leffler: We're less across the board agenda digital product level.

Scott J. Leffler: But really, what we're seeing, almost across the board, is much greater than that 2% improvement in ASP. And that's something that we believe certainly is sustainable. And based on the number of initiatives, we continue to have... Great. I appreciate the time. I'll hop back in the queue.

Scott J. Leffler: Outside the ESP again.

Scott J. Leffler: When you look at the selected performance, where we are I think we felt that protect contribution from ASP.

Speaker Change: In some ways the highest significantly tampered.

Scott J. Leffler: Then the individual product level, because we have a little bit of product mix fit.

Scott J. Leffler: I think that blended number but really what we are seeing almost across the board much.

Speaker Change: Much greater than that.

Speaker Change: <unk> been in ASP.

Scott J. Leffler: That's something that we certainly are sustainable and refill the number of initiatives. We continue to have the display.

Scott J. Leffler: Okay.

Speaker Change: Great I appreciate the time I'll hop back in the queue.

Operator: Thank you. Our next question comes from the line of Rachel Vassendal of JPMorgan. Hi Rachel.

Speaker Change: Thanks, Andrew.

Rachel Marie Vatnsdal Olson: Thank you.

Rachel Marie Vatnsdal Olson: Our next question.

Rachel Marie Vatnsdal Olson: It comes from the line of Rachel vast mobile of Jpmorgan.

Operator: Hi, good afternoon. Hi, you guys. Thanks so much for taking the questions. So first, I just wanted to dig into seasonality and 2Q expectations. Last quarter, you provided guidance for 1Q on top and bottom. So I was wondering if you could do something along those lines for 2Q as well.

Rachel Marie Vatnsdal Olson: Hi, Rachel Hi, good afternoon, Hi, guys. Thanks, so much for taking my questions. So firstly I just wanted to dig into seasonality into Q expectation last quarter, you provided guidance for <unk> on top and bottom. So I was wondering if you can do something along those lines for Q2 as well. So first up how comfortable are you with the street at around $200 million of revenues and roughly.

Operator: Penny Mark for sure and then given some of the moving pieces that you highlighted today ranging from Ali <unk> with some of the product launches and competitive dynamics. How are you thinking about the various segments performing into Q.

Speaker Change: [laughter] so that.

Paul J. Diaz: So first up, how comfortable are you with the street at around $200 million in revenues and roughly a penny of loss per share? And then, given some of the moving pieces that you highlighted today, ranging from LDT to some of the product launches and competitive dynamics, how are you thinking about the various segments performing in 2Q? So, that was a lot and fast. First, we did not get Q1 DIAZ.

Operator: That was a lot in fast.

Paul J. Diaz: So first we did not give Q1 guidance.

Paul J. Diaz: And we're not giving Q2 guidance. I think directionally, the street's in a pretty good place in terms of where estimates are for Q2. Obviously, building on our Q1 success, you know, there's nothing that we're seeing in the estimates for Q2 that would trouble us. I would encourage folks not to get ahead of us here. Again, just there's a lot of moving parts with labs, the future, and everything else going on. But, you know, on individual products, it continues to be a story of continuing to grow.

Paul J. Diaz: And we're not giving Q2 guidance I think directionally the street pretty good place in terms of where estimates are for Q2.

Paul J. Diaz: And building on our Q1 success.

Paul J. Diaz: There's nothing that we're seeing in your estimates for Q2 that trouble us.

Paul J. Diaz: No.

Paul J. Diaz: Folks not to get ahead of us here.

Paul J. Diaz: It took a lot of moving parts with lots of future and everything else.

Paul J. Diaz: Going on but.

Paul J. Diaz: Q2 is typically a stronger quarter for us in terms of volume. And Scott just said, you know, the ASP tailwinds that we have to continue in the year, so that does bode well for a strong [inaudible] quite frankly create real and strong momentum going into this fourth quarter. Great.

Paul J. Diaz: On individual products at <unk>.

Paul J. Diaz: <unk> to be a story of <unk>.

Paul J. Diaz: <unk>.

Paul J. Diaz: Ro.

Paul J. Diaz: Q2 is typically a stronger quarter for us in terms of volume and.

Paul J. Diaz: Scott just said.

Paul J. Diaz: The USP tailwind that we have to continue in the year, so that does bode well for a strong.

Paul J. Diaz: Year, even without big market share gains as Mark said, probably happened later next year later this year.

Paul J. Diaz: Quite frankly, great strong momentum going into the spot.

Paul J. Diaz: And then just on my follow-up around ACOG, you mentioned that ACOG guideline expansion would be good news later this year if we were to see it. So I guess, what's your latest assumption on when we could see an update from ACOG? I appreciate it's not embedded into guidance at this point, and then I just wanted to talk for a minute about market share regarding 22Q. One of your peers out there has more of an opt-out strategy when it comes to 22Q testing.

Speaker Change: Great and then just for my follow up around <unk>, you mentioned that a cards guideline expansion would be upside later this year, if we were to see it.

Paul J. Diaz: What's your latest assumption on when we can see an update from Chicago appreciate it's not embedded into guidance at this point and then I just wanted to talk for a minute about market share regarding 2000 Q1 of your peers out there have more of an opt out strategy. When it comes to <unk> testing I know you guys have focused more on the profitability side and have more of that opt in type of strata.

Paul J. Diaz: I know you guys have focused more on the profitability side and have more of that opt-in type of strategy. So when ACOG eventually, you know, expands their guidelines, should we see that as a positive guideline inclusion? How do you see that playing out from a market share perspective, given that shift between opt-in and opt-out?

Paul J. Diaz: So when a cog and eventually at Stanford guidelines should we see that positive guideline inclusion how do you see definitely not from a market share perspective, given that shift between opt in and opt out. Thank you.

Paul J. Diaz: Thank you. Yeah, we just released a study on 22Q, which was, you know, the power of prequels, quite frankly, differentiated from everything else on the market. And so if 22Q is included in ACOG guidelines, we think that will give us, you know, just another reason to continue to win share and win share that's profitable. The thing that I just want to keep underscoring for everybody is... profitable growth. That's what we're focused on, and that's what we delivered this quarter. And that's what we're going to continue to deliver. But you're absolutely right.

Paul J. Diaz: We just.

Paul J. Diaz: The study on <unk>, which was sure.

Paul J. Diaz: Power pre book quite frankly differentiated.

Paul J. Diaz: Joe from everything else on the market quite frankly, and so if <unk> is included in <unk> guidelines, we think that will give us.

Paul J. Diaz: Just another reason to continue to win share.

Paul J. Diaz: And with share that's profitable.

Paul J. Diaz: I just want to keep underscoring for everybody.

Paul J. Diaz: Its profitable growth year, that's what we're focused on and that's what we've delivered this quarter and that continued to deliver.

Paul J. Diaz: The expansion of ACOG guidelines, should they happen, we think those will broaden adoption, as well as improve ASP. The launch of Foresight Universal Plus will include those genes that we expect, so we're holding off until we see that, and that kind of just goes to the product management discipline overall. We want to make sure that we are not launching products that are not in guidelines, and that we don't, and that we have a path to payment, which is the thing that I think the industry is finally grappling with, launch is not just having your studies and going out and selling doctors on your product. It is also having an eye for getting paid and running it through your lab efficiently.

Paul J. Diaz: But youre absolutely right the expansion of <unk> guidelines should they happen.

Paul J. Diaz: Think both will broaden adoption.

Paul J. Diaz: As well as improve AFP.

Paul J. Diaz: And.

Paul J. Diaz: The launch of fore sight Universal plus will include those genes that we expect so we're holding off until we see that.

Paul J. Diaz: And that kind of just go through a product management discipline overall, we want to make sure that we are not launching products that are not a timeline and.

Paul J. Diaz: And as we don't have a pass through payment, which is the thing that I think the industry is finally grappling with is launches not just having your your studies and going out and selling docs on your product. It is also happening.

Paul J. Diaz: Eight and running it through your last efficiently. So that's the balance we're trying to bring a product management.

Paul J. Diaz: So that's the balance we're trying to bring to product management. But the expansion of guidelines would be a great tailwind for us going into next year if they are adopted, as we hope, later this summer, and we're all kind of up to stand by there. And 22Q would also be great to have in that context.

Paul J. Diaz: The expansion of diverse great tailwind for us going into next year. If they are adopted as we'd hoped later this summer, but we're all kind of understand why <unk> would be also just right to have in that context.

Speaker Change: Thank you.

Operator: Thank you. Our next question comes from the line of Sabu Nambi of Guggenheim Security. Hey guys, thank you for taking my question. On reproductive health, a couple of larger players have exited the market. And you clearly have made progress in capturing share, but how are you gaining share without compromising personal moving forward in the business model that excites them all? I'm not really sure if I followed you correctly, because you didn't come through particularly clearly. I think the question was how we gain a share profitably. I'm sorry.

Speaker Change: Our next question.

Subhalaxmi T. Nambi: Comes from the line of Sogou Nambi of Guggenheim Securities.

Speaker Change: Hey, guys. Thank you for taking my question.

Operator: On reproductive health a couple of larger players have exited the market.

Operator: You clearly have made progress in capturing share, but how are you gaining share without compromising.

Operator: Going forward.

Operator: This model.

Operator: Okay.

Subhalaxmi T. Nambi: I'm not really sure if I followed you didn't come through particularly clearly I think the question was how are we gaining share profitably im sorry could you just restate. The question. Please I apologize.

Operator: Could you just restate the question, please? My apologies. Yes. Can you guys hear me now? It's a little better. Yeah, maybe just a little louder.

Speaker Change: Can you guys hear me now.

Speaker Change: It's a little better, but yes, maybe just a little louder. Thank you.

Operator: Thank you. Okay, so on reproductive health, a couple of larger players have exited the market, and you are clearly making progress in capturing share. But how are you gaining share without compromising margin, given the business model of those that exited the market didn't really focus on the margin? Yeah, so good, good question.

Operator: Okay.

Operator: So in reproductive health a couple of larger players have exited the market and you are clearly making progress in capturing share, but how are you gaining share without compromising margins given the business model of those that exited the market given the business model of those that exited the margin market seem to really focus on the margins.

Speaker Change: Yes, so good question.

Paul J. Diaz: We absolutely are trying to be there for customers. As Mark said, we see patients; we don't see payers, but that doesn't mean that we are not focused on making sure that we are bringing in business with good margins, that we can do it effectively. So I think what you've seen over the last two years is our ability to grow and grow more profitability than you saw in the last two quarters.

Paul J. Diaz: We absolutely are.

Paul J. Diaz: To be there for customers as Mark said, we see patient.

Paul J. Diaz: Steve.

Paul J. Diaz: The payor.

Paul J. Diaz: But that doesn't mean, if we are we are not focused on making sure that we are bringing on business with good margins that we can do it effectively so I think what <unk> seen over the last two years that our ability to grow and grow.

Paul J. Diaz: More profitability and you saw at the last two quarters.

Paul J. Diaz: So it is about profitable growth, maintaining those growth margins near 70%. That'll fluctuate sometimes in quarter to quarter depending on mix and other factors, but we've stayed in that 68 to 70%, and I think we can probably do a little bit better as the year progresses here, absolutely committed to not just bringing on business to win business but to bring on business that is profitable, and that generates cash flow. If you look at our cash flow conversion and we look at our 50 days and DSOs, we've got to convert, you know, billings into cash.

Paul J. Diaz: So it is about profitable growth maintaining those gross margins near 70%.

Paul J. Diaz: Such way, sometimes from quarter to quarter, depending on mix and other factors, but we have stayed in that 68% to 70%.

Paul J. Diaz: I think we can probably do a little bit better in Europe progresses here.

Paul J. Diaz: But.

Paul J. Diaz: Absolutely committed to not just bringing on business to win business, but to bring on business that is profitable and that generates cash flow. If you look at our cash flow conversion and you look at our 50 days in Dsos.

Paul J. Diaz: We've got to convert billings into cash.

Paul J. Diaz: And ultimately, I think that's what disciplined businesses need to do. And we're trying to do it. Very helpful. And one last one for me.

Paul J. Diaz: And ultimately I think that with disciplined businesses need to do and we're trying to do.

Paul J. Diaz: On MRD, any updates on clinical data? How is the enrollment progressing? And are you still planning commercial launch the back half of next year? Yeah, so, there'll be some additional studies at ASCO. And then we are expecting to get a readout on an R.D. Anderson study this fall, late summer. And in addition, we will be running samples for pharma in July, I am told.

Speaker Change: Super helpful and one last one from me.

Paul J. Diaz: Any updates on clinical data how is the enrollment progressing.

Paul J. Diaz: And are you still planning commercial launch in the back half of next year.

Speaker Change: Yes so.

Paul J. Diaz: Those bill that there'll be some additional studies at <unk>.

Paul J. Diaz: And then we are expecting to get a readout on our MD Anderson study this fall late summer.

Paul J. Diaz: And in addition, we will be running samples for pharma in July I am Paul. So I think Q3 Q4, we will have a lot more to talk about the progress we're making.

Paul J. Diaz: So I think Q3, Q4, we will have a lot more to talk about the progress we're making with the studies, but everything is progressing there. We have another patent we're expecting to get out of issues here shortly. So, you know, while we all wish we were making more progress, we are going to be investing in some additional studies. But so far, you know, my understanding from Dale is that they're running through the labs really well. Sensitivity is high.

Paul J. Diaz: With this study, but everything is progressing there and we have another pattern, we're expecting to get.

Paul J. Diaz: Issue here shortly.

Paul J. Diaz: So.

Paul J. Diaz: While we all wish we were making progress.

Paul J. Diaz: We are going to be investing in some additional study, but so far.

Paul J. Diaz: My understanding is brookdale is that they're running through the last really well sensitivity is high.

Paul J. Diaz: Our partners are really pleased with what they are seeing in terms of the results. And we'll be talking, as Mark said, more about this at ASCO, including with our partners that have already.

Paul J. Diaz: Our partners are really pleased with what they are seeing in terms of the results.

Paul J. Diaz: We'll be talking as Mark said more about this at ash.

Paul J. Diaz: <unk> with our partners at MD Anderson.

Operator: Thank you, guys. Thank you. Thank you. Our next question comes from the line of Mason Carrico on Stephen. Hey, this is Jacob on for Mason.

Speaker Change: Perfect. Thank you guys.

Jacob: Thank you.

Jacob: Thank you.

Jacob: Our next question.

Operator: Yeah.

Jacob: Comes from the line of Mason Caracol.

Jacob: Of Stephens, Inc.

Operator: Congrats on a strong start to the year. Lots have already been covered, so maybe just keep it to one here.

Operator: Hey. This is this is jacob on for Mason Congrats on a strong start to year lots already been covered so I'll, maybe just keep it to one here, but could you talk a bit about the.

Jacob: Early traction you're seeing within your oncology portfolio after acquiring inner mountain I realized launching precise liquid and your <unk> offering will be big drivers of this opportunity, but have you maybe seen an increase in the number of docs ordering multiple test within this segment yet.

Paul J. Diaz: But could you talk a bit about the early traction you're seeing within your oncology portfolio after acquiring Intermountain? I realize launching Precise Liquid and your MRD offering will be a big drivers of this opportunity, but have you maybe seen an increase in the number of doctors or in multiple tests within this segment yet? Yeah, I mean, I think it's still early days here.

Speaker Change: Yes, I mean, I think it's still early days here.

Paul J. Diaz: I mean, the first thing was to make sure that we integrated it Sam and the team are doing a great job there and we've seen a slight increase but the real push will happen.

Paul J. Diaz: I mean, the first thing was to make sure that we integrated it, and Sam and the team are doing a great job there. And we've seen a slight increase, but the real push will happen later this year once it's fully integrated and going into 25. It's not really envisioned to be a driver of our guide for this year, but we do see precise tumor numbers growing overall, and not just in terms of the intermountain deal. And that really sets the stage for liquid next year and MRD.

Paul J. Diaz: Later this year once it's fully integrated and going into 'twenty five.

Paul J. Diaz: As Tom really envision to be a driver of our guide for this year.

Paul J. Diaz: But we do see precise tumor numbers overall growing.

Paul J. Diaz: And not just in terms of the inner mountain deal and now we control 100% of P&L.

Paul J. Diaz: So it's not just sort of the allocated part of P&L.

Paul J. Diaz: So that is that is starting to contribute but I think what youll see coming out of <unk>.

Paul J. Diaz: The big push in terms of our oncology team about preparing a hereditary cancer with precise tumor and that really sets the stage for liquid next year and Marty so.

Paul J. Diaz: So, you know, stay tuned. I think we'll have a lot to say at ASCO about how this portfolio comes together in terms of precision medicine tools for oncologists, particularly for breast cancer patients, but for other indications as well. And that's what we'll be highlighting at ASCO. We're pretty excited about the feedback we've gotten. Colleges in terms of that will be reviewed in February.

Paul J. Diaz: Stay tuned I think we will have a lot to say about how this portfolio come together in terms of precision medicine tools for oncologists, particularly for breast cancer patients, but for other indications as well.

Paul J. Diaz: That's where we'll be highlighting it as though we're pretty excited about feedback we've got from local colleges in terms of that is it.

Paul J. Diaz: <unk>.

Speaker Change: Thank you.

Paul J. Diaz: Thank you. Our next question comes from the line of Michael Riskin of B of A. Good afternoon, this is John on for Mike. Hey, afternoon.

Speaker Change: Our next question.

John: Comes from the line of Michael Riskin Bofa.

Paul J. Diaz: Good afternoon, Sean on for Mike Hey afternoon.

Operator: I wanted to ask about GeneSites, you know, it's a great volume ASP and did better than our models, so exceptionally well. Could you provide any update you've had in terms of improving the coverage, like what states and blue plans are next for you? And, you know, what's in your guide versus what can be an upside? It's, it's, um, Scott said, it's just blocking and tackling right now. It's, um, we haven't even fully leveraged the biomarker pieces yet. You know, we're, You probably don't want to call it individual states, but we are amping up a couple of states in the Attorney General's Office and other places.

John: I wanted to ask on gene sites.

Operator: Yeah, Great volume ASP and did better than our models. So exceptionally well could you provide any update you've had in terms of improving the coverage like what states and Blue plans are next for you and.

Operator: What's in your guide.

Operator: Versus what can be an upside.

Operator: It's.

Speaker Change: Got it.

Operator: It's just blocking and tackling right now.

Operator: <unk>.

Operator: We haven't even really fully levered biomarker can you suggest.

Operator: Sure.

Operator: So probably don't want to call out individual state, but we are ramping up a couple of states and the attorney General's office and other places.

Paul J. Diaz: But it's been a number of different, you know, wins, you know, a billion bucks here, a billion bucks there. All of a sudden, you're talking about a nice lift in ASP and just gaining more traction on coverage writ large in terms of chain site and also improving prior auth requirements and working with CMS, Medicare Advantage plans with respect to prior auth requirements, along with other industry participants, and again, as Scott said, it's been an across-the-board effort across all our products in terms of, you know, seeking out places where we didn't have coverage, even for my risk, hereditary cancer, where we had certain blues plants that were not covered.

Operator: But it's been a number of different.

Paul J. Diaz: Yes.

Paul J. Diaz: But tier 1 billion, but there also.

Paul J. Diaz: You talked about a nice lift in asps.

Paul J. Diaz: And just gaining more traction on coverage with large in charter.

Paul J. Diaz: Change site and also improving prior off requirements.

Paul J. Diaz: Working with CMS Medicare advantage plans with respect to prior off requirements along with other industry participants.

Paul J. Diaz: As Scott said, it's been across the board effort across all our products in terms of seeking.

Paul J. Diaz: Seeking out places, where we didnt have coverage even for my risk hereditary cancer at Sir <unk> plant that we're not covering.

Paul J. Diaz: And as Scott said, you know, last year was a really tough year from ASP's perspective. And we're seeing the results of that turnaround now, working through some of those coding changes and other things. And we think, again, that momentum will continue. We'll build on that throughout the year and going into. Gotcha, understood. And then, on the flip side, if I could ask for the tumor profiling.

Paul J. Diaz: As Scott said last year was a really tough year from an ASP perspective.

Paul J. Diaz: And we're seeing the result of that turnaround now working through some of those coding changes and other things.

Paul J. Diaz: We think again that momentum will continue will build on that.

Paul J. Diaz: Throughout the year and filling it.

Speaker Change: Got you understood.

Paul J. Diaz: And then on the on the flip side, if I could ask for the tumor profiling.

Paul J. Diaz: Any thoughts on.

Paul J. Diaz: Any thoughts on, Yeah, any thoughts on how the volume and ASP are going to go there? A tumor profile was an impact because we had a really big win in Q1 of last year with a couple of biopharma partners. So it was really the biopharma revenue that skews that performance. You know, my choice has been a little lower because of the change to average risk. But overall, that negative 17% was driven by the fact that we had a big win in Q1 of last year with two or three biopharma partners. The biopharma business is very lumpy. So we're not really, you know, not really clear. It always happens, we always get paid, and it's always really good business. But sometimes it falls in Q1 and sometimes it falls in Q3.

Paul J. Diaz: Any thoughts on how the volume at the Asps is going to go there.

Paul J. Diaz: Yes, a tumor profiling was impacted because we had a really big win in Q1 of last year with a couple of Biopharma partners. So it was really in the Biopharma revenue that skews that performance.

Paul J. Diaz: My choice has been a little down because of change to average risk.

Paul J. Diaz: And so we still are excited about the prospects of building that business, and that's something Sam and Patrick are really partnering up on. All right. Thank you. Thank you. I would now like to turn the conference back to Paul Diaz for closing remarks. Thanks, everyone. I think everyone's heard enough from me today.

Paul J. Diaz: But overall.

Paul J. Diaz: That negative 17% was driven by the fact that we had a big win in Q1 of last year with two or three big file.

Paul J. Diaz: Partners. The Biopharma business is very lumpy. So we're not really not really clear it always we always get paid but we have really good business.

Paul J. Diaz: Sometimes it followed the coupon.

Paul J. Diaz: Both Q3, and so we still are excited about the prospects of building that business and Thats, something Sam and Patrick or partnering.

Paul J. Diaz: Understood Alright, thank you.

Paul J. Diaz: Thank you.

Patrick: Thank you I would now like to turn the conference back to Paul Diaz for closing remarks, Sir.

Paul J. Diaz: So I appreciate you guys spending time on the call today. I want to thank my teammates for all their hard work. It was actually a difficult operating order.

Paul J. Diaz: We had a few issues in the lab, and we had to work through the team rally. And again, we're just really pleased at the start of the year. I appreciate all of you participating in the call today and for your support. And again, I hope you are starting to see, as Scott said, just the beginning of the process here of us really starting to grow Myriad Genetics. And I think you can expect and should expect more from us as the year progresses. Thank you all. This concludes today's conference call. Thank you for participating. You may now disconnect. [inaudible] Please See The Complete Disclaimer At https://www.youtube.com or on my website at www.islington.net

Paul J. Diaz: Thanks, Kevin I think everyone's heard enough from me today. So I. Appreciate you guys spent time on the call today I want to thank my teammates for all their hard work.

Paul J. Diaz: It was actually a difficult operating quarter.

Paul J. Diaz: We had a few issues to the last one we got to work through the team rallied and and again, we're just really pleased with the start of the year I. Appreciate all of you participating in the call today and your support and again I Hope that you are starting to see as Scott just the beginning.

Paul J. Diaz: Of.

Paul J. Diaz: <unk> of the process here of us really starting to grow myriad genetics and.

Paul J. Diaz: And I think you can expect and should expect more from us as your breath. So thank you all.

Paul J. Diaz: This concludes today's conference call. Thank you for participating you may now disconnect.

Paul J. Diaz: Goodbye.

Paul J. Diaz: Okay.

Paul J. Diaz: [music].

Paul J. Diaz: Yes.

Paul J. Diaz: [music].