Q1 2025 iRhythm Technologies Inc Earnings Call

Operator: presentation portion of the call with an opportunity for questions and answers at the end.

Questions and answers at the end if he would like to ask a question. Please press star one on your telephone keypad due.

Operator: If you would like to ask a question, please press star one on your telephone keypad. Due to the interest of time, we ask that you ask one question and to requeue for any follow-up questions. Again, due to the interest of time, we ask that you ask one question and to requeue for any follow-up questions.

Due to the interest of time, we ask that you ask one question its a re queue.

For any follow up question again due to the interest of time, we ask that you ask one question and to re queue for any follow up questions I would now like to pass the conference over to your host Stephanie as Actavis director of Investor Relations. Please proceed.

Stephanie Zhadkevich: I would now like to pass the conference over to your host, Stephanie Zhadkevich, Director of Investor Relations. May proceed.

Quentin Blackford: Thank you all for participating in today's call.

Stephanie: Thank you all for participating in today's call earlier today.

Quentin Blackford: Earlier today, Irhythm released financial results for the first quarter ended March 31st, 2025.

Stephanie: <unk> financial results for the first quarter ended March 31st 2000, pullback before I begin I'd like to remind you that management will make statements. During this call that include forward looking statements within the meaning of federal Securities laws pursuant to the Safe Harbor provisions of the private Securities Litigation Reform Act of 1995.

Quentin Blackford: Before we begin, I'd like to remind you that management will make statements during this call that include forward-looking statements within the meaning of federal securities laws pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that are not statements of historical fact should be deemed to be forward-looking statements. These are based upon our current estimates and various assumptions and reflect management's intentions, beliefs, and expectations about future events, strategies, competition, products, operating plans, and performance.

Stephanie: Any statements contained in this call that are not statements of historical fact should be deemed to be forward looking statements.

Stephanie: Based upon our current estimates and various assumptions and reflect management's intentions beliefs and expectations about future events strategies competition products operating plans and performance.

Quentin Blackford: These statements involve risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward-looking statements. Accordingly, you should not place undue reliance on these statements.

Stephanie: These statements involve risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward looking statements.

Stephanie: Accordingly, you should not place undue reliance on these statements.

Quentin Blackford: For a list and description of the risks and uncertainties associated with our business, please refer to the risk factors section of our most recent annual and quarterly reports on Form 10-K and Form 10-Q, respectively, filed with the Securities and Exchange Commission.

Stephanie: For lithium description of the risks and uncertainties associated with our business. Please refer to the risk factors section of our most recent annual and quarterly reports on Form 10-K, and Form 10-Q, respectively filed with the Securities and Exchange Commission.

Quentin Blackford: Also during the call, we will discuss certain financial measures that have not been prepared in accordance with U.S. GAAP with respect to our non-GAAP and cash-based results, including adjusted EBITDA, adjusted operating expenses, and adjusted net loss. Unless otherwise noted, all references to financial metrics are presented on a non-GAAP basis.

Stephanie: Also during the call we will discuss certain financial measures that have not been prepared in accordance with U S. GAAP with respect to our non-GAAP and cash based results, including adjusted EBITDA adjusted operating expenses and adjusted net loss.

Stephanie: Unless otherwise noted all references to financial metrics are presented on a non-GAAP basis. The presentation of this additional information should not be considered in isolation as a substitute for or superior to results compared in accordance with GAAP. Please refer to the tables in our earnings release and 10-Q for a reconciliation of these measures to their most directly comparable GAAP financial measures.

Quentin Blackford: The presentation of this additional information should not be considered in isolation of, as a substitute for, or superior to results compared in accordance with GAAP. Please refer to the tables in our earnings release in 10-2 for reconciliation of these measures to the most directly comparable GAAP financial... Unless otherwise indicated, all references to financial measures in this call, other than revenue, refer to non-GAAP results.

Stephanie: Unless otherwise indicated all references to financial measures on this call other than revenue referred to non-GAAP results.

Quentin Blackford: This conference call contains time-sensitive information and is accurate only as of the live broadcast today, May 1st, 2025.

Stephanie: This conference call contains time sensitive information and is accurate only as of the live broadcast today may one 2020, I rhythm disclaims any intention or obligation except as required by law to update or revise any financial projections or forward looking statements, whether because of new information future events or otherwise.

Quentin Blackford: Irhythm disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events.

Quentin Blackford: And with that, I'll turn the call over to Quentin Blackford, Irhythm's president and CEO. Thank you, Stephanie. Good afternoon, and thank you all for joining us today.

Stephanie: And with that I'll turn the call over to Quentin Blackford, our rhythm as president and CEO.

Stephanie: Thank you Stephanie good afternoon, and thank you all for joining US today, Dan Wilson, Our Chief Financial Officer is joining me on today's call. My remarks will cover our business performance during the first quarter of 2025, and our outlook for the remainder of the year I will then turn the call over to Dan to provide a detailed review of our first quarter financial results and updated guidance for 2025.

Quentin Blackford: Dan Wilson, our Chief Financial Officer, is joining me on today's call. My remarks will cover our business performance during the first quarter of 2025 and our outlook for the remainder of the year.

Quentin Blackford: I will then turn the call over to Dan to provide a detailed review of our first quarter financial results and updated guidance for 2025. Irhythm has begun 2025 in an exceptionally strong position with near-record revenue unit volume, despite what is typically a meaningful seasonal sequential decline, resulting in robust top-line results of $158.7 million, representing more than 20% growth compared to the first quarter of 2024. This growth was driven by continued market penetration in our core U.S. business, increasing appreciation of Zio's value proposition in national value-based care accounts, continued expansion into the undiagnosed arrhythmia market segment, and strong demand in our international business.

Stephanie: Our rhythm has begun 2025 and an exceptionally strong position with near record revenue unit volume. Despite what is typically a meaningful seasonal sequential decline, resulting in robust topline results of $158 $7 million representing.

Stephanie: Representing more than 20% growth compared to the first quarter 2020 for.

Stephanie: This growth was driven by continued market penetration in our core U S business, increasing appreciation of <unk> value proposition and national value based care accounts.

Stephanie: <unk> expansion into the undiagnosed arrhythmia market segment and strong demand in our international business.

Quentin Blackford: Following record new account onboarding achieved during 2024, we were very pleased to observe significant volume demand throughout the first quarter of 2025 for both XeoMonitor and XeoAT. Demand within our XeoMonitor product line originated from cardiologists, electrophysiologists, and primary care physicians, and we were encouraged to see another large, national, innovative health channel partner begin implementing the XeoMonitor for their population. Additionally, the strong ZOAT demand noted in the fourth quarter of last year continued throughout the first quarter and we continue to welcome a substantial number of new accounts to the Irhythm family.

Stephanie: Following record New account Onboarding achieved during 2024, we were very pleased to observe significant volume demand throughout the first quarter of 2025 for both video monitor and <unk>.

Stephanie: Demand within our zeal monitor product line originated from cardiologist Electrophysiologist and primary care physicians and we were encouraged to see another large national innovative health channel partner began implementing the zeal monitor for their population.

Stephanie: Additionally, the strong <unk> demand noted in the fourth quarter of last year continued throughout the first quarter and we continued to welcome a substantial number of new accounts to the algorithm family.

Quentin Blackford: Marking a momentous occasion in Irhythm's history, during the first quarter we surpassed 10 million cumulative patient reports since the company's inception. underscoring our unwavering commitment to delivering superior patient care. In our long-term continuous monitoring service line, momentum remains robust as we continue our strategic expansion into upstream care pathways. deepening our presence in existing cardiology and electrophysiology accounts and drive further ACM modality mix shift away from short-term and event monitoring. We estimate that there are approximately 27 million patients in the United States who either present to their primary care provider with cardiac palpitations or are at a high risk to have cardiac arrhythmias due to patient-specific risk factors but remain unaware that an arrhythmia may be present.

Stephanie: Marking a momentous occasion and I rhythms history during the first quarter, we surpassed 10 million cumulative patient reports since the company's inception, underscoring our unwavering commitment to delivering superior patient care.

Stephanie: And our long term continuous monitoring service line momentum remains robust as we continue our strategic expansion into upstream care pathways deepening our presence in existing cardiology, and electrophysiology accounts and drive further ACM modality mix shift away from short term and event monitoring.

Stephanie: We estimate that there are approximately 27 million patients in the United States, who either present to their primary care provider with cardiac competitions.

Stephanie: Alright, a high risk that have cardiac arrhythmias due to patient specific risk factors that remain unaware that an arrhythmia may be present.

Quentin Blackford: Many of these patients have comorbid chronic diseases and frequently misattribute arrhythmia symptoms. By implementing Xeo long-term continuous monitoring earlier in the care pathway, we can reduce time to diagnosis, eliminate unnecessary specialist referrals where capacity is limited, and facilitate timely patient care. Furthermore, recent scientific evidence demonstrates that these improvements lead to reductions in hospitalizations, enhanced clinical outcomes, and decreased health care At Large Integrated Delivery Networks, our upstream expansion into primary care has been facilitated by our land and expand strategy of creating awareness, education, and clinical champion engagement to drive earlier monitoring in the care journey and enabling better targeting of patients in need of further referral to specialists.

Stephanie: Many of these patients have comorbid chronic diseases and frequently miss attribute arrhythmia symptoms by implementing zero long term continuous monitoring earlier in the care pathway. We can reduce time to diagnosis eliminate unnecessary specialist referrals, where capacity is limited and facilitate timely patient care.

Stephanie: Furthermore, recent scientific evidence demonstrates that these improvements lead to reductions in hospitalizations enhanced clinical outcomes and decreased health care system cost.

Stephanie: Now large integrated delivery networks, our upstream expansion into primary care has been facilitated by our land and expand strategy of creating awareness education and clinical champion engagement to drive earlier monitoring in the care journey, and enabling better targeting of patients in need of further referral to a specialist.

Quentin Blackford: By enabling more efficient workflow and an earlier accurate diagnosis, we have the potential to drive additional capacity for specialists like cardiologists and electrophysiologists to see better qualified patients, which in time also may result in additional monitoring. Fueling this focus to move more broadly across large integrated delivery networks is the advancement of our EPIC-ORA partnership, which is in the very early innings and demonstrating success, with our first health systems on the platform already realizing the expected IT and operational efficiency gains, and dozens more health systems either in progress or planning to kick off an ORA integration this quarter.

Stephanie: By enabling more efficient workflow and an earlier accurate diagnosis, we have the potential to drive additional capacity for specialists like cardiologist and electrophysiologist to see better qualified patients which in time also may result in additional monitoring.

Stephanie: Fueling this focus to move more broadly across large integrated delivery networks is the advancement of our epic or a partnership which is in the very early innings and demonstrating success with our first health systems on the platform already realizing the expected it and operational efficiency gains and dozens more health systems, either in progress or planning to kickoff and we're.

Stephanie: <unk> this quarter.

Quentin Blackford: Furthermore, our progress with large, value-based, innovative channel partners who understand the importance of upstream identification of clinically actionable arrhythmias continues to advance success. The majority of these organizations focus on earlier detection within targeted at-risk populations, recognizing that earlier identification often results in lower downstream cost of care and contributes to improved patient outcomes. Based upon recent real-world retrospective claims analysis performed by our partner Eversana, for every 1,000 patients with certain comorbid conditions who are diagnosed with an arrhythmia earlier in the care pathway, it may result in over $10 million in downstream cost avoidance by preventing events that could increase healthcare resource utilization, such as emergency department visits or hospitalizations.

Furthermore, our progress with large value based innovative channel partners, who understand the importance of upstream identification of clinically actual arrhythmias continues to advance successfully.

Stephanie: The majority of these organizations focus on earlier detection within targeted at risk populations, recognizing that earlier identification often results in lower downstream cost of care and contributes to improve patient outcomes.

Stephanie: Based upon recent real World retrospective claims analysis performed by our partner ever Sona for every 1000 patients with certain comorbid conditions, who are diagnosed with an arrhythmia earlier in the care pathway. It may result in over $10 million in downstream cost avoidance by preventing events that could increase healthcare resource utilization such as emergency.

Stephanie: C Department visits or hospitalizations during.

Quentin Blackford: During the first quarter of 2025, we drove the strongest revenue contribution to date from these innovative channel partners originating from undiagnosed arrhythmia monitors. Our pipeline of interest from these accounts remains robust, and we are uniquely positioned to capture this emerging market opportunity due to our leadership and long-term continuous monitoring, our scalability, our industry-leading AI that contributes to superior clinical reporting, and our extensive repository of clinical evidence demonstrating improved The execution of our multi-pronged approach to move further up the care pathway and open the primary care channel by implementing our land and expand strategy and partnering with value-based innovative channel partners has resulted in tremendous progress.

Stephanie: During the first quarter of 2025, we drove the strongest revenue contribution to date from these innovative channel partners originating from undiagnosed arrhythmia monitoring our pipeline of interest from these accounts remains robust and we are uniquely positioned to capture this emerging market opportunity due to our leadership and long term continuous monitoring our scalability our industry leading AI.

Stephanie: That contributes to superior clinical reporting and our extensive repository of clinical evidence demonstrating improved outcomes.

Stephanie: The execution of our multi pronged approach to move further up the care pathway and opened the primary care channel by implementing our land and expand strategy and partnering with value based innovative channel partners has resulted in tremendous progress.

Quentin Blackford: Coming out of the first quarter, nearly one-third of our long-term continuous monitoring volumes now originate from primary care physician channels. where health care providers continue to recognize the value that Irhythm is uniquely positioned to deliver. In addition to the strong demand for long-term continuous monitoring, Irhythm's mobile cardiac telemetry service achieved its strongest quarter in our history, with our commercial teams driving continued ZOAT momentum in accounts acquired during the fourth quarter of last year, as well as another strong quarter of new account additions in Q1. ZOAT, as a proportion of revenue volume, reached its highest level to date, and the year-over-year revenue growth rate continued to significantly outpace our overall corporate revenue.

Stephanie: Coming out of the first quarter nearly one third of our long term continuous monitoring volumes now originate from primary care physician channels, where healthcare providers continue to recognize the value of the IRA them is uniquely positioned to deliver in addition to the strong demand for long term continuous monitoring hybrid those mobile cardiac telemetry service achieved its strongest quarter in our here.

Stephanie: Street with our commercial team is driving continued momentum.

Stephanie: Momentum in accounts acquired during the fourth quarter of last year.

Stephanie: As well as another strong quarter of new account additions in Q1.

Stephanie: <unk> as a proportion of revenue volume reached its highest level to date and the year over year revenue growth rate continued to significantly outpace our overall corporate average.

Quentin Blackford: The sustained momentum in ZOAT represents a good portion of our improved revenue outlook for 2025 and we continue to look forward to submitting our new ZOMCT with the FDA in the third quarter.

Stephanie: The sustained momentum in <unk> represents a good portion of our improved revenue outlook for 2025, and we continue to look forward to submitting our new zero MCT with the FDA in the third quarter of this year.

Quentin Blackford: Beyond our core U.S. business, we continue to make steady progress in bringing the ZEOS service to potentially millions more patients globally. In Europe, our commercial team in the United Kingdom has achieved another quarter of record volume while we continue to navigate reimbursement dynamics with the National Health Service. In Switzerland, Austria, the Netherlands, and Spain, our commercial teams continue to make progress with a solid pipeline of account activations and increasing clinician appreciation for ZEAL across an expanding.

Stephanie: Beyond our core U S business, we continue to make steady progress in bringing the <unk> service to potentially millions more patients globally.

Stephanie: In Europe, our commercial team in the United Kingdom has achieved another quarter of record volume, while we continue to navigate reimbursement dynamics with the National Health service.

Stephanie: In Switzerland, Austria, the Netherlands, and Spain, our commercial teams continue to make progress with a solid pipeline of account activations and increasing clinician appreciation for zeal across an expanding hospital footprint.

Quentin Blackford: Additionally, we announce today our commercial launch in Japan as the first ambulatory cardiac monitoring solution to utilize a 14-day PMDA-cleared artificial intelligence in arrhythmia detection. As the demand for effective long-term monitoring grows, we believe the introduction of Xeo in Japan represents an opportunity to enhance patient care and support evolving clinical needs in cardiac monitoring, an impact also recognized by our esteemed partners at the Japanese Heart Rhythm Society. Our entry into the second largest ambulatory cardiac monitoring market globally follows a recent decision by the Japanese Ministry of Health, Labor, and Welfare to reimburse Zio at the established halter monitoring rate.

Stephanie: Additionally, we announced today, our commercial launch in Japan as the first ambulatory cardiac monitoring solution to utilize a 14 day PMD cleared artificial intelligence and arrhythmia detection as.

Stephanie: As the demand for effective long term monitoring grows we believe the introduction of <unk> in Japan represents an opportunity to enhance patient care and support evolving clinical needs in cardiac monitoring and impact also recognized by our steam partners at the Japanese Heart Rhythm Society.

Stephanie: Our entry into the second largest ambulatory cardiac monitoring market globally follows a recent decision by the Japanese Ministry of Health Labor and welfare to reimburse <unk> at the established Holter monitoring right.

Quentin Blackford: While this initial reimbursement decision is not ideal, we understand the necessity of demonstrating superiority against existing market products, which are predominantly Holter-style monitors.

Stephanie: While this initial reimbursement decision is not ideal we understand the necessity of demonstrating superiority against existing market products, which are predominantly holter style monitors.

Quentin Blackford: With this launch, we intend to generate additional clinical evidence through real-world studies and local IRB-approved research to support future reimbursement applications that better reflect and seal long-term continuous monitoring's value proposition. We look forward to continuing our collaboration with clinicians and working alongside Senco Medical Instruments, our distribution partner, to expand access to advanced cardiac monitoring. In support of these efforts, we have continued to expand our already substantial repository of clinical evidence demonstrating the benefits of Xeoambulatory Cardiac Monitoring for improved patient outcomes.

Stephanie: With this launch we intend to generate additional clinical evidence through real World studies and local IRB approved research to support future reimbursement applications that better reflect <unk> long term continuous monitoring is value proposition.

Stephanie: We look forward to continuing our collaboration with clinicians and working alongside single medical instruments, our distribution partner to expand access to advanced cardiac monitoring services.

Stephanie: Supported these efforts we have continued to expand our already substantial repository of clinical evidence demonstrating the benefits of zero ambulatory cardiac monitoring for improved patient outcomes enhanced clinician efficiency and optimize healthcare resource utilization.

Quentin Blackford: Enhanced Clinician Efficiency and Optimized Healthcare Resource Utilization.

Quentin Blackford: At the American College of Cardiology conference in March, our scientific evidence teams presented two large, real-world studies encompassing over one million patients. Demonstrating that short term Holter duration monitoring frequently fails to detect actionable arrhythmias. and that patient-reported symptoms are unreliable predictors of a rhythmic event. Specifically, among patients with daily or more frequent symptoms who were diagnosed with actionable arrhythmias, nearly two-thirds remained undetected through the first 48 hours of monitoring, indicating that 24- to 48-hour monitoring, such as with Holter, would have failed to identify these conditions. In the U.S. market, approximately 1.5 million 24- to 48-hour monitors, or nearly $400 million of market value, continue to be prescribed annually, representing a significant opportunity to continue to improve patient care within the current ambulatory cardiac monitoring market.

Stephanie: At the American College of Cardiology Conference in March our scientific evidence teams presented two large real world studies encompassing over 1 million patients.

Stephanie: Demonstrating that short term holter duration monitoring frequently fails to detect actionable arrhythmias.

Stephanie: And that patient reported symptoms are unreliable predictors of a rhythmic events.

Stephanie: Specifically among patients with daily or more frequent symptoms who are diagnosed with actual written is nearly two thirds remained undetected through the first 48 hours of monitoring, indicating that 24 to 48 hour monitoring such as with Holter would've failed to identify these conditions.

Stephanie: In the U S market, approximately $1 5 million, 24% to 48 hour monitors or nearly $400 million of market value continue to be prescribed annually, representing a significant opportunity to continue to improve patient care within the current ambulatory cardiac monitoring market.

Quentin Blackford: More recently, at the Heart Rhythm Society Conference this past week, data was presented from the Avalon study of more than 400,000 patients, showing that real-world claims within a commercially insured patient population demonstrated once again that Xeo long-term continuous monitoring resulted in the highest diagnostic yield, lowest retest rate, and lowest risk of cardiovascular events during a one-year follow-up period compared to alternative ambulatory cardiac monitoring modalities in competitor brands. These results confirmed our earlier Camelot study, but within a younger, healthier, and commercially insured population. Collectively, these studies have now examined both Medicare and commercially insured world world claims of more than 700,000 patients and provide important evidence of the clinical superiority of 14-day cardiac monitoring with Xeo and contribute to the growing body of evidence supporting guideline updates and improved market accuracy.

Stephanie: More recently at the Heart Rhythm Society Conference. This past week data was presented from the Avalon study of more than 400000 patients showing that railroad claims within a commercially insured patient population demonstrated once again that <unk> long term continuous monitoring resulted in the highest diagnostic yield lowest retest rate and lowest risk.

Stephanie: A cardiovascular events during a one year follow up period compared to alternative ambulatory cardiac monitoring modalities and competitor brands.

Stephanie: These results confirmed our earlier Camelot study, but within a younger healthier and commercially insured population.

Stephanie: Collectively these studies have now examine both Medicare and commercial insured world rolled claims of more than 700000 patients and provide important evidence of the clinical superiority of 14 day cardiac monitoring with zero and contribute to the growing body of evidence supporting guideline updates and improved market access.

Quentin Blackford: Fundamental to delivering these results has been our continued transformation toward becoming a best-in-class organization committed to quality, integrity, and operational excellence.

Stephanie: Fundamental to delivering these results has been our continued transformation towards becoming a best in class organization committed to quality integrity and operational excellence. This dedication was recognized through several recent third party awards for zeal monitor, including the 2025 Red Dot Award and a bronze Edison Award in the cardiovascular health diagnostics and.

Quentin Blackford: This dedication was recognized through several recent third-party awards for XeoMonitor, including the 2025 Red Dot Award and a Bronze Edison Award in the Cardiovascular Health Diagnostics and Monitoring category. We also reaffirm this commitment to excellence in our latest Corporate Sustainability Report which details our progress across four key pillars of corporate impact. Quality and Sustainable Technology Innovation, Access and Health Equity, Workforce and Inclusion, and Environmental Matters.

Stephanie: Monitoring category.

Stephanie: We also reaffirm this commitment to excellence and our latest corporate sustainability report, which details our progress across four key pillars of corporate impact quality and sustainable technology innovation access and health equity.

Stephanie: Workforce inclusion and environmental matters.

Quentin Blackford: An essential component of our commitment to excellence is our organizational focus on quality systems. Throughout the first quarter of 2025, regulatory and quality matters have remained our highest corporate priority, and we continue to make significant progress on our remaining remediation and compliance activities. These initiatives will remain our priority throughout the year, and we are progressing well against the timelines we have committed regarding the warning letter and 483 observations. We remain dedicated to exceeding the FDA's expectations and are on track to complete these additional compliance efforts by the end of 2025. As previously communicated, we will allocate all necessary resources to ensure best-in-class quality standards and are committed to addressing the FDA's warning letter and observations to their complete Finally, I want to address the topics of tariff.

Stephanie: And a central component of our commitment to excellence is our organizational focus on quality systems throughout the first quarter 2025 regulatory and quality matters have remained our highest corporate priority and we continue to make significant progress on our remaining remediation and compliance activities.

Stephanie: These initiatives will remain our priority throughout the year and we are progressing well against the timelines we have committed regarding the warning letter and 43 observations, we remain dedicated to exceeding the fda's expectations and are on track to complete these additional compliance efforts by the end of 2025.

Stephanie: As previously communicated we will allocate all necessary resources to ensure best in class quality standards and are committed to addressing the fda's warning letter and observations to their complete satisfaction.

Stephanie: Finally, I want to address the topics of tariffs.

Quentin Blackford: Irhythm is well-positioned to navigate this uncertainty.

Stephanie: Hi, rhythm is well positioned to navigate this uncertainty our number one priority remains our patients and physicians and we are fully committed to ensuring uninterrupted access to our critical products and services.

Quentin Blackford: Our number one priority remains our patients and physicians, and we are fully committed to ensuring uninterrupted access to our critical products and services. Our teams have implemented robust mitigation strategies that address potential supply chain concerns and cost implications. Importantly, Irhythm's unique value proposition aligns perfectly with health care's current focus on upstream intervention. Our ability to identify cardiac issues earlier in the care pathway directly supports reduced downstream cost and improved outcomes. This positioning becomes even more valuable in an environment where health care systems are seeking cost-effective solutions that deliver meaningful clinical impact. We remain confident in our ability to execute our growth strategy while managing these external challenges.

Stephanie: Our teams have implemented robust mitigation strategies that address potential supply chain concerns and cost implications importantly, I rhythms unique value proposition aligns perfectly with healthcare's current focus on upstream intervention, our ability to identify cardiac issues earlier in the care pathway directly supports reduced downstream cost and improved outcomes.

Stephanie: This positioning becomes even more valuable in an environment, where health care systems are seeking cost effective solutions that deliver meaningful clinical impact we remain confident in our ability to execute our growth strategy, while managing these external challenges.

Daniel Wilson: With that, I'll turn the call over to Dan to discuss our recent financial performance. Thank you, Quentin. As a reminder, unless otherwise noted, the financial metrics that I discussed today will be presented on a non-GAAP basis. Reconciliations to GAP can be found in today's earnings release and on our IR website. Our first quarter 2025 results were once again reflective of our continued focus on profitable We are pleased to have delivered a second consecutive quarter of greater than 20% year-over-year revenue growth, while driving 750 basis points of improvement to adjust On the top line, our teams continue to drive impressive momentum in our core markets, as we achieved revenue of $158.7 million, representing 20.3% year-over-year revenue.

Stephanie: With that I will turn the call over to Dan to discuss our recent financial performance. Thank you Clinton as a reminder, unless otherwise noted the financial metrics that I discussed today will be presented on a non-GAAP basis reckon.

Stephanie: Reconciliations to GAAP can be found in today's earnings release and on our IR website.

Stephanie: Our first quarter of 2025 results were once again reflective of our continued focus on profitable growth. We are pleased to have delivered a second consecutive quarter of greater than 20% year over year revenue growth, while driving 750 basis points of improvement to adjusted EBITDA margin.

Stephanie: On the top line our teams continued to drive impressive momentum in our core markets as we achieved revenue of $158 7 million, representing 23% year over year growth.

Daniel Wilson: These results were driven by robust volume growth across both product lines, with an especially strong mixed contribution from ZOAT and volume growth from new. New store growth with new store defined as accounts that have been open for less than 12 months, accounted for approximately 65% of our year-over-year volume. Home enrollment for Xeo Services in the U.S. was approximately 23% of volume. Moving down the P&L, gross margin for the first quarter was 68.8%, slightly ahead of our expectation. Compared to the first quarter of 2024, the improvement to gross margin was driven by volume leverage, as well as the realized benefits from operational efficiencies that we have been driving over the prior year, partially offset by higher blended costs per unit from an increased ZOA.

Stephanie: These results were driven by robust volume growth across both product lines with an especially strong mix contribution from <unk> and volume growth from new account launches.

Stephanie: New store growth with new store defined as accounts that have been open for less than 12 months accounted for approximately 65% of our year over year volume growth.

Stephanie: Home enrollment for <unk> services in the U S was approximately 23% of volume in the first quarter.

Stephanie: Moving down the P&L gross margin for the first quarter was 68, 8% slightly ahead of our expectations compared to the first quarter of 2024, the improvement to gross margin was driven by volume leverage as well as the realized benefits from operational efficiencies that we've been driving over the prior year, partially offset by higher <unk>.

Stephanie: Blended cost per unit from an increased product.

Stephanie: Product mix.

Daniel Wilson: First quarter adjusted operating expenses were $140.4 million, an 11.8% increase year-over-year, primarily driven by our ongoing remediation activities and funding of innovation and commercial growth. These purposeful investments were enabled by savings generated from operational excellence initiatives, which demonstrate our ability to deliver top-line growth while generating meaningful opportunities. Adjusted net loss in the first quarter of 2025 was $30.3 million, or an adjusted net loss of $0.95 million. compared to an adjusted net loss of $38.1 million or an adjusted net loss of $1.23 per The adjusted EBITDA in the first quarter of 2025 was negative $2.6 million, or negative 1.7% of revenue, compared to an adjusted EBITDA margin of negative 9.2% in the first quarter of 2025.

Stephanie: First quarter adjusted operating expenses were $140 4 million and 11, 8% increase year over year, primarily driven by our ongoing remediation activities and funding of innovation and commercial growth initiatives.

Stephanie: These purposeful investments were enabled by savings generated from operational excellence initiatives, which demonstrate our ability to deliver topline growth, while generating meaningful operating leverage.

Stephanie: Adjusted net loss in the first quarter of 2025 was $30 3 million for an adjusted net loss of <unk> 95 per share compared to an adjusted net loss of $38 1 million on an adjusted net loss of $1 23 per share in the first quarter of 2024 adjusted.

Stephanie: Adjusted EBITDA in the first quarter of 2025 was negative $2 6 million or negative one 7% of revenue compared to an adjusted EBITDA margin of negative nine 2% in the first quarter of 2024.

Daniel Wilson: This 750-basis-point improvement in adjusted EBITDA profitability is the direct result of thoughtful and intentional initiatives that our teams have implemented to drive sustainable, efficient For more information visit www.FEMA.gov As noted in prior quarters, we continue to incur incremental legal and consulting fees, as well as other company expenses related to FDA remediation efforts and DOJ subpoenas. We continue to expect these incremental remediation expenses to be approximately $15 million for the federal government. Beginning in the first quarter of 2025, we have excluded third-party attorneys' fees and expenses associated with the patent litigation with Baxter from our non-GAAP results, including In the quarter, we incurred approximately $0.8 million of IP litigation.

Stephanie: The 750 basis point improvement in adjusted EBITDA profitability is the direct result of thoughtful and intentional initiatives that our teams have implemented to drive sustainable efficiency at scale.

Stephanie: As noted in prior quarters, we continue to incur incremental legal and consulting fees as well as other accompanying expenses related to FDA remediation efforts and Doj subpoena activities.

Stephanie: We continue to expect these incremental remediation expenses to be approximately $15 million for the full year.

Stephanie: Beginning in the first quarter of 2025, we have excluded third party attorneys fees and expenses associated with the patent litigation with Baxter from our non-GAAP results, including adjusted EBITDA.

Stephanie: In the quarter, we incurred approximately zero point $8 million of IP litigation expenses associated with the Baxter litigation.

Daniel Wilson: associated with the back.

Daniel Wilson: Turning to guidance, we are raising full year 2025 revenue guidance to $690 million to $700 million to account for our outperformance during the first quarter and the durable volume growth we are seeing across both the XeoMonitor and XeoEdge. This outlook continues to contemplate significant U.S. volume growth along with low single-digit percentage prices. For the second quarter of 2025, we expect revenue to be consistent with historical averages with approximately 25% of full-year revenue generated. We continue to expect that gross margin will be flat for the full year 2025 with improvements from clinical operations and manufacturing efficiencies largely offset by proposed tariffs of global.

Stephanie: Turning to guidance, we are raising full year 2025 revenue guidance to $690 million to 700 million to account for our outperformance during the first quarter and the durable volume growth, we are seeing across both the <unk> monitor and <unk>.

Stephanie: This outlook continues to contemplate significant U S volume growth, along with low single digit percentage pricing headwind.

Stephanie: For the second quarter of 2025, we expect revenue to be consistent with historical averages with approximately 25% of full year revenue generated during the second quarter.

Stephanie: We continue to expect that gross margin will be flat for the full year 2025 with improvements from clinical operations and manufacturing efficiencies largely offset by proposed tariffs of global imports.

Daniel Wilson: As a reminder, we contemplated approximately 50 to 75 basis points of negative impact from tariffs in our original Based on current tariff rates, we anticipate the impact to continue to be within that range and we are actively exploring potential opportunities to offset a portion of this impact through various supply chain measures. As a reminder, our Xeo devices are manufactured and assembled at our facility in California, and we have a widely distributed supplier base, including suppliers in Mexico, China, and other Asian countries. Our highest priority is ensuring continued supply to meet the growing demand for our Accordingly, we have begun to invest to strategically build up our inventory of raw materials for future finished goods and expect a slight headwind to free cash flow while we ensure that we have sufficient inventory to mitigate any potential unforeseen supply changes.

Stephanie: As a reminder, we contemplated approximately 50 to 75 basis points of negative impact from tariffs in our original guidance.

Stephanie: Based on current tariff rates, we anticipate the impact to continue to be within that range and we are actively exploring potential opportunities to offset a portion of this impact through various supply chain strategies.

Stephanie: As a reminder, our zero devices are manufactured and assembled at our facility in California, and we have a widely distributed supplier base, including suppliers in Mexico, China and other APAC countries.

Our highest priority is ensuring continued supply to meet the growing demand for our Z O services.

Stephanie: Accordingly, we have begun to invest to strategically build up our inventory of raw materials for future finished goods and expect a slight headwind to free cash flow. While we ensure that we have sufficient inventory to mitigate any potential unforeseen supply chain disruptions.

Daniel Wilson: On adjusted EBITDA margin, we are raising our full year 2025 guidance range to between 7.5% and 8.5% of full year revenue. The conclusion of assumed acquired IP R&D charges and the impact of tariffs no We continue to anticipate normal seasonality in our adjusted operating expense profile with higher expenses coming through in the earlier half of the year due to spend associated with corporate activities and payroll We expect adjusted EBITDA margin in the second quarter of 2025 to range between 6 and 7%. Finally, we ended the first quarter in a strong financial position with $520.6 million in unrestricted cash.

An adjusted EBITDA margin, we are raising our full year 2025 guidance range to between seven five and eight 5% of full year revenues inclusive of assumed acquired IP R&D charges and the impact of tariffs noted previously.

Stephanie: We continue to anticipate normal seasonality in our adjusted operating expense profile with higher expenses coming through in the earlier half of the year due to spend associated with corporate activities and payroll expenses.

Stephanie: We expect adjusted EBITDA margin in the second quarter of 2025 to range between six and 7%.

Stephanie: Finally, we ended the first quarter in a strong financial position with $526 million in unrestricted cash on hand.

Daniel Wilson: For full year 2025, we continue to anticipate being slightly free cash flow negative and anticipate becoming free cash flow positive for full year This expectation takes into consideration the cash flow impact from the inventory buildup of raw materials as discussed previously, as well as prioritized investments into the buildout of next generation technology.

Stephanie: For full year 2025, we continue to anticipate being slightly free cash flow negative and anticipate becoming free cash flow positive for full year 2026.

Stephanie: This expectation takes into consideration the cash flow impact from the inventory buildup of raw materials as discussed previously as well as prioritized investments into the build out of next generation technology platforms.

Daniel Wilson: In closing, we are pleased with our financial results to begin 2025 and our updated outlook for the remainder of the year. The resiliency of our end markets, a balanced set of near and long-term growth drivers, and a focus on operational excellence that yields sustainable profitability is positioning Irhythm to continue to grow our business and serve millions more patients into the future.

Stephanie: In closing we are pleased with our financial results to begin 2025, and our updated outlook for the remainder of the year.

Stephanie: The resiliency of our end markets, a balanced set of near and long term growth drivers and a focus on operational excellence that yield sustainable profitability is positioning IRA them to continue to grow our business and serve millions more patients into the future.

Quentin Blackford: I will now turn the call back to Quentin for closing. Thanks, Dan, and thank you all for your continued support of Irhythm today. As we begin 2025 amid economic uncertainty, I want to highlight Irhythm's compelling value proposition that benefits multiple health care stakeholders. While reaching our 10 million patient report milestone represents significant progress, the ambulatory cardiac monitoring market remains largely untapped with substantial growth potential. Zio's clinically validated, physician-trusted platform uniquely positions us to transform cardiac care through earlier detection that enables truly preventative interventions before serious cardiac events occur. Our technology empowers healthcare providers to deliver proactive care by identifying subtle rhythm abnormalities that might otherwise go undetected, while our AI-powered analytics enable precision care pathways tailored to individual patient needs.

Stephanie: I will now turn the call back to Clinton for closing remarks.

Clinton: Thanks, Dan and thank you all for your continued support of IRA them today.

Clinton: As we begin 2025 amid economic uncertainty I want to highlight I rhythms compelling value proposition that benefits multiple health care stakeholders.

Clinton: Reaching our 10 million patient report milestone represents significant progress the ambulatory cardiac monitoring market remains largely untapped with substantial growth potential.

Clinton: <unk> clinically validated physician trusted platform uniquely positions us to transform cardiac care through earlier detection that enables truly preventative interventions before serious cardiac events occur.

Clinton: Our technology empowers health care providers to deliver proactive care by identifying subtle rhythm abnormalities.

Clinton: Otherwise go undetected, while our AI powered analytics enable precision care pathways tailored to individual patient needs.

Quentin Blackford: This approach has the potential to substantially reduce health care costs by shifting diagnosis earlier in the care journey, preventing costly emergency interventions and hospitalizations, while also addressing the capacity challenges that plague our system today. We're expanding into new channels and international markets with capabilities to incorporate additional vital signs monitoring over time. Our technology foundation enables scalability that will support future clinical insights and ultimately allow Irhythm to contribute to value-based population health management, the direction healthcare is evolving toward in the coming decade. We are accomplishing this with an efficient operating model featuring strong and improving gross margins, improving adjusted EBITDA performance, and a path of sustainable free capital.

Clinton: This approach has the potential to substantially reduce health care costs by shifting diagnosis earlier in the care journey.

Clinton: Renting costly emergency interventions and hospitalizations, while also addressing the capacity challenges that plagued our system today.

Clinton: We're expanding into new channels in international markets with capabilities to incorporate additional vital signs monitoring over time, our technology Foundation enable scalability that will support future clinical insights and ultimately allow IRA them to contribute to value based population health management, the direction healthcare's evolving toward in the coming decade, we are accomplishing this with <unk>.

Clinton: Efficient operating model, featuring strong and improving gross margins, improving adjusted EBITDA performance and a path to sustainable free cash flow. This combination of elements creates long term shareholder value, while advancing health care quality and we're grateful to you on our global partners for your ongoing support operator, we're now ready for questions.

Quentin Blackford: This combination of elements creates long-term shareholder value while advancing health care quality.

Quentin Blackford: And we're grateful to you and our global partners for your ongoing support.

Operator: Operator, we're now ready for you. Thank you.

Operator: We will now begin the question and answer session. If you would like to ask a question, please press star 1 on your telephone keypad. If for any reason you would like to remove that question, please press star 2. Again, to ask a question, please press star 1. And as a reminder, if you are using a speakerphone, please remember to pick up your handset before asking a question. And as another brief reminder, due to the interest of time, we ask that you ask one question and to for any follow-up questions. And we will pause here briefly as questions are registered.

Speaker Change: Thank you we will now begin the question and answer session. If you would like to ask a question. Please press star one on your telephone keypad. If for any reason you would like to remove that question. Please press star two again to ask a question. Please press star one and as a reminder, if you were using a speaker.

Clinton: Phone, please remember to pick up your handset before asking a question.

Clinton: Another brief reminder, and so the interest of time, we ask that you ask one question and to re queue for any follow up questions and we will pause briefly ask questions are registered.

Alan Gong: First question is from the line of Alan Gong with J.P. Morgan. You may proceed. Hi team, thanks for the question and congrats on the good quarter. I guess just the first question on, you know, the outlook. Clearly you had a much stronger than expected quarter to start off the year, but when we look at the guide, especially in light of, you know, as you yourself said, a bit of an uncertain macro backdrop, it's definitely good to see you kind of raising the outlook for the balance of the year and access at the beat. So I guess what are you seeing, you know, in the quarter so far?

Speaker Change: First question is from the line of Allen Gong with J P. Morgan.

Clinton: You May proceed.

Speaker Change: Okay.

Speaker Change: Hi, John Thanks for the question and congrats on the good quarter I guess, just the first question on the outlook clearly much stronger than expected quarter to start off the year, but when we look at the guide, especially in light of as you yourself said a bit of an uncertain macro backdrop, it's definitely good to see you kind of raising the.

Speaker Change: Outlook for the balance of the year and access that to be so I guess what are you seeing.

Alan Gong: What did you see in April that really gives you the confidence to kind of raise that kind of range? And how should we think about, you know, room for upside or like kind of what gets you to the high end of that range or the bottom of that range in light of the ongoing macro environment?

Speaker Change: In the quarter. So far what did you see in April that really gives you the confidence to kind of raise that kind of range and how should we think about it.

Speaker Change: Room for upside or is that kind of what gets you to the high end of that range or the bottom end of that range in light of the ongoing macro environment.

Dan Wilson: Yeah, thanks, Allen, for the comment there. And for the question, this is Dan, I can I can start and Quentin can add anything he'd like to. So, you know, I think as we thought about the guide, obviously, you called out that we're raising guidance above the beat in Q1. And that's reflective of kind of the momentum we're seeing in the business. We've seen ZOAT grow really nicely now for two quarters in a row and have high confidence that that's going to sustain for, for the remainder of the year. So we've baked that that into guidance, I would say from a overall approach standpoint, you know, no change as we think about how to set guidance, we want to continue to be thoughtful, we don't want to get ahead of ourselves.

Speaker Change: Yeah. Thanks, Alan for the comment there and for the question. This is Dan I can I can start and Clinton can add anything he'd like to so.

Speaker Change: Yes, I think as we thought about the guide obviously you called out that we're raising guidance above the beat in Q1, and Thats reflective of kind of the momentum we're seeing in the business we've seen.

Speaker Change: Grow really nicely now for two quarters in a row and have high confidence that thats kind of sustained for for the remainder of the year. So we've baked that into guidance I would say from a overall approach standpoint, no change as we think about how to set guidance. We want to continue to be thoughtful we don't want to get ahead of ourselves.

Dan Wilson: And, you know, want to make sure we're putting something out there that's well balanced. In terms of upside drivers, you heard us talk about undiagnosed monitoring and our innovative channel partners that is contributing nicely to the business. There's the really nice pipeline of potential contribution there on the horizon, but at the same time, that is a new business that's emerging for us, there's different We've got selling cycles, different prescribing patterns. And until we have, you know, higher visibility into that, we're going to hold back from taking too much of that into the guide. So, again, overall approach to guidance hasn't changed.

Speaker Change: Yes, I want to make sure we're putting something out there.

Speaker Change: It's well balanced in terms of upside drivers you heard us talk about on diagnostic monitoring and our innovative channel partners that is contributing nicely to the business, we see a really nice pipeline of potential contribution there on the horizon, but at the same time that is.

Speaker Change: And new business, that's emerging for US there is kind of different.

Speaker Change: Selling cycles different prescribing patterns and until we have higher visibility into that we're going to hold back from making too much of that into the guide so.

Speaker Change: Overall approach to guidance hasn't changed.

Quentin Blackford: A lot of momentum in the business, which is reflected in the updated guide. The only thing I would add to that is certainly we don't want to get ahead of ourselves here. Allen, you know, we're two quarters into growth, north of 20%, you know, as you think about the revised guide and a bit of an increase in the remaining three quarters beyond just the beat in Q1, it still has us growing roughly 15% to 17% in those three quarters compared to what we've seen in the last two quarters of north of 20%. So I feel really good about where we're at.

Speaker Change: A lot of momentum in the business, which is reflected.

Speaker Change: And the updated guidance.

Speaker Change: The only thing I would add to that is certainly we don't want to get ahead of ourselves here Alan.

Speaker Change: Two quarters into growth North of 20% as you think about the revised guide on a bit of an increase in the remaining three quarters beyond just the beat in Q1 is still has us growing roughly 15% to 17% in those three quarters compared to what we've seen in the last two quarters of north of 20%. So feel really good about where we're at as Dan said.

Quentin Blackford: As Dan said, a lot of really good momentum in the business, a lot of things that we're excited about, but also some things that we just want to see play out before we start to make those into the expectations.

Speaker Change: A lot of really good momentum in the business a lot of things that we're excited about but also some things that we just wanted to see play out before we start to bake those into the expectations.

Alan Gong: Thanks.

Alan Gong: And then a quick follow up just on Japan. You know, I think, you know, I'm sure you're disappointed that you didn't get kind of differentiated reimbursement from traditional holders, especially since I think the, you know, the kind of body language you were getting with the high medical needs designation seemed to point to the potential for that. So when I think about, you know, in the near term, while you're working to hopefully improve upon that, how should we think about the contribution you've previously been contemplating for this year? And, you know, how confident are you in your ability to improve reimbursement?

Speaker Change: Thanks, and then a quick follow up just on Japan.

Speaker Change: Thank you.

Speaker Change: Sure you're disappointed that you didn't get kind of differentiated reimbursement from traditional holter is especially since I think.

Speaker Change: That kind of body language, you are getting with the high medical needs designation.

Speaker Change: The point to the potential for that so when I think about in the near term, we're working to hopefully improve upon that how should we think about the contribution you had previously been contemplating for this year and how confident are you in your ability to improve reimbursement and what kind of timeline will that take thank you very much.

Alan Gong: And what kind of timeline will that take? Thank you very much.

Dan Wilson: Yeah, Alan, I can take the first part of that question as it relates to what's incorporated in the guide. If you recall in our call back in February, when we gave guidance initially, we did say Japan, you know, we expected $2 million of contribution to growth for the full year. With the reimbursement rates where they landed, that will be a bit below, you know, that original $2 million expectation. And that's obviously reflected in the guide, but obviously a strategically important market for us. We will be launching in there to generate the clinical evidence, you know, needed to ultimately land to that higher reimbursement rate.

Speaker Change: Yes, I can take the first part of that question as it relates to what's incorporated in the guide if you recall in our.

Speaker Change: Call back in February when we gave.

Speaker Change: Initially, we did say, Japan, we expected $2 million of contribution to growth for the full year.

Speaker Change: With the reimbursement rates, where they landed that will be a bit below that original $2 million expectation.

Speaker Change: Obviously reflected in the guide, but obviously a strategically important market for us we will be launching in there to generate the clinical evidence needed to ultimately land to that higher reimbursement rate.

Quentin Blackford: And I'll let Quentin answer that. Yeah, I think, without question, Alan, a bit disappointed in where the rate got set, considering, you know, all the support around the high medical needs designation, and I think the understanding from the Japanese Heart Rhythm Society, sort of the differentiation of our product relative to other products that are out in the market. But to be, you know, Specific, we don't have head-to-head sort of comparable data in the local Japanese market, and it's clear that that's what they're looking for to differentiate sort of reimbursement. And so we're committed to moving down that path.

Speaker Change: Quentin I think without question Alan a bit disappointed in where the rate got set considering all the support around the high medical need designation and I think the understanding from the Japanese heart Rhythm Society is sort of the differentiation of our product relative to other products that are out in the market but to be.

Speaker Change: Specific we don't have head to head sort of comparable data in the local Japanese market and it's clear that that's what they're looking for to differentiate sort of reimbursement and so we're committed.

Quentin Blackford: We've got a great number of hospitals sort of that are right on the verge of contracting with us and getting started. We've got a great deal of reps that are dedicated to selling Xeo into that market. And we've got studies sort of designed in a way that's going to allow us to show that head-to-head analysis. And if we look back at any of the data that's come out of the Camelot study or the recent Avalon study where we show Xeo specifically head-to-head against competitor brands or Holter monitors, we know that we're going to show a superior result.

Speaker Change: Moving down that path, we've got a great number of hospitals that are right on the verge of contracting with us in getting started we got a great deal of reps that are dedicated to selling <unk> ended up market.

Speaker Change: And we've got.

Speaker Change: Study sort of designed in a way that's going to allow us to show that head to head analysis, and if we look back at <unk>.

Speaker Change: Any of the data that's come out of the Camelot study or the recent Avalon study, where we showed <unk> specifically head to head against competitor brands are holter monitors, we know that we're going to show a superior results. So we need some time to build that in the local market, but we will be back with the reimbursement agencies to argue for a higher rate that reflects the value that we're going to bring.

Quentin Blackford: So we need some time to build that in the local market, but we will be back with the reimbursement agency to argue for a higher rate that reflects the value that we're going to bring into that market. So we're excited about it, second largest market in the world, a tremendous opportunity, but we're going to need to work through sort of that process to ultimately get to the right rate.

Speaker Change: Into that market. So we're excited about it second largest market in the world tremendous opportunity.

Speaker Change: But we're going to need to work through that process to ultimately get to the right rate.

Kallum Titchmarsh: The next question is from the line of Kallum Titchmarsh with Morgan Stanley. You may proceed. Great, thanks guys for taking the question. Just on the AT momentum, and you know, obviously you kept a fair amount of the share you gained in the back half of 2024. Why do you think that was? Why don't you think they went back to your competitor? And then I guess, how do you think that frames you for the MCT launch?

Speaker Change: Okay.

Speaker Change: The next question is from the line of calendar pitch Marsh with Morgan Stanley You May proceed.

Speaker Change: Great. Thanks, guys for taking the question just on the <unk> momentum.

Speaker Change: Obviously, you kept a fair amount of the share you gained in the back half of 2024 why do you think that was why don't you think they went back to your competitor and then I guess, how do you think that frames you for that.

Kallum Titchmarsh: Do you now think that that could be accelerating quicker than your expectations before, given your AT customer base is broader? Yeah, I don't want to get ahead in terms of expectations around the new Xeo MCT product just yet, but we're certainly very excited by the new features that that product is going to bring and believe it's a superior product to Xeo AT. But clearly, Xeo AT is having success in the market. And I think what you saw play out over the back part of last year, and certainly in the first quarter here is that we're in the vast majority of these accounts already with our Xeo Monitor, our long term continuous monitor.

Speaker Change: MCT launched do you now think that that could be accelerating quicker than your than your expectations before given your customer base is broader thanks a lot.

Speaker Change: Yes, I don't want to get ahead in terms of expectations around the new zero MCT product just yet, but we're certainly very excited by the new features that that product is going to bring and believe it's a superior product to <unk>.

Speaker Change: But clearly <unk> is having success in the market and I think what you saw play out over the back part of last year and certainly in the first quarter here is that we're in the vast majority of these accounts already with our zeal monitor our long term continuous monitor and we have our MCT or zero zero <unk> product on the shelf already so it's very easily for R. R.

Kallum Titchmarsh: And we have our MCT or Xeo AT product on the shelf already. So it's very easily for our customers to try the Xeo AT product. And I think in that process of trying Xeo AT, they realize just how good of a product it is. You know, the reality is there are some features to that Xeo AT product that are superior to even products that are in the market today. As an example, having 14 days of continuous wear on an MCT product is really unlike any other product that's out there today, you're wearing multiple patches, even to get to 14 days with most competitors.

Speaker Change: Customers to try the product and I think in that process of trying.

Speaker Change: They realize just how good of a product that is.

Speaker Change: The reality is there are some features to that product that are superior to even products that are in the market today. As an example, having 14 days of continuous way or on an MCT product is really unlike any other product that's out there today, you're wearing multiple patches even to get to 14 days with most competitors. So I think there are aspects that customers begin to learn around <unk>.

Kallum Titchmarsh: So I think there are aspects that customers began to learn around Xeo AT realizing that maybe it was better than what they initially anticipated or hadn't tried it yet. Once they tried it, they've decided to stick with it. And I think what's encouraging to me is that we saw that momentum from accounts that were already in, we know there's tremendous opportunity having 70% of the long term cardiac monitoring market yet only having call it 10 to 12% of the MCT market, but being in those accounts already. So when when our own MCT or enhanced MCT product does come to market, I think there's going to be a real right to win.

Speaker Change: <unk> that maybe it was better than what they initially anticipated or haven't tried it yet once they tried it they've decided to stick with it.

Speaker Change: And I think what's encouraging to me is that we saw that momentum from accounts that we're already in we know theres tremendous opportunity, having 70% of the long term cardiac monitoring market only having call it 10% to 12% of the MCT market, but being in those accounts already so when our own MCT or enhanced MCT product does come to market I think there's going to be a real right.

Kallum Titchmarsh: And that opportunity, but we'll wait to get that to market and talk about the expectations at that point.

Speaker Change: To win in that opportunity, but we'll wait to get that to market and talk about the expectations at that point.

Macaulay Kilbane: The next question is from the line of Macauley Kilbane with William Blair. May proceed. Hi, everyone. This is Macaulay on for Margaret tonight. Thanks for taking our question. And congrats on the strong start to the year here.

Speaker Change: The next question is from the line of.

Speaker Change: <unk> with William Blair You May proceed.

Speaker Change: Okay.

Speaker Change: Hi, everyone. This is Macquarie on for Margaret Tonight, Thanks for taking our questions and congrats on the strong start to the year here.

Macaulay Kilbane: I want to ask on the EPIC integration, which the feedback sounds quite positive so far and understand we're still early in that rollout. But other than that, the natural workflow efficiencies you've talked to, can you can you just help quantify the impact those integrated accounts are seeing? Whether that be volume growth versus non-integrated accounts, the cost reductions or other metrics you're tracking within these accounts? Thanks, Macaulay. Look, we've been very pleased with the early stages of the EPIC integration, and I think it's met our expectations. Certainly, the workflow efficiencies, the IT efficiencies, reducing the amount of time for integration is all being realized, and I think we're only going to continue to get better in and around those opportunities and those efforts.

Speaker Change: Wanted to ask on the epic integration, which the feedback sounds quite positive so far and understand we're still early in that rollout, but other than that the natural workflow efficiencies you've talked to can you can you just help quantify the impact those integrated accounts are seeing.

Speaker Change: That would be volume growth.

Speaker Change: Versus non integrated accounts, the cost reductions or other metrics you're tracking within these accounts.

Speaker Change: Thanks for the color.

Speaker Change: Look we've been very pleased with the early stages of the epic integration and I think it's met our expectations certainly the workflow efficiencies the efficiencies reducing the amount of time for integration is all being realized in and I think we're only going to continue to get better in and around those opportunities in those efforts.

Macaulay Kilbane: The pipeline that sits out in front of us relative to the ability to bring new accounts on board is really, really strong. Frankly, when we look at the overall pipeline of new customer accounts that we're onboarding over the next several months, the vast majority are Aura accounts, some existing customers, some greenfield opportunities for us.

Speaker Change: Pipeline that sits out in front of us relative to the ability to bring new accounts on board has is really really strong and frankly, when we look at the overall pipeline of new customer accounts that we're onboarding over the next several months, but vast majority are or account some existing customers. Some greenfield opportunities for us. It's early in terms of being able to speak.

Macaulay Kilbane: It's early in terms of being able to speak with a high degree of confidence around what the incremental benefit might be from EPIC. I will tell you in the handful of accounts that have been integrated now for multiple months, we've seen on average a high 20% increase in the prescribing pattern of those accounts on their daily averages, post-integration versus pre-integration, with some of those pushing almost 40%. So we want to see that play out before we start to bake it into expectations. Our guide does not anticipate any incremental benefit from the EPIC integrations in terms of post-integration uplift, but early signs are positive around that, and we're certainly encouraged by what we're seeing, but it's early.

Speaker Change: With a high degree of confidence around what the incremental benefit might be from epic I will tell you and a handful of accounts that have been integrated now for multiple months.

Speaker Change: We've seen on average a high 20% increase in the prescribing pattern of those accounts on their daily averages post integration versus pre integration with some of those pushing almost 40%. So we want to see that play out before we start to bake it into expectations. Our guide does not anticipate any incremental benefit from the epic integrations and.

Speaker Change: Terms of post integration uplift, but early signs are positive around that and we're certainly encouraged by what we're seeing but it's early.

Speaker Change: Okay.

Joanne Wuensch: Question is from the line of Joanne Wuensch with Citigroup. You may proceed. Hey, good afternoon. This is Anthony on for Joanne. Thanks for taking our question. Is there anything you could break out or quantify on how much volume now is coming out of these volume based accounts? It sounds like they're really starting to become a much bigger piece of the pie.

Speaker Change: Question is from the line of Joanne Wuensch with Citigroup you May proceed.

Hey, Good afternoon. This is Anthony on for John Thanks for taking our question.

Speaker Change: Is there anything you could break out or quantify how much of volume now is coming out of juniors.

Speaker Change: Volume base.

Speaker Change: So it sounds like they are really starting to become a much bigger piece of the pie.

Joanne Wuensch: Thank You know, we haven't disclosed that yet. I'll give you some color. It's it's in the low single digits as a percent of total volume in the quarter. But it's growing quite nicely. So when you think about, you know, the staff that I put out there, nearly a third of our prescriptions in the quarter have now come through primary care. It's still a very small single digit percent of total volume that's coming from the innovative channels, which ultimately means that a lot of the primary care move is coming from our existing IDNs, where cardiologists and EPs are recommending prescribing earlier in the care pathway at their primary care physician's office, which is incredibly encouraging.

Speaker Change: We haven't disclosed that yet I will give you some color it's in the low <unk>.

Speaker Change: Single digits as a percent of total volume in the quarter, but it is growing quite nicely. So when you think about the stat that I put out there nearly a third of our prescriptions in the quarter have now come through primary care.

Speaker Change: A very small single digit percent of total volume that's coming from the innovative channels, which ultimately means that a lot of the primary care move is coming from our existing <unk>, where cardiologist and EPS are recommending prescribing earlier in the care pathway at their primary care physicians office, which is incredibly encouraging we want to see that play out but I do think.

Joanne Wuensch: We want to see that play out.

Joanne Wuensch: But I do think the bigger opportunity long term is going to be in the innovative channels. And, you know, I mentioned we signed up one new innovative channel partner in the first quarter. We're certainly very excited to get them going. The partner that we had in the fourth quarter, while didn't prescribe a tremendous amount in the first quarter, did begin to patch again and will will patch over the course of the year. So we're excited to see that go again. I think this is really how we expand the market from six million tests per year to call it twenty seven million patients showing up in primary care.

Speaker Change: The bigger opportunity long term is going to be in the innovative channels.

Speaker Change: I mentioned, we signed up one new innovative channel partner in the first quarter.

Speaker Change: Certainly very excited to get them going.

Speaker Change: The partner that we had in the fourth quarter, while it didn't prescribe a tremendous amount in the first quarter did begin to patch again, and we will we'll patch over the course of the year. So we're excited to see that go again I think this is really how we extend the market from 6 million tests per year to call. It 27 million patients showing up in primary care. This is going to be a big part of that lever in our <unk>.

Joanne Wuensch: This is going to be a big part of that lever. And we're certainly very excited about it.

Joanne Wuensch: But we're in the we're in the very, very early stages, right? We're in the top of the first inning here that just demonstrates the amount of runway that's in front of us.

Speaker Change: Certainly very excited about it but we're in the very very early stages right. We're at the top of the first inning here.

Speaker Change: This demonstrates the amount of runway in front of us.

Speaker Change: Okay.

David Roman: The next question is from the line of David Roman with Goldman Sachs, you may proceed. Hi guys, you've got Daniel here for David tonight. Thanks for taking the question. After attending HRS, something we observed was the number of companies that are pursuing multi-parameter sensor opportunity. Although none of them have the equivalent infrastructure that you guys have built up over time.

Speaker Change: Yeah.

Speaker Change: The next question is from the line of David Roman with Goldman Sachs. You May proceed.

Speaker Change: Okay.

Daniel: Hi, guys, you've got Daniel here for David Tonight, Thanks for taking the question.

Daniel: After attending HRS something we observed was the number of companies that are pursuing multi parameter sensor opportunity.

Daniel: Although none of them have the equivalent infrastructure that you guys have built up over time. So how do you think about that opportunity here, both with your own pipeline, but also potential M&A given your balance sheet capacity.

David Roman: So how do you think about that opportunity here, both with your own pipeline, but also potential M&A given your balance sheet capacity? Well, I think you hit on something that's very important to us over, you know, our three to five year horizon. It's a big part of why we did the Biointellisense transaction in the mid part of last year. It brings some incremental capabilities onto our platform that we believe are truly differentiated, but ultimately gets us to that multi-parameter sensing platform off of a single device. That's really what we're ultimately building at the company. We're making great progress towards it.

Daniel: Well I think you hit on something Thats very important to us over.

Daniel: Three to five year horizon, it's a big part of why we did the bio intelligence.

Daniel: Transaction in the mid part of last year. It brings some incremental capabilities onto our platform that we believe are truly differentiate it but ultimately gets us to that multi parameter sensing platform off of a single device. That's really what we're ultimately building at the company, we're making great progress towards it I think if we saw technology out there that really.

David Roman: I think if we saw technology out there that really captured our attention, and I think we've got a good robust process to evaluate those sort of things. Look, we're in a good position to be able to bring that into the company, but we're going to be very thoughtful around those sort of opportunities. I'm bullish on what we have the opportunity to develop and innovate within our four walls, but if we could speed things up and evaluation was right, we certainly would look at those opportunities, but it would have to be right down the middle of the fairway from a strategic fit perspective for us to look that way, because I'm very bullish on our ability to innovate within the four walls of the company.

Daniel: <unk> captured our attention and I think we've got a good robust process to evaluate those sort of things.

Daniel: Look we're in a good position to be able to bring that into the company, but we're going to be very thoughtful around those sort of opportunities I'm bullish on what we have the opportunity to develop and innovate within our four walls, but if we can speed things up.

Daniel: And evaluation was right, we certainly would look at those opportunities, but it would have to be right down the middle of the fairway from a strategic fit perspective for us to look that way because I am very bullish on our ability to innovate within the four walls of the company.

Nathan Treybeck: The next question is from the line of Nathan Treybeck with Wells Fargo. You may proceed. Hi, thanks for taking the question and congrats on a good quarter. Um, so you said that you still assume you're going to file for ZOMC-T and Q3. I guess, can you talk about the conversations that you've had with the FDA? And have they given you any indication that they would do the facility reinspection as part of the approval process? Thanks.

Daniel: Okay.

Nathan: The next question is from the line of Nathan <unk> with Wells Fargo. You May proceed.

Speaker Change: Hi, Thanks for taking the question on congrats on a good quarter.

Speaker Change: You said that you still assume youre going to file for <unk> in Q3, I guess can you talk about the conversations that you've had with the FDA and have they given you any indication that they would do the facility re inspection as part of the approval process.

Nathan Treybeck: Hey, Nathan. Thanks for the Thank you for your comments. With respect to the FDA, around MCT, there's nothing at this point that gives us any concern around the ability to get that submitted in the third quarter. I have a high degree of confidence that we'll be able to make that happen. And frankly, the vast majority of that sits within our own control, and we control our own destiny from that sense. So I feel good about that based upon what we know right now. And there has been back and forth with the FDA, and there's been nothing that they've indicated to us that would give us any reason to think differently than that Q3 timeframe.

Nathan: Hey, Nathan.

Nathan: Thanks for the call.

Nathan: Comments.

Nathan: With respect to the FDA around MCT.

Nathan: There is nothing at this point that gives us any concern around the ability to get that submitted in the third quarter I have a high degree of confidence that we have available to make that happen and frankly, the vast majority of that sits within our own control and we control our own destiny from that sense. So I feel good about that based upon what we know right now and there has been back and forth with the FDA and Theres been nothing.

Nathan: And that they've indicated to us that would give us any reason to think differently than that Q3 timeframe. So feel good about continuing to expect MCT on file in Q3 in terms of sort of their inspection of facilities to close out the warning letter I can't I can't give you any color around that I don't know what to.

Nathan Treybeck: So I feel good about continuing to expect MCT on file in Q3.

Nathan Treybeck: In terms of sort of their inspection of facilities to close out the warning letter, I can't give you any color around it. I don't know what to advise around that. I can tell you we have good discussions with the FDA. We continue to make great progress on the remediation efforts. We are on time and on track with all of the remediation activities that we identified and committed to the agency. And we will continue to close those out. And I expect by the mid part of the year, we will have finished all of our remediation activities specific to the warning letter and specific to the 483s.

Nathan: What's the advisor around that I can tell you we have good discussions with the FDA, we continue to make great progress on the remediation efforts, we are on time and on track with all of the remediation.

Nathan: Activities that we identified and committed to the agency and we will continue to close those out and I expect by the mid part of the year. We will have finished all of our remediation activities specific to the warning letter and specific to the 40 threes and keep in mind, we're not going to stop there we've committed ourselves to go above and beyond those efforts on our own doing to continue to reap.

Nathan Treybeck: And keep in mind, we're not going to stop there. We've committed ourselves to go above and beyond those efforts on our own doing to continue to rebuild and revamp that QMS that will take place in the back half of the year. So those things within our control, I feel very good about.

Nathan: Build and revamped that qos that will take place in the back half of the year. So those things within our control I feel very good about.

Nathan Treybeck: What I can't tell you is when the FDA might get back out here. I think with all the turnover within the agency, it's a little bit difficult to predict exactly what that might look like. And I think we're just going to need some time and clearly some direction from them on what they expect. I don't see in any way, Nathan, that that holds up anything that we're trying to do as a company. Doesn't hold up remediation efforts, doesn't hold up new innovation, doesn't hold up our ability to submit new submissions for new product approvals. We're going to continue to move down the pathway as we have, and they've given no indication at all of disruption there.

Speaker Change: What I can't tell you is when the FDA might get back out here I think with all the turnover within the agency, it's a little bit difficult to predict exactly what that might look like and I think we're just going to need some time and clearly some direction from them on what they expect I don't see in any way Nathan that that holds up anything that we're trying to do as a company.

Speaker Change: It doesn't hold up remediation efforts as a holdup, new innovation doesn't hold up our ability to submit.

Speaker Change: Submissions for new product approvals.

We're going to continue to move down the pathway as we have and they've given no indication at all of of disruption there.

David Rescott: The next question is from the line of David Rescott with Baird, you may proceed. Oh, great. Thanks for taking the questions and congrats on the quarter here.

David <unk>: The next question is from the line of David <unk> with Baird. You May proceed.

David <unk>: Oh, great. Thanks for taking the questions and congrats on the quarter here.

David Rescott: I wanted to ask, you know, on the upside in the quarter and then in the obviously raised guidance above the beat that you had so far, you know, when we think about the Q4 number, I think maybe we assumed about half of the upside you had at Q4 was around these innovative channel partners coming online, maybe about half from the share gain in MCT. You know, when you think about the guide, what's making the guidance for the second half or Q2, Q3, Q4 this year, is it still a similar mix where you have a, you know, maybe relatively split benefit of these newer innovative channel partners in the MCT kind of share gain, or is one of those starting to, you know, become a bigger contributor into what you've baked into this upside, you know, for the rest of the year?

Speaker Change: The ask.

Speaker Change: On the upside in the quarter and on that on the obviously raised guidance above the beat that.

Speaker Change: You had so far when we think about the Q4 number I think maybe we assumed about the upside you had in Q4 was around these innovative channel partners coming online maybe about half from that share gain and MCT. When you think about.

Speaker Change: The guide what's baked in the guidance for the second half or Q4.

Speaker Change: For this year is it still a similar mix, where you have a maybe relatively split benefit of these newer innovative channel partners in the MCT kind of share gain or is one of those starting to be.

Speaker Change: Become a bigger contributor into what you baked into this upside.

Speaker Change: For the rest of the year.

Speaker Change: Thanks for the questions.

David Rescott: Yeah, thanks for the question, David.

David Rescott: This is Dan. So, I think maybe a couple of comments that will be helpful for you, you know, in terms of how we would characterize the beat in Q1, we would say that was primarily from ZOAT. We do see contribution from undiagnosed monitoring and our innovative channel partners as we've been talking about, but really that performance, the outperformance in Q1, we would tie that to primarily to ZOAT. And I'll say that's kind of how we thought about updated guidance as well in terms of the raise of guidance that is mostly reflective of ZOAT and that performance that we've seen now for the last two quarters with the expectation that that will, you know, that will continue and that will sustain for the remainder of the year.

Speaker Change: Yes. Thanks for the question David This is Dan So I think maybe a couple of comments there will be helpful for you.

Speaker Change: Terms of how we.

Speaker Change: I would characterize the beat in Q1, we would say that was primarily from <unk>.

Speaker Change: We do see contribution from diagnosing monitoring and our innovative channel partners as we've been we've been talking about but really that performance.

Speaker Change: Our performance in Q1, we would tie that to primarily two zero.

Speaker Change: And I would say that's kind of how we thought about updated guidance as well in terms of the raise of.

Speaker Change: Guidance that is mostly reflective.

Speaker Change: And that performance that we've seen now for the last two quarters with the expectation that that will that will continue and that will sustain for the remainder of the year, yes on diagnosed monitoring as part of that mix as well.

David Rescott: Yes, undiagnosed monitoring is part of that mix as well and is contributing to, you know, to the guide. But again, that's something that's early. It's a little less predictable in terms of how and when these new accounts come on. When they come on, they can come on in a big way. But again, want to make sure that plays through before, you know, baking that into the guide and make sure we're not getting ahead of ourselves.

Speaker Change: It is contributing to the guide.

Speaker Change: But again Thats something thats early.

Speaker Change: A little less predictable in terms of how and when these new accounts come on when they come on they can come on in.

Speaker Change: Big way, but again want to make sure that plays through before.

Speaker Change: Taking that into the guidance and make sure we're not getting ahead of ourselves.

Speaker Change: Okay.

David Saxon: The next question is from the line of David Saxon with Sinem & Company, you may proceed. Oh, great. Good afternoon. Thanks for taking my question. And congrats on the quarter and Strongguide. So just wanted to follow up on that last question around zero AT. So can you give us a sense for like how much of the AT strength is driven by that, you know, competitor being off the market and that dynamic? Or are you seeing traction in accounts that weren't with that player? Thanks so much.

Speaker Change: The next question is from the line of David Saxon with company May proceed.

Speaker Change: Yeah.

Speaker Change: Great. Good afternoon. Thanks for taking my question and congrats on the quarter and strong guide. So just wanted to follow up on that last question around <unk>. So can.

Speaker Change: Can you give us a sense for like how much of the a key strength is driven by that.

Speaker Change: <unk> being off the market in that dynamic or are you seeing traction in accounts that werent with that that player. Thanks. So much.

David Saxon: Hey, David, I think it's a bit of the latter, to be honest with you. I mean, we certainly see accounts that we onboarded in the fourth quarter, continuing to grow nicely, but the number of new accounts being added to the company in the first quarter was right there, you know, near another record high. So I think what's happening is word of mouth within the local market is starting to be made around the value and the ability of the ZOAT product and folks are trying it, learning that it's quite good, and they're sticking with it. You know, one thing that's interesting, while the MCT category is typically prescribed for up to 30 days of monitoring.

Speaker Change: Hey, David I think it's a bit of the latter to be honest with you I mean, we certainly see accounts that we on boarded in the fourth quarter continuing to grow nicely, but the number of new accounts being added to the company in the first quarter was right there near another record high. So I think what's happening is word of mouth within the local market.

Speaker Change: <unk> is starting to be made around the value and the ability of the <unk> product and folks are are trying it learning that it's quite good and they are sticking with it one thing thats interesting well, while the MCT category is.

Speaker Change: Typically prescribed for up to 30 days of monitor and you can see in the data very clearly our competitors MCT products are worn on average about $12 eight days out of 30 days, we know that when they get a single <unk> put on they're going to wear it for 13 eight days there were nearly 14 days, so we're giving folks.

David Saxon: You can see in the data very clearly, our competitors MCT products are worn on average about 12.8 days out of 30 days. We know that when they get a single ZOAT put on, they're going to wear it for 13.8 days. They're going to wear it nearly 14 days. We're giving folks something that's very comparable, if not better than what they're currently experiencing. I think once they try it and see it, they stick with it and then we see the nice growth. We're excited by it. Obviously, we get the new ZOMCT product into the market. I think the success that we're having with ZOAT currently is only going to give us higher degree of confidence that ZOMCT is going to be just as successful in the market as well.

Speaker Change: Something that's very comparable if not better than what they are currently experiencing.

Speaker Change: I think once they try it and see it they stick with it and then if we see the nice growth so.

Speaker Change: We're excited by it obviously, we get the new zeal MCT product into the market I think the success that we're having with <unk>.

Speaker Change: Currently.

Speaker Change: Is only going to give us a higher degree of confidence that <unk> is going to be just as successful in the market as well.

Suraj Kalia: Next question is from the line of Suraj Kalia with Oppenheimer. You may proceed. Quentin, Dan, can you hear me all right? We got ya. That's right.

Speaker Change: Next question is from the line of Suraj Kalia with Oppenheimer you May proceed.

Speaker Change: Yeah.

Dan can you hear me all right.

Speaker Change: We've got yes suraj.

Suraj Kalia: For a gentleman, congrats on a great quarter. So, gentlemen, a lot of numbers have been thrown around. I was wondering if you could distill it for us and forgive me if I haven't gotten some of this. So Dan, if I give you three buckets. Legacy ZOXT versus ZOAT The second bucket is growth in the legacy channel versus TCP. And the third bucket is large IDNs versus the non-IDNs. Can you quantify for us, just help us dissect a bit more, what are the moving parts? How is relative growth in these three buckets? It would be greatly appreciated.

Speaker Change: Gentlemen, congrats on a great quarter.

Speaker Change: So.

Speaker Change: Gentlemen lot numbers have been shown around I was wondering if you could distill it for us.

Dan Wilson: Forgive me if I haven't gotten into some of this is Dan.

Dan Wilson: If I give you three buckets legacy deal XT versus <unk>.

Dan Wilson: The second bucket is growth of the legacy channel versus PCP and the third bucket is large idms versus.

Dan Wilson: Non IBM can you quantify for us just help us dissect a bit more what are the moving parts how is relative growth.

Speaker Change: In these three buckets would be greatly appreciated. Thank you for taking my questions.

Suraj Kalia: Thank you for taking my question. Yeah, Suraj, let me see if I can be helpful to that. So, just to clarify, Legacy XT, I'm assuming you mean Xeo Monitor as well as, you know, we've moved most of that long-term continuous monitoring business now to XT. And again, maybe a couple of comments that are helpful. AT has outpaced overall company growth, you know, fairly meaningfully the last two quarters. So that is now, call it 14% of overall, you know, overall revenue. Quentin made a couple of remarks in his prepared comments. You know, primary care is now over a third of our prescriber base in terms of percent of volume.

Speaker Change: Yes, Suraj, let me see if I can be helpful to that so just to clarify legacy XT I'm, assuming you mean zero monitor as well we've moved most of that long term continuous monitoring.

Speaker Change: <unk> now to XT.

Speaker Change: And again, maybe a couple of comments that are helpful.

Speaker Change: <unk> has outpaced overall company growth fairly meaningfully in the last two quarters. So that is now.

Speaker Change: At 14% of overall overall revenue.

Speaker Change: <unk> made a couple of remarks in his prepared comments primary care is now over a third of our prescriber base in terms of percent of volume and I think that gives you an appreciation for for how that segment has grown for US we gave that number call it a year and a half ago.

Suraj Kalia: And I think that gives appreciation for how that segment has grown for us. We gave that number, call it a year and a half ago when it was in the low 20s. So that's been a nice, you know, nice contributor to us. The undiagnosed monitoring, that innovative channel, referred to it as value-based care group. We commented earlier, you know, that is, call it low single digits in terms of percent of volume in Q1, 25. And, you know, that really was kind of zero, you know, 18 months ago. So that has been a nice grower for us.

Speaker Change: When it was in the low <unk>. So that's been a nice nice contributor to us.

Speaker Change: The undiagnosed monitoring that innovative channel.

Speaker Change: We've referred to it as value based care group, we commented earlier that.

Speaker Change: As you can call it low low single digits in terms of percent of volume in Q1 dollars 25 in.

Speaker Change: That really was kind of zero.

Speaker Change: 18 months ago, So that has been a nice grower for us.

Suraj Kalia: And as Quentin noted, you know, we're really in the very, very early innings for that. So I would expect that to continue to grow as a percent of our revenue. So hopefully those comments kind of help you.

Speaker Change: And as Quint noted, we're really in the very very early innings for that so we would expect that to continue to grow as a percent of our revenue. So.

Speaker Change: Hopefully those comments kind of help you.

Suraj Kalia: get a little better visibility into the sources of growth for us.

Speaker Change: Yes.

Speaker Change: Visibility into the sources of growth for us.

John E. Young: Press this from the line of John E. Young with Canaccord Genuity. You may proceed.

Speaker Change: Question is from the line of John Young with Canaccord Genuity.

Speaker Change: You May proceed.

John E. Young: Thank you so much for answering our questions and congrats on the great quarter. I also wanted to ask about the AT strength you're continuing to see. Is the overall MCT market growing here pretty rapidly? And are you seeing just a benefit in MCT from the post-ablation monitoring, especially if the PSA expands just the number of catheter ablations here in the U.S.? I think that the latter part of that question, it's very hard for us to identify sort of what volume benefits might be coming from PFA. We can't see it in the data. It's not as clear.

Speaker Change: Thanks for taking my questions and congrats on a great quarter. I also wanted to ask one just 80 shrank youre continuing to see.

Speaker Change: Overall MCT market growing here pretty rapidly and are you seeing just a benefit in <unk> from.

Speaker Change: The post ablation monitoring, especially PSA expand just the number of catheter ablation is here in the U S. Thanks.

Speaker Change: I think the.

Speaker Change: The latter part of that question, it's very hard for us to identify sort of what volume benefits might be coming from Psa.

Speaker Change: We can't see it in the data set not as clear. There is no question I think we're probably getting some benefit but to be honest with you.

John E. Young: There's no question I think we're probably getting some benefit. But to be honest with you, you know, PFAs aren't being done by primary care physicians. And to see the growth coming in the primary care channel the way that we are, we know that that's not specific to it. And I don't think that our MCT utilization is being driven by that either. I think it's much more competitive conversion, taking share in the existing accounts that we already have, ZEO long-term, continuous monitoring in, and then getting the opportunity with the ZEO AT product. In terms of the overall category, I tend to believe that that MCT category is going to be, you know, slightly flat over time.

Speaker Change: <unk> aren't being done by primary care physicians and to see the growth coming in the primary care channel. The way that we are we know that that's not specific to it.

Speaker Change: And I don't think that our MCT utilization is being driven by that either I think it's much more competitive conversion taking share in the existing accounts that we already have zero long term continuous monitoring and then getting the opportunity with with the <unk>.

Speaker Change: <unk> product in terms of the overall category I tend to believe that that MCT category is going to be slight.

Speaker Change: Slightly flat over time.

John E. Young: I think that there continues to be a nice, healthy market there, but we know that price has been under a bit of pressure from CMS for the last two years. I suspect that will continue to be the case, but it's going to continue to be a nice, attractive market for a player like us where we only have, call it, 10 to 12 percent market share and have, call it, 70 percent market share in the long-term continuous monitoring segment. I don't think we ever replicate the 70 percent market share. Most of our competitors are entrenched in that MCT category, but I think our recent success demonstrates we can have success taking share in the existing accounts we're already in.

Speaker Change: I think that there continues to be a nice healthy market there, but we know that price has been under a bit of pressure from CMS for the last two years I suspect that will continue to be the case, but it is going to continue to be a nice attractive market for a player like us where we only have call it 10% to 12% market share.

Speaker Change: And have call it 70% market share in the long term continuous monitoring segment.

Speaker Change: We have a replicate the 70% market share most of our competitors are entrenched in that MCT category, but I think our recent success demonstrates we can have success taking share in the existing accounts, we're already in and for every 10 points of market share gain that's call it $80 million to $100 million of incremental revenue. So if we could get our our market.

John E. Young: And for every 10 points of market share gain, that's, call it, 80 to $100 million of incremental revenue. So if we could get our market share position to 25, 30, 40 percent, it's tremendous growth for the company over the next few years here.

Speaker Change: Sure positioned.

Speaker Change: <unk> 25 30, 40%.

Speaker Change: It's tremendous growth for the company over the next few years here.

Speaker Change: Okay.

Sam Eiber: Next question is from the line of Sam Eiber with BTIG, you may proceed. Hey, good afternoon. This is Sam Wong from Marie. Thanks for taking the questions here.

Sam Hibor: Next question is from the line of Sam Hibor with <unk> you May proceed.

Murray: Hey, good afternoon, Sam on for Murray, Thanks for taking the questions here.

Sam Eiber: Maybe I can ask a tariff question. And Dan, you talked about some of the mitigation strategies and pulling forward inventory, but wondering if there's any opportunity also to pass along price to customers, maybe as contracts come up for renegotiation. Yeah, hey, Sam, thanks for the question. I would, you know, referring to my prepared remarks, you know, I was referring more to kind of supply chain strategies in terms of moving things around and other opportunities to offset a bit of that impact. From a pricing standpoint, we'll certainly look at that and evaluate that. I would say that's not the first place we will look.

Murray: Maybe I can ask a tariff question and Danny you talked about some of the mitigation strategies and pulling forward inventory, but I'm wondering.

Murray: If theres any opportunity also to pass along price to customers.

Murray: Maybe as contracts come up for renegotiation is here.

Murray: Okay.

Murray: Yes, Hey, Tim Thanks for the question I would.

Murray: Referring to my prepared remarks.

Murray: He was referring more to kind of supply chain strategies in terms of moving things around and other opportunities to offset a bit of that impact from a <unk>.

Murray: Pricing standpoint, we will certainly look at that and evaluate that I would say that's not the first place we will we will look.

Sam Eiber: You know, we do want to continue to drive volume and continue to grow our share of the overall market. So we'll look at those opportunities as they come, but also see, you know, supply chain strategies to really offset the tariff impact that we that we are getting.

Murray: Do we want to continue to drive volume in <unk>.

Murray: Continuing to grow our share of the overall market so well.

Murray: We will look at those opportunities as they come but also see supply chain strategies to really offset the tariff impact that we that we're guiding to.

Murray: Okay.

Richard Newitter: The next question is from the line of Richard Newitter with Truist, you may proceed. Hi, thanks for taking the questions, and congrats on the quarter. Wanted to just ask, going back to the FDA, you know, Quentin, I appreciate that, you know, there's a lot of moving parts there and going on in the backdrop, but I'm just curious if the if the people that you're dealing with at the FDA remain consistent with kind of who you were talking to, the guidance you were getting, and kind of the benchmarks and the goals that were laid out where you were tracking towards what you think the FDA wanted.

Speaker Change: The next question is from the line of Richard Winter with Truest you May proceed.

Richard Winter: Hi, Thanks for taking the questions and congrats on the quarter wanted to just ask going back to the <unk>.

Speaker Change: Quintin I appreciate that.

Speaker Change: A lot of moving parts there going on in the backdrop, but I'm just curious if the if the the people that you are dealing with at the FDA.

Speaker Change: Remained consistent with kind of who you're talking to the guidance you were getting ahead of the benchmarks and the goal, but we're laid out where you were tracking towards what you think the FDA wanted so just by the players the same as the first question.

Richard Newitter: So just, are the players the same, is the first question. Yeah, good question, Rich. They are the most senior leaders are absolutely the same folks, we have not seen turnover in that that relationship continues to be the same. So no change there, which we view, you know, very favorably, and we're encouraged by that. We're hearing that, you know, deeper down in the agency, there are folks who may have been part of the review that that maybe aren't with the agency any longer, I will tell you, those aren't folks that we had direct access to necessarily on a daily basis.

Okay.

Speaker Change: Yes, good question rich.

They are the most senior leaders are absolutely the same folks we have not seen turnover and that relationship continues to be the same so no change there, which we view very favorably and we're encouraged by that we're hearing that deeper down in the agency. There are folks who may have been part of the review that maybe aren't what the agency any longer.

Speaker Change: I would tell you those are folks that we had direct access to necessarily on a daily basis.

Richard Newitter: But those folks who who we've been working with directly, the more senior folks at the agency, in charge of our engagement, those are the same, same people, same faces, same names. Okay, thanks.

Speaker Change: But those folks who who we've been working with directly at the more senior folks at the agency in charge of our engagement those of the same same people same face the same names.

Speaker Change: Okay.

Richard Newitter: And then just on primary care, where can that 30% percentage get to? Or maybe you've disclosed that in the past, where your longer term goal is, if you could just remind us. Well, I don't think we've ever put out a specific goal. But Rich, I continue to be more bullish than ever that our market is not six and a half million ACM tests being prescribed a year, which is predominantly coming out of cardiology and EP. I believe that there are 27 million folks who are presenting in the primary care channel today that either have cardiac palpitations already in their medical records, we can see it very clearly, or they're unaware that they have an arrhythmia, many times confusing sort of comorbid disease states and symptoms with arrhythmias.

Speaker Change: Okay. Thanks, and then just on the.

Speaker Change: Primary care.

Speaker Change: We're looking at 30% for semi cap to or maybe you have disclosed that in the past where your longer term goal is if you could just remind us.

Speaker Change: Well I don't think we've ever put out a specific goal.

Richard Winter: But rich I.

Richard Winter: I continue to be more bullish than ever that our market is not six 5 million ACM tests being prescribed a year, which is predominantly coming out of cardiology and EP.

Richard Winter: I believe that there are 27 million folks who are presenting in the primary care channel today that either have cardiac palpitations already in their medical records, we can see it very clearly.

Richard Winter: Or are there they are unaware that they have an arrhythmia many times confusing sort of co morbid disease states and symptoms with arrhythmia is and I think when you look at that total population call. It somewhere around 27 million folks you have to be up in primary care to look for those opportunities and that's exactly where we're moving the business and I have a high degree.

Quentin Blackford: And I think when you look at that total population, call it somewhere around 27 million folks, you have to be up in primary care to look for those opportunities. And that's exactly where we're moving the business. And I have a high degree of confidence that's where it's gonna go. I couldn't be more bullish on the opportunity to open that up. Some of the data that we're seeing coming out of our efforts to work with partners where we can look into their data sets, review medical history of their clients on a de-identified basis, identify markers, and then put patches on those patients.

Richard Winter: We are confident that's where it's going to go.

Richard Winter: I couldnt be more bullish on the opportunity to open that up some of the data that we're seeing coming out of our efforts to work with partners, where we can look into there.

Richard Winter: Data sets review medical history.

Richard Winter: Their clients on a D identified basis identify markers and then put patches on those patients take a diabetic population as an example, we've run some early trials here with a meaningful number of folks.

Quentin Blackford: Take a diabetic population as an example. We've run some early trials here with a meaningful number of folks. The yield on actionable arrhythmias coming out of that trial on folks who had no idea they had an arrhythmia was north of 90%. And another one, it was north of 80%. So we know that we're able to dial in sort of through an AI approach exactly where these patients likely sit, and then we just need to get patches on them. And that's gonna happen through the primary care channel more so than anywhere else. So what the overall prescription pattern looks like in terms of PCP as a percent of total volume, I don't know.

Richard Winter: The yield on actionable arrhythmia is coming out of that trial on folks who had no idea. They had an arrhythmia was north of 90%.

Richard Winter: And another one it was north of 80%. So we know that we're able to dial in and sort of through an AI approach exactly where these patients likely set and then we just need to get patches on them and thats going to happen through the primary care channel more so than anywhere else. So what the overall prescription.

Richard Winter: Pattern looks like in terms of PCP as a percentage of total volume I don't know I think.

Quentin Blackford: I think the market's much larger than what it is today. And if we can open up that 27 million patient markets, the vast majority is gonna be prescribed through primary care. So we'll watch it as we go, I'm very encouraged by what we're seeing in these early days of building up capability to target patients who are at high risk of arrhythmias and then being able to find them.

Richard Winter: The market is much larger than what it is today and if we can open up that 27 million patient market. The vast majority is going to be prescribed to primary care. So we'll watch it as we go but.

Richard Winter: I am very encouraged by what we're seeing in these early days of building out capability to target patients who are at high risk of <unk>.

Richard Winter: Arrhythmia is and then being able to find them.

Quentin Blackford: There are no additional questions waiting at this time. I would like to pass the conference back over to the management team for any closing Great. Well, thank you for your time, and thank you to our Irhythm team. It's a great start to the year, and it's hard to imagine a time when we've been more excited about the future that sits in front of us, and we look forward to continuing to execute our VINSTA strategic plan to unlock the tremendous potential that sits ahead. Thanks again for your time. Thanks again to the teams, and we'll see you all soon on the road.

Speaker Change: There are no additional questions waiting at this time I would like to pass the conference back over to the management team for any closing remarks.

Speaker Change: Great well. Thank you for your time and thank you to our IRA them team. It's a great start to the year and it's hard to imagine a time when we've been more excited about the future that sits in front of us and we look forward to continuing to execute our against our strategic plan to unlock the tremendous potential that sits ahead. Thanks again for your time, Thanks again to the teams and we'll see you all soon.

Operator: Take care.

Speaker Change: Take care.

Operator: That concludes the Irhythm Technologies Inc. first quarter 2025 earnings conference call. Thank you for your participation and enjoy the rest of your day.

Speaker Change: That concludes the <unk> rhythm technologies, Inc. First quarter 'twenty can be five earnings conference call. Thank you for your participation in the inventory the rest of your day.

Speaker Change: Okay.