Good afternoon and welcome to Myriad Genetics Third Quarter 2023 Earnings Call. During the call, we will review the financial results we released today. And afterwards, we will host a question-and-answer session. Our quarterly earnings release was issued this afternoon on Form 8-K and can be found on our website at investor.myriad.com. I'm Matt Scalo, Senior Vice President of Investor Relations. On the call with me today are Paul Diaz, our President and Chief Executive Officer; Bryan Riggsbee, our Chief Financial Officer; and Mark Verratti, our Chief Commercial Officer. This call can be heard live via webcast at investor.myriad.com, and a recording will be archived in the Investors section of our website, along with this slide presentation. Please note that some of the information presented today contains projections or other forward-looking statements regarding future events or the future financial performance of the company. These statements are based on management's current expectations, and the actual events or results may differ materially and adversely from these expectations for a variety of reasons. We refer you to the documents the company files from time to time with the Securities and Exchange Commission, specifically the company's annual report on Form 10-K, its quarterly reports on Form 10-Q and its current reports on Form 8-K. These documents identify important risk factors that could cause the actual results to differ materially from those contained in our projections or forward-looking statements. With that, I'll now turn the call over to Paul.

Thank you, Matt. Good afternoon, everyone, and thank you for joining us. On today's call, we will discuss highlights from our strong third-quarter performance and provide an update on our progress in accelerating revenue growth towards profitability. First, I'd like to take a moment to acknowledge the impressive work the team has accomplished in repositioning the company over the last three years. Like many early entrants to a new market, Myriad Genetics initially relied on its successes but struggled to adapt to changing market conditions. This led to challenges in the business and complexities that hindered growth and innovation. Additionally, misguided product development, poor integration of acquisitions, outdated technologies, deteriorating facilities, and ongoing litigation impacted the brand. To restore Myriad's leadership position, we initiated a multiyear transformation journey with four main objectives: First, to build and rejuvenate the team and refocus on the patients and providers we serve; second, to modernize and enhance our lab, IT, and support center capabilities; third, to restore organic growth and profitability; and fourth, to strengthen the company's R&D and product management. While this hard work is ongoing, we can confidently state that we have made substantial progress on all four objectives and in furthering our mission to empower patients with the potential for improved health and wellness through genetic testing and precision medicine. Now, I want to highlight some key performance indicators and operational activities fueling our growth. We have continued to develop an experienced and engaged team, evidenced by our low turnover rate of just 9.3% and our designation as one of the Best Places to Work. We’ve invested in tools and resources to enable our teammates to perform at their best by upgrading our labs, IT infrastructure, and support center. Our focus on enhancing the patient and provider experience has driven double-digit growth. Our Net Promoter Scores are strong at 69%, provider retention has increased to 70%, turnaround times are down to just 6.3 days, and we've welcomed 5,000 new ordering providers this quarter. Making it easier to do business with Myriad is yielding results, as we are seeing gains in market share across all product lines and making progress with large account wins and new strategic partnerships. Our payer markets and revenue cycle teams have worked diligently to ensure we are compensated for our mission. Recent highlights include a four-year contract extension and coverage expansion for Prolaris with UnitedHealthcare, as well as GeneSight coverage determinations among various Medicaid and commercial payers. The team has made significant strides this quarter in improving ASPs, cash collections, and DSOs. We often discuss the increase in teammate productivity across the entire organization. Excluding SneakPeek, our COGS decreased to $179 per test in Q3 of this year from $196 in Q3 of last year. Our adjusted gross margins rose to 70.4%, while our operating expenses as a percentage of revenue fell from 80% in Q1 of this year to 72% in Q3. We resolved several legacy litigation matters, enhancing our legal and financial visibility and operational focus moving forward. Lastly, we've made notable progress in advancing our clinical validation efforts and prelaunch commercial and operational activities for Foresight Universal Plus, FirstGene, and Precise MRD for biopharma partners. Myriad Genetics experienced significant volume growth in the third quarter across our portfolio as our commercial and lab operations team continue to perform well. We are gaining market share in the hereditary cancer market, with volumes growing 18% year-over-year in the third quarter, driven by competitive wins and increased adoption of myRisk. We also experienced momentum in our prenatal business; excluding contributions from SneakPeek, prenatal testing volumes rose 20% in the third quarter. This is the third consecutive quarter of double-digit growth in prenatal volumes, reflecting effective execution from our Women's Health team as we strive to simplify collaboration with providers. Other products like GeneSight and Prolaris also contributed to our fourth consecutive quarter of double-digit revenue growth. We have maintained strong gross margins and diligently managed costs, with our adjusted operating loss of $2.2 million significantly reduced from an operating loss of $20.6 million in Q3 of last year. Other highlights from Q3 included an increase in our full-year revenue guidance, which Bryan will discuss later, a new four-year agreement with UnitedHealthcare, and a settlement of the Ravgen litigation, now firmly in our past, allowing us to focus on our operations. Finally, I'm pleased to announce that Sam Raha, our new Chief Operating Officer, will join the company shortly. Sam brings over 25 years of experience in general management, commercial roles, and operations and will begin on December 11, building on Nicole Lambert's accomplishments in lab operations, customer service, and product innovations. Sam's initial focus will be on enhancing the patient-provider journey and overall customer experience, implementing our Lab of the Future strategy, and identifying opportunities to strengthen supply chain management and procurement, which will support our growing biopharma business. I look forward to introducing Sam to the investor community soon and want to extend my gratitude to Nicole Lambert for her 22 years of service to Myriad Genetics, its patients, and providers. Now, I will turn the call over to our Chief Commercial Officer, Mark Verratti.

Thanks, Paul. I'd like to start on Slide 7 and talk about our core business units. In the third quarter, hereditary cancer testing volumes from our oncology sales team grew 15% year-over-year, well above the estimated industry growth, which speaks to our enduring franchise and improving brand reputation. Prolaris, our prostate cancer test, continued its momentum with third-quarter revenues up 18% year-over-year. We are pleased to share that UnitedHealthcare has issued a positive medical policy covering Prolaris in the biopsy setting for all risk groups. This policy will take effect on January 1, 2024, and represents another win for the urology teams as they continue to reach patients with diagnosed prostate cancer to provide them and their physicians with important information needed for better treatment decisions. This aligns with several other positive Prolaris policy that were released in the third quarter. Now I'll move to Women's Health on Slide 8. Myriad Genetics Women's Health business serves women of all ancestries by assessing the risk of cancer and offers prenatal testing solutions for those who are pregnant or planning a family. In the quarter, hereditary cancer testing volumes of Women's Health increased 22% year-over-year, marking five consecutive quarters of positive volume growth. Prenatal volumes, excluding SneakPeek, grew 20% in the quarter. With quarterly sales force productivity up 25% in Women's Health and leading turnaround time, it's no surprise that this team continues to outperform and grow our share of these markets. Recently, much attention has been placed on 22q microdeletion syndrome in prenatal screening tests. We want to highlight that our internal data on Prequel’s positive predictive value for microdeletion syndrome is significantly higher, nearly 2x that of our leading competitor. Lastly, I want to give a shout out to the SneakPeek team for reaching one million tests to date. And now that the test is stocked in over 4,000 Walgreens stores, we are optimistic about future test growth. Let's move now to Slide 9 and talk about GeneSight. Mental illness continues to have a lasting effect on patients and their families in the U.S. as those suffering failed to receive proper medical treatment. GeneSight helps physicians better understand how antidepressants and other drugs will affect their patients. Importantly, for this patient group, the test can be performed with a single cheek swab sample that can be taken in the privacy of their own home. In the third quarter, GeneSight volumes increased 19% year-over-year and 24% year-to-date as we've added approximately 4,000 new clinicians to the franchise during the quarter. Myriad continues to build on GeneSight's solid foundation of clinical data, including a collaboration with Optum Genomics to create a multiphase study designed to better understand GeneSight's ability to improve clinical outcomes and reduce overall healthcare costs. As mentioned at our Investor Day in September, we are pleased with the positive Phase I readout from our real-world study with Optum. I would also like to point out a couple of new partnerships and collaborations on the next slide. We recently announced the collaboration between Myriad and QIAGEN to develop kit-based companion diagnostic tests. Combining our strengths in assay development, clinical testing, and regulatory approvals, we are excited to offer a comprehensive global companion diagnostic solution based on a wide range of testing platforms to our pharma partners. Not only are we excited about the opportunity to better serve pharma partners, but we hope that this collaboration sets the stage for advanced analysis and accessibility of MRD and HRD assays to potentially improve cancer treatment decision-making. Additionally, in the quarter, we announced a new partnership with Onsite Women's Health to launch a new breast cancer risk assessment program to help more women understand their breast cancer risk. Combining Myriad's strengths in hereditary breast cancer risk assessment with Onsite's expertise in breast health services, this new partnership is expected to deliver personalized breast cancer risk insights to more than 400,000 patients that Onsite currently serves nationwide.

Thanks, Mark. I'd like to start by reviewing product volume trends on Slide 12. Overall, hereditary cancer test volumes in the quarter grew 18% year-over-year, marking five consecutive quarters of volume growth for hereditary cancer testing. Combined quarterly volumes for prenatal and carrier screens grew 20% year-over-year, excluding contributions from SneakPeek. Our pharmacogenomic test GeneSight experienced healthy growth of 19% in test volumes year-over-year, and Prolaris, Q3 volumes grew 9% year-over-year. We credit the ongoing commercial momentum of the business to competitive account wins as well as disciplined execution from our tenured sales force. While Q3 has historically been a seasonally weaker quarter impacted by fewer patient-provider interactions and general summer travel, on a year-to-date basis, hereditary cancer and GeneSight test volumes have grown at or above 20% year-over-year, and prenatal and Prolaris have grown at 14% year-over-year. Now on Slide 13, we will discuss quarterly revenue trends. Excluding contributions from change of revenue estimates in both Q3 of last year and Q3 of this year, quarterly revenue grew 14%, marking four consecutive quarters of double-digit revenue growth. For the nine months ending September 30, 2023, total revenue, excluding the contribution from change of estimates, grew 15% over the nine months ending September 30, 2022. I would mention our third-quarter 2023 revenue growth rate includes the negative headwind in tumor profiling revenue of approximately $3 million due to the completion of a commercial arrangement with one of our European biopharma clients, which ended in Q3 of last year. You may recall commentary from our second-quarter earnings call this year that we, along with many peers in our industry experienced a negative impact to our revenue cycle process from the transition of multiple health plans to a new claims administrative process. During Q3, we made substantial progress in resolving these issues and ultimately collected more cash than we expected, which drove the majority of the $7 million change of estimates that we experienced in this quarter. Excluding the impact of change of estimates from third-quarter revenue, we expect sequential revenue growth of 3% to 6% from Q3 to our implied Q4 revenue guidance range, which is in line with historical seasonal trends. Moving down the P&L, adjusted gross margin was approximately 70%, compared to 68% in Q3 of last year and approximately 69% last quarter, reflecting the impact of the positive change in estimates as well as the impact of positive volume leverage. We'll now turn to Slide 14 and discuss quarterly progression through the year. We have seen nice improvement through the year on our path to profitability, with the first quarter showing an adjusted loss of $0.21, second quarter at an adjusted loss of $0.08, and third quarter an adjusted loss of $0.03. We remain confident in our ability to achieve our goal of reaching adjusted profitability and generating positive adjusted operating cash flow in the fourth quarter of this year. For the full quarter, we have narrowed the adjusted EPS guidance range to a loss of between $0.33 and $0.28. I'll now turn to Slide 15 to review our liquidity and cash flow. Looking at the balance sheet, we ended the quarter with $86.3 million of cash and marketable investment securities and expanded our asset-based credit facility from $90 million to $115 million. With the capital needs for the construction of our new lab substantially behind us, we anticipate total liquidity of approximately $107.5 million at the end of 2023. We believe that this, along with our continued business momentum, gives us financial flexibility as we enter 2024. Note that we have not made a final decision on funding the remainder of the shareholder lawsuit settlement. As you may recall, we have given ourselves the flexibility to use shares for the final payment, and as we make our final determination of whether to use cash, stock, or a mixture of both for the final payment, we will continue to review our capital structure, funding requirements, and alternatives available to us. As stated in the earnings release, the Ravgen litigation refers to a settlement, of which $5 million was paid on October 31, 2023, $5 million is payable on or before October 31, 2024, and $2.75 million is payable on or before October 31, 2025. Any final payment of the $21.25 million is contingent on whether Ravgen is successful in resolving all outstanding patent reexaminations and litigation. If Ravgen is successful, the contingent payment would be payable over a five-year period beginning no earlier than 2026.

Now on Slide 16, we are updating our full-year financial guidance. We raised the midpoint of our 2023 revenue guidance by $10 million, representing 10% to 11% year-over-year revenue growth from 2022, which is in line with our long-term estimates. Adjusted gross margins are expected to be at the high end of our prior guidance. We increased our full-year GAAP OpEx guidance primarily to include expected costs associated with the settlement of the Ravgen litigation, and we narrowed our full-year adjusted OpEx range with one quarter remaining in the year. Adjusted operating expense in the current quarter reflected the impact of normal expense fluctuations based on timing, we expect Q4 expenses to decline from Q3 levels and be approximately $134 million at the midpoint of our guidance range. On Slide 17, we also want to take this opportunity to introduce our 2024 revenue guidance of between $815 million and $835 million or 9% to 11% growth over the midpoint of our 2023 revenue guidance range. This revenue range is consistent with our longer-term revenue growth target of 10-plus percent discussed at our September investor event and reflects the performance we've demonstrated over the last year. In addition, we reiterate our other long-term financial targets discussed in September, which include gross margins over 70%, annual growth in SG&A spend of approximately 5% to 6%, and positive adjusted operating income and adjusted cash flow. I'll now turn it back over to Paul for closing remarks on the next slide. Thanks, Bryan. As I mentioned in my introduction, we continue to build on the pillars required for long-term growth and profitability. Top-tier science and products with clinical differentiation and adoption are enabled by technology that deliver value in real-world clinical settings, and enable early detection and better treatment decisions. A commitment to continuous quality improvement and customer satisfaction powered by our modernized lab and commercial platform to improve workflows, test turnaround times, and reduce costs through advanced technology and automation. Together with best-in-class regulatory reimbursement and revenue cycle capabilities. Great science is used to develop practical high-quality diagnostic tests, operated in efficient state-of-the-art facilities with the ability to get paid for our efforts. As discussed, excluding contributions from SneakPeek, total test volumes year-to-date and in 2023 have grown 18% compared to last year. Total year-to-date revenue, excluding out-of-period adjustments, is up 15% compared to 2022. We believe these results demonstrate our ability to execute on our long-term growth strategy as the investments we have made across the enterprise take hold. 2023 has been a foundational year, and we are confident in our balance sheet as well as our forward-looking financial guidance. We are pleased to put the rest of the litigation that has been an overhang for investors behind us. We continue to reenergize the enterprise around our shared mission and vision to make genetic testing and precision medicine more accessible, helping people take more control of their health and enabling providers to better treat and prevent disease. I'll turn it back to Matt now for Q&A. Thank you.

Thanks, Paul. And as a reminder, during today's call, we use certain non-GAAP financial measures. A reconciliation of the GAAP and non-GAAP financial results and a reconciliation of GAAP to non-GAAP financial guidance can be found in our earnings release and under the Investor Relations section of our website. Now we're going to begin with the Q&A session. To ensure broad participation, we're asking participants to please ask only one question and one follow up. Operator, we're now ready for the Q&A portion of the call.

Your first question comes from Matt Sykes with Goldman Sachs.

This is Evie Koslosky on for Matt. So first, can you walk us through any progress you've made on addressing zero pays and what type of positive impact that could have on margins as we move into next year?

Yes. I think a lot of progress in the quarter. As you can see, year-to-date, $6.2 million of net out-of-period cash collections, DSOs are down, gross margins are up, which reflects ASP improvement, and starting to feel more optimistic about the progress we've made beginning to follow the state biomarker laws. There are 14 states now, including California, that have passed them; 11 of those states, including California, should cover GeneSight. So we're beginning to engage state by state. And this quarter, we saw two different payers under the biomarker laws pick up coverage. Now these are bunts and singles, so it's not going to be huge overnight successes, but we think the momentum there and the general recognition on things like prior authorizations within the Medicare program and other places gives us a lot of opportunity to continue to improve ASP. And so good cost management and ASP improvement are what gives us the confidence that we can grow gross margins above 70% going into next year.

Great. That's super helpful. And then great to see you're still gaining share within hereditary cancer testing. Could you talk through the market penetration within myRisk? I think in the past, you've said the market is only 15% penetrated. Has there been any progress in recent months? And what actions are you taking to further drive that?

Yes. Just to clarify, the 15% market penetration was in the unaffected market, which is where our Women's Health team focuses, and so we see a great opportunity there. But quite honestly, for the hereditary cancer growth, we've seen it both in our affected population on the oncology side, where we continue to drive depth within our core customers, but we're also winning back customers from the competition. And then we also see the same amount of growth on our Women's Health side in the unaffected population where, again, we see a huge blue ocean opportunity there, and that speaks to the collaborations that we talked about on the call as well and being able to penetrate larger accounts, and quite honestly, just increase the adoption of both providers and patients.

Maybe first, diving in a little bit just on the gross margin. You noted a $7 million adjustment regarding the sequential gross margin movement. Could you provide some insights? It appears there might be a slight impact. What are some key factors we should consider as we approach Q4 and look towards the 70-plus number for next year?

Well, thank you, Andrew. I mean as I mentioned in the operational highlights, we're just seeing productivity in the sales force, as Mark said, a 25% cost per test drop year-over-year. I mean, that's net of inflationary increases. And as Bryan mentioned, just starting to see the leverage in the P&L. So we think opportunities continue to affect sequencing costs and opportunities to leverage our new labs, both in South San Francisco and Salt Lake; we're just beginning to start seeing some of that, and the automation hasn't even taken hold yet. We haven't moved our Arches project over yet. So I would just say we're increasingly optimistic about our ability to grow gross margins over the next couple of years as we see Lab of the Future automation as well as the other productivity things that we're focusing on take hold. And as we talked about at the Investor Day, we've just identified a lot more opportunities to reduce no pays. And we think over the next year, that can be meaningful as well.

Okay. Great. Super helpful. And then maybe just one on the guidance that you're giving for '24 already. Obviously, early to give that. But just was hoping you could give us a little bit more flavor for maybe some of the underlying kind of pieces where maybe there's wider error bars versus narrower as we think about that initial guide for 2024 already here in November?

Yes. Andrew, this is Bryan. I'll start and let Paul chime in. But I think that where we started just in really looking at what we've laid out over the last four-plus quarters now we've seen double-digit top-line revenue growth. And our stated long-term goal is for 10-plus percent. We just feel very confident that when you look at the midpoint of the current year guide based on what we're seeing today in the business, that it adds up to something that's in that range. So we felt like that was something that we wanted to make sure that people understood that this is not aspirational; that's kind of what the business is doing today.

Yes. Let me emphasize this. We grew 15% year-to-date, excluding out-of-period adjustments, and we continue to generate net positives. There are still some individuals who doubt our capabilities, but we see a lot of momentum as we head into '24. The midpoint of our revenue guidance aligns with our long-term goals; it is 10% above the stated midpoint of this year’s guidance. We believe it is important for investors and shareholders to recognize our strong confidence in achieving this 10% growth, especially given our 15% year-to-date performance and positive momentum in the business. It is clear that some people are skeptical, but we have demonstrated our ability to achieve this, and we are integrating our new labs and initiatives. This reflects our confidence and the visibility we have in the business's future.

And I would say the only thing I would add, Andrew, is just that getting the United renewal behind us in October is obviously another thing that was incremental relative to where we sat back in the industry, and that was a positive.

This is Neil on for Rachel. Just digging into the 2024 guidance just a little bit more. Can you give us any incremental color on that $815 million to $835 million guidance? It's significantly above expectations. Is that mainly due to that United contract renewal, as you just referenced? Can you give us any sort of updated volume or price expectations heading into 2024? Or anything that you can sort of do just sort of frame the 2024 year would be super helpful?

So volumes are up 18%. Revenue year-to-date is up 15%. We see acceleration in customer acquisitions and wallet share. We see acceleration in market adoption and ASP visibility with the United contract and other recent wins. So those are the component pieces that would drive us to a high degree of confidence of that midpoint and that longer-term guidance. It's not a really big numerical jump to get from our guidance this year to $825 million next year; it's 10% off the midpoint of this year's guidance.

The margin profile indicates that you might be performing better than expected in terms of margins. Is this primarily due to the increased traction with payers, or is there another factor we should consider?

I mean margins are a function of everything going down the P&L. So as we talked about, it's increased productivity; it's just a function of our fixed costs versus variable costs and the ASP progress all play into that. I think incrementally, as Bryan spoke to, as we think going into next year, now that we have moved along in terms of opening our both of our new labs, as we're seeing turnover down to 9.6%, 9.3%. All of that operationally is what plays into our opportunity to continue to grow margins beyond the adjusted 70.4% going into next year. There's a lot of leverage in this P&L.

Just a question and apologies if we missed this on the call, but on GeneSight, can you provide any timeline for additional publications supporting utility?

So go ahead, Mark.

Yes. The only thing I would add is, so we at the Investor Day, we talked about the preliminary results from Phase 1 of the Optum trial. And we also talked about at Investor Day, Phase 2 of the Optum trial, which will be coming later this year, where we've got some control groups, and we'll also be looking deeper into the economic utility as well as the clinical utility. There are several other publications that are going on, and you'll see those published sometime next year.

All right. Great. And then, on the pipeline, do you have any updates on timing for products, including FirstGene? You previously expected a soft launch in fourth quarter this year. And then, when should we expect to hear any updates on your MRD offering?

So no updates to the pipeline since our Investor Day in September. Everything is sort of tracking consistent with that. Still got a lot of work to do. But as we mentioned in the call, continuing to make great progress on our clinical validation work. We're excited about the new studies with MD Anderson and others. And so that's all tracking well. The new partnership with QIAGEN is really exciting in terms of the ability, and those are additional discussions with having with QIAGEN about MRD and different offerings there. So progress continues, but nothing substantive since our Investor Day.

Thank you. Good afternoon. The cash bridge that you laid out in the press release landing at $107.5 million at year-end, just wanted to clarify, are the payments to Ravgen incremental to that? Or is there a reason that the $5 million from October 31 was excluded?

We didn't exclude the $5 million; it's in the expectation. So the $107 million has that, and then the other payment would be a year from now of October 31 of next year.

Okay. Just because I see it says end of the third quarter, $86.3 million amount available under the facility, $28 million, and then has the fourth-quarter CapEx, but I didn't see the Ravgen payment, but it's included in one of those first three numbers?

Yes, just to break it out, Jack, it just says in cash flow from operations. So it would be in that cash flow from operations number for the fourth quarter.

I remain quite confident in our ability to navigate those regulatory changes. We're actively engaged with our associations during this comment period. I want to remind everyone that we already operate FDA-like labs, and many of our quality assurance processes are already in place. We have been considering FDA regulation across our products throughout the Lab of the Future planning process. I reiterate my previous comments regarding GeneSight. There have been no inquiries about GeneSight from the FDA under its enforcement authority, and the comments in the proposed regulations addressed broader concerns raised by investors, as highlighted by the New York Times article and the resolved litigation. I believe you misinterpreted that in your note.

This is Isabella on for Puneet. On the $40 million Rav opportunity that you highlighted during the Investor Day, would you mind just talking us through how much of the benefit will be assumed in the 2024 guide?

I'm sorry. You were talking about the ASP opportunity we talked about at the Investor Day, the no-pay opportunity? Yes. I mean, we didn't put a specific timeline on that. But as you can see from this quarter's results, we made progress on ASP, cash collections. And quite frankly, we incrementally see more visibility, again, under the context of the United contract has been signed for four years. The progress that we've been making with different payers for GeneSight and other products, and the continued growth of these biomarker laws that are not only for oncology tests but also extend GeneSight in the majority of these states. So again, the first half of the year and some of the ASP challenges just gave us a refreshed view. And so we've really doubled down on our efforts there. And again, as we talked about earlier, we think it can contribute to margin expansion as we go into '24 and beyond.

Sure. Great. No, that makes sense. And for GeneSight specifically, would you mind walking us through what the 2023 guide is contemplating in terms of whether that's sustained volume growth versus ASP improvements?

We don't provide that information separately. However, GeneSight has experienced a growth of 24% year-to-date. We believe it can continue to grow at a rate of 20%. This is one of our significant no-pay issues, and we are actively addressing it. We see several opportunities to reduce no-pays for GeneSight and increase the average selling price. We've made substantial progress, especially this quarter, in this regard.

Your next question comes from the line of Derik De Bruin with Bank of America.

This is Wolf Chanoff on for Derik. Congrats on the quarter. I just wanted to start by digging into some of the top-line drivers here. As you guys talked about, a fair amount of the beat was due to period adjustments. So I was just looking for some clarity on how we should be thinking about the impact of adjustments going forward and kind of a normalized rate, given the dynamics that you've laid out that you're currently experiencing? And I have a follow-up.

Can I just underscore that when we've given you the 14% and 15% revenue numbers, it's excluding the out-of-period collections. We've gone to great lengths to separate that out. It was actually a 23% increase when you look at the outer collections. And year-to-date, again, you're going to have some quarterly volatility, what happened with the third-party payers last quarter. But the revenue trends and the stability of ASP are coming through the P&L. And so anyway, I hope that's responsive, but nothing else in terms of the pieces there. But Bryan, would you add anything?

Yes. If you exclude the out-of-period change in estimate, you arrive at a figure closer to 185, which aligns with the adjusted number. This is still significantly ahead of our earlier projections, which were in the 179 to 180 range. Throughout the year, we've aimed to keep the out-of-period figures minimal. However, we encountered a challenge with a payer and an administrative claims processing agent last quarter, which we discussed in our previous call, but we were able to recover a substantial amount this quarter. This situation is somewhat unique to the current quarter. Overall, even excluding that, we are still performing better than our initial expectations.

And which is why we try to point everyone's attention understanding there's been some quarterly volatility that year-to-date, it's all ahead of our long-term growth rates. So anyway.

Yes, and I would just say in closing, keep in mind that we are committed to achieving our long-term financial targets and expectations.

And there are no further questions. I'll turn the call back to Matt Scalo for closing remarks. Thank you very much.

Okay. Thanks, Dave. This concludes our earnings call. A replay will be available via webcast on our website for one week. Thank you again for joining us this afternoon, and have a good night.