Good afternoon, everyone. I'm Robbie Marcus, the med tech analyst at J.P. Morgan. Thanks for joining. Happy to introduce our next session with Nevro, and the speaker is Chairman, CEO, and President, Keith Grossman. Keith, I'll turn it over to you, and then we'll do a little Q&A. Okay. Thank you, Robbie. Good afternoon, everyone. Thanks for joining us here in the room and for those of you who've joined us online. We will. There we go. We'll make some forward-looking statements, and we'll talk a little bit about some non-GAAP versus GAAP financial metrics. I would refer you back to our SEC disclosures and safe harbor. Okay. Let's talk a little bit about here we are in January at J.P. Morgan. Let's talk a little bit about how we exited 2022 and how we think we're coming into 2023. First of all, we grew in 22 in the quarter and for the full year in a market where that wasn't as easy to do as it once was. It has remained a challenging environment for our therapy and our segment through 2022, though things are certainly getting better. We grew nonetheless. We think we grew at a advantage pace relative to our competitors throughout the year. We now have indications in 3 very large and very under-penetrative patient segments within spinal cord stimulation. I'll talk a little bit about all of those. We continue to benefit, as we have from our very first market entry in the mid-teens. We continue to benefit from a very differentiated high-frequency therapy. That differentiation really is as great now as it was when we came to market in 2015. We actually think it will be for quite some years to come. We're preparing to launch a brand-new generation of our product, what we call the HFX iQ platform, in early 2023. We're actually in limited market release now. We're gonna be in full market release here in fairly short order, and that is the first AI-powered personalized approach to SCS that this market has seen. This, for us, is probably the biggest platform introduction since our initial one in 2015, and I am for sure gonna spend some time talking about that. We've also spent a lot of time in the last four years, and I'll cover some of this, focusing on our cost structure, both our cost of manufacturing and our operating expense structure, which is a fairly intense one in this space, as some of you know, and feel like we're really well-positioned coming out of 2022. Let's talk about those things that we think are particularly important. First of all, as we come out of this pandemic-impacted environment, we see some continued signs of recovery. We think the challenges in our market are beginning to recede. We're seeing much more interesting rates of growth in trial rates, in implant rates, in patient visits to pain doctors for this procedure, and we're starting to see the recovery that we expected to see. We think, by the way, that that is going to continue throughout 2023. I mentioned the new patient populations. The PDN patient population, the diabetic neuropathic pain patients, continues to represent a really interesting growth opportunity for this company. We'll talk a little bit about the numbers as does nonsurgical back pain. In the short term, the PDN patient population is proving to be a significant growth driver. We think that's gonna be a big market. Eventually, that market, I think, is going to be one of the most significant parts of spinal cord stimulation. We're preparing to launch the iQ launch. I think that is gonna be a differentiator. That now has been something that's been in the works for the last two or three years as we've really revitalized our product roadmap, and I think that has the opportunity to really augment our competitive position in this space. I talked a little bit about opportunity to drive profitability, and I'll come back to that. From a highlight standpoint, we are now past 100,000 patients treated with our high-frequency therapy. That's grown, it seems, pretty quickly, and that number will continue to grow, obviously. We're FDA approved now for not only the PDN indication, but the NSBP or nonsurgical back pain population is new to us. We're the first ones with that formal label indication, the first ones to complete a trial for that, and we're beginning to work with payers now to augment their rates of approval for this new and larger group of patients than those we typically treat. We are in the process of teeing up our final long-term follow-up from our two biggest trials, the Senza PDN trial for diabetic neuropathic pain and the Senza NSRBP nonsurgical trial. Both of those will read out to 24-month endpoints at the NANS conference later this week. We continue to expect to see those results be just as encouraging and just as durable as they have been through the 18-month mark. We've made a ton of progress with payers. Recall that PDN, when we got that approval, was a brand-new group of patients. Typically takes years to really navigate payer acceptance for a new indication like this. These are not patients that have ever been candidates for device intervention in the past. We've made a ton of progress there in a very, very short timeframe. We've only been on the market there about 18 months. We think we've got most of those covered lives covered by commercial and public payers now. I'll talk more about some of those numbers. We've made a lot of progress with clinical society acceptance for PDN. We've received approval for the iQ product. We started, by the way, during the pandemic, we kicked off our first vertical manufacturing integration project with the Costa Rica plant. We started it, we completed and got FDA approval all on time and on budget over the course of the pandemic, and it'll be extremely helpful for us as we begin to improve our cost of goods. I'll talk a little bit about operating expense control. This, I think, is maybe one of the most important slides in our deck. Some of you are familiar with the treatment paradigm for spinal cord stimulation. The patient starts with a trial to see if they're responders, if they're pain responders and able to proceed with payer approval and permanent implant of a device. If you look at the second half of 2021 there, those trial rates were down 1% on a year-over-year basis. We began to talk in 2022 about the fact that we were seeing some early signs of recovery in our business. This, I think, puts a very fine point on that. We saw a 12% increase in our trial rates in the first half, and that was 13% in the second half. Now, for sure, an important part of that is our PDN activity. That is a part of the SCS market that we frankly created, with our clinical trial and our FDA approval, and we're enjoying the vast majority of those patients with our technology. This, I think, is an important slide. We introduced our product in 2015, and we've climbed. Now, it hasn't been quite this steady and linear, but close throughout most of the time. We've gained up to 20% share in the U.S. market over that timeframe against 3 pretty large and pretty powerful competitors in our space. In fact, as recently as the end of 2018, we were about 14% market share. We've made a lot of progress. We pre-released this morning our Q4 revenue, and our sales were up in the U.S. about 13%. Up actually, not on this slide, but up 9% on a constant currency basis overseas. We continue to see very positive rates of recovery and growth. I'm gonna actually switch gears instead of looking down here. I think I'm gonna look right here. Forgive me while I put on my eyeballs. Based on claims data. We have a couple different ways of looking at our progress relative to our competitors. One is obviously sales. It's kind of a rough measure. We also look very deeply at claims data. We've been doing this for quite some time. We actually have been growing anywhere from 500 to 1,000 basis points faster than the overall market in terms of our patients treated, both in terms of trials and permanent procedures. We continue to gain share both inside of the PDN claim and in our core business. Let's talk about some of these growth drivers because I think as we emerge from this environment, as we look forward, these are really the most important way of thinking about the company. I'm gonna start with iQ because I've mentioned this is a very, very important product generation for us. Let me describe the kind of the current paradigm with our treatment. We have an implanted device that speaks to an external programmer, just essentially based on a laptop. It connects to the implanted portion of our system through a standard MedRadio connection. The patient comes back to be optimized actually fairly frequently in the first six months. Usually, by the end of six months, they've gotten to an optimal point of pain relief. Over that six months, there's a lot of interaction between our reps in the field, our reps over the phone, and the doctors bringing those patients back in for reprogramming and optimization. Along the way, over the last 10 years, we created a cloud database. Every patient we've treated is in the U.S. is in that database. I mentioned we now have 100,000 patients in that database. We've tracked not only all of those patients, but all of their endpoints. We have 20 million clinical endpoints in that cloud database. All of that was in order to create a treatment and programming algorithm. That's something that our clinical reps have been following now for years. What we've done with the IQ. Let me advance to the next slide. This gives you some screen grabs of what is now a patient app. The implanted portion of our system, the actual pulse generator, is now Bluetooth-enabled. It connects to an app on the patient's phone, and instead of this patient coming in once every few weeks, once a month to meet with one of our representatives, to meet with a doctor, this patient is now interacting with the rep every single day. This app is querying the patient, "How is your pain? What is your pain level? What's your level of pain improvement? What's your activity, your level of med utilization, et cetera?" It's informing the algorithm that we've been using now for years. The device actually follows that algorithm. It gets smarter based on the patient's input. There are different modules for both lower back pain patients and PDN patients. It begins to optimize the patient's care. What it does is it puts the patient in the position of closing the loop, so to speak. Let's say it's two weeks into this, into this course of questioning. The app will show up one morning and say, "I think it's time for you to try the next program. Do you wanna do that?" The patient selects yes, and it automatically begins working the patient through this algorithm. Depending on how the patient responds to that, it gets smarter and smarter and narrows in to the waveform, the frequency, the algorithm, through the algorithm that the patient needs to be most effectively treated. It's a phenomenal use of time in terms of not having to bring the patient in, being able to interact real-time every day with the patient, actually get their input. Doesn't require, by the way, our field or phone personnel to walk the patient through the algorithm. It's far more effective and efficient for us. Frankly, it's just better for the patient. It gets them to a better outcome quickly. This is the only thing like this in spinal cord stimulation. It's the only application of a true artificial intelligence-informed product that's available for these patients. If you look at these numbers on the left, these percentages, what we did was we ran a clinical trial with this, with this product design about 1 year ago. The idea of now engaging patients in their care, and I think we all know that any time a therapeutic treatment engages the patient and part of that treatment, the data suggests they tend to do better and perform better, and that was clearly reflected in our clinical trial. Where are we now with this? We're in limited market release. It's been FDA approved. We have a limited market release going on in the US this quarter. We'll go to a full market release, we think sometime a little bit later in this quarter or early next quarter. As I said, it's hard to overestimate the importance of this product to our position in the market, there just isn't anything like this in the marketplace. Important growth driver number two, this is not necessarily an order of importance, is HFX for PDN. We were the first, and we are currently the only SCS device approved for treating Painful Diabetic Neuropathy. Let's talk a little bit about what this is. I think many of you sitting in this room have the background on this. Very briefly, this is a very different set of patients. These aren't lower back and leg structural pain, post-surgical or non-surgical patients. These are longtime sufferers from late-stage diabetes. These patients develop this neuropathy that oftentimes turns into neuropathic pain that involves a burning, tingling, sometimes even a cold sensation, and paradoxically, along with that, a loss of sensation or numbness in many of these patients. It is the most common complication of late-stage diabetes, and these are patients that have usually been suffering for quite a number of years. These patients do very poorly. Once they have this level of pain, and once they lose sensation in their lower extremities, they tend to more often fall, cut themselves. These patients tend to get infected. The patients in this category suffer from a much higher rate of amputations. These are patients who just don't do well, and this is part of that dangerous cascade of events. That's the patient we're treating. Up to this point, they've really had no other option but drug treatment, and it's not terribly effective. Same drugs that have been on the market for probably the last 15 years or longer, and about half the patients will become refractory to that medication within about 6 months. This is also a very large group of patients. These are U.S. numbers. If you start on the left with a prevalence pool of almost 30 million patients diagnosed with diabetes, about 20% of them will suffer from Painful Diabetic Neuropathy. Of that 20%, almost half will become refractory within 6 months to medical management. That's about $2.5 million patients sitting out there in that incidence or that prevalence pool. From an incidence standpoint, every year we've got about 140,000-200,000 patients coming into this pool, which just based on incidence is a $3 billion-$5 billion market for SCS. These are, this is a very large group of patients, very few options. They've never had anything like this to treat PDN from an interventional standpoint. The data that we generated from our clinical trial was just fantastic. I would say that these patients probably predictably do better uniformly and more consistently do well than almost any other group of patients we treat. You see 83%-86% kind of pain responder rates. About 90% of our patients who receive a trial respond to the therapy and go on to a permanent device. The only other device out there with any other real meaningful data from an older 2014 study is the Medtronic device, and you see the kinda differences between high-frequency therapy and traditional paresthesia-based low-frequency therapy. It's extreme. We've launched this. We received approval in late 2020. 2021 or sorry, rather 2021, 2022 is our first full commercial year, and we're coming into our second year, and we'll talk a little bit about results momentarily. As partly as a result of those clinical results, we have seen a lot of success with payers. After when we launched this indication with FDA approval, we think we had about 25% of PDN lives who were covered by a plan. That number, we think, is now up to about 66% in a year and a half. We've made really quick progress on the payer front, which isn't, which isn't typical. This is what we've seen from a revenue standpoint. We, we launched this in the third quarter of 2021, and these are the quarterly revenues as they've ramped through the fourth quarter of 2022, which we just released of almost seventeen and a half million dollars. In the quarter, PDN already represented about 16% of our permanent implant procedures. By the way, it represented about 20%. Looking forward, it represented about 20% of our patient trials in the U.S. were PDN patients. Sequential growth was obviously a terrific. Year-over-year growth was pretty extraordinary. This continues to do very well, and we have great expectations for this group of patients coming into 2023, and we think we'll continue to be able to treat them differentially from our competitors. We also in the year received approval for a new group of patients, called non-surgical. Most of our patients in the back pain category have been failed back surgery patients. We know there's a much larger group of patients who aren't candidates for back surgery, but who never get referred for intervention. That's the patients we identified in our NSBP trial. We received a FDA approval for this indication, and we're now beginning the task of working with payers, and we'll have a lot more to say about this patient category. This is sort of a rising tide, I think, for the core back and leg part of the SCS market. All of our competitors are pursuing NSBP. I think it will be a little bit easier for them to treat NSBP patients than PDN patients, and I think that's gonna be very good for the back and leg segment of the SCS market. I would expect this to be a bit of a tailwind for SCS growth rates over, say, the next 5 years, and certainly an important part of what we do since it's such an under-penetrated group of patients. I talked a little bit about clinical data. Every year at NANS, which is sort of the bellwether event in clinical data in the SCS space, we usually have a very strong showing. This year is no exception. We've got 18 abstracts. We're gonna be on the podium, or rather our investigators will be probably half a dozen times. We're presenting the final 24-month follow-up results for both of these very large trials in PDN and in non-surgical back pain, and that's a little later this week and over the weekend. Stay tuned. We're excited to get some of the data out there. We spent a lot of time, particularly over the last few years, working on our cost and expense structure. We were previously, our supply chain was dominated by contract manufacturing partnerships. We made the decision in 2020 to begin to construct our own manufacturing capacity. We kicked that off in 2020. We received FDA approval in 2022, and we are now building commercial product in Costa Rica that will, over the course of 2023, sort of take over our manufacturing volumes and our commercial volumes. As we get to, say, the end of 2023, and certainly coming into 2024, this will begin to have a meaningful impact on our cost of goods, and we think over time, gets us from sort of the high 60s where we are today, to what we expect to be the mid-70s. Just give us a lot more flexibility from a manufacturing standpoint and a product line, change-making standpoint. We've also spent a fair amount of time working on our expense structure. This is part of the barrier to entry in coming into the space. It's an expensive place to do business. It's a fragmented customer base. The patients require a lot of intervention and contact. This is something where we've focused very hard on preparing for our next round of growth to be done much more efficiently. I think this is an important. This is kind of an important chart. If you look at the first three quarters of 2019, you compare it to the first three quarters of 2022, despite two or three years of inflationary pressure then. If you take out what we're spending really pushing the growth of the PDN market and also a little bit of litigation expense that's now behind us in the IP area, our core operating expenses, and those are taken out of both columns. Core operating expenses without those two items are actually down in real terms from 2019. We've done a tremendous amount of re-engineering of our commercial structure. This iQ product line is the next logical step to allowing us to drive more profitable growth from a commercial spend standpoint. This, combined with the Costa Rica changes, are really gonna put us in good shape. I think the next $500 million of revenue are going to come through much more profitably than the first $500, as we're now an established presence in this market. As we come into 2023, we gave guidance this morning on the top line of $445 million-$455 million. That represents about 10%-12% revenue growth. We guided on the PDN line, a line that finished at $48 million this year. We guided to $75 million-$85 million as a portion of our revenue next year. That continues to be an important revenue growth driver for us. These are some of the things that we think will really drive growth and improvement in the business throughout 2023. Not only the HFX iQ launch and the continued PDN growth, but the Costa Rica manufacturing scaleup. The NSBP market will begin to impact the business this year, and I think even more so in 2024, and we expect to see continued core market recovery from some of the post-pandemic implications for the SCS market. I think all of those things combine to make us pretty bullish and actually pretty excited about 2023. We're well-positioned. I think we are now really one of the leaders in this industry, certainly, from a market share, but I think more importantly from an innovation and outcome standpoint with high-frequency treatment. We've set ourselves up here with 2 or 3 really significant growth drivers that are gonna be important over the next 12 to 36 months, and I think as we begin to see the recovery of the market impact our growth rates, and we begin to see that growth come through with a little bit more operating leverage, there's a lot of opportunity for improvement and and value creation. With that, Robbie, I'll stop there and take some questions. Thank you. Great. Thank you. it was a lot of news that came out this morning. I wanna first start with your retirement announcement. We'll all be very sad to see you go. Maybe just give us some thoughts around why now, and why not get someone in place to replace you before making the announcement? Yeah. Well, it's been a frequent question all day today with you guys. I think, look, from a timing standpoint, I don't think the company has been this well-positioned for the last few years. That was very important to me to get the company to this point. You think about things like the product roadmap. When I arrived here at Nevro, we had one product in our technology roadmap, and it was the Omnia product that we introduced in late 2019. We've now introduced HFX Connect. We've got iQ coming out. We've got two generations of product in early-stage innovation behind that and a bunch of other things going on in new indications, waveforms, frequencies. The product roadmap, the technology roadmap at the company right now is really robust. We were at 14% share of the U.S. market at late 2018. We're about 20% now. We're now FDA approved in Costa Rica and ready to improve our cost structure, and we're about to introduce the IQ, and we've got the PDN and NSBP drivers approved. We've really changed the business. We've changed the cost structure. We've certainly, I can assure you, changed the culture and the way of doing business inside the company. It's actually a good time to be doing it. I'm comfortable from a company standpoint that this is the right time to do it. From a personal standpoint it's 40 years in the industry for me this year, and I see a couple of colleagues around the room chuckling at me. About 27 years since my first stint as a CEO, and as they say, when you know, you know. It's a good time for me to doing this personally. By the way, I'm not going anywhere. I'm not leaving the company. I still have a lot of ownership in the company. I've actually bought shares on the open market in this company over the years. Never sold any. I'm staying on as Chairman of the Board. I'm gonna continue to be very active. Your last question, sorry. As for the timing, I think we felt strongly because we had a good year, good quarter, good guidance, a lot of things going on right now. It was easier to do this way and avoid trying to do it confidentially. How long should we be thinking middle of the year, second half? Is that a reasonable timeframe for a search like this? Sure. It's it's, it'll happen this year. It could be 2 months. It could be 7 months. I think we'll just see. It'll happen when we as a board decide we've got the right person who's up to the task and the opportunity. It, and it doesn't really matter. It doesn't matter to me personally if it's 2 months or 9 months, and I'm fully engaged, and the company is really energized right now about the things we're doing this year. Great. Maybe if we could touch on the fourth quarter pre-announcement. PDN beat the Street by $2 million or so. U.S. beat by a little. International beat by a little. The U.S.-based business, I believe, missed consensus by a little bit. Maybe you could just talk to the trends of what you're seeing in the U.S.-based business, both from a Nevro perspective and a market perspective, and then vice versa on the PDN side. Yeah. Let me let me answer sort of qualitatively, and then I'll let Rod maybe fill in the blanks. I think for sure the core market has been the FDA or PDN rather has been really a dramatic growth engine for us. The core back and leg market has been a little bit of a laggard, but it's been getting better. I think you say, well, it's probably it's probably in the fourth quarter, 2% or 3% negative growth, but 2 or 3 quarters ago, it was probably 10%-15% negative growth. Those lines have been continuing to narrow. We have continued to grow faster than the market and pick up share. What we see happening is the market in 2023 the lines will probably cross, and we think that the core back and leg market is probably all in for the year, a low single-digit grower. Probably will exit the year at a little bit better pace than that, and we think we will grow a little faster than the market, of course, because we have been since 2015, number 1, but also because of the iQ launch. I think beyond 2023, we see the market more consistently getting back to traditional growth rates of sort of mid, maybe even mid-to-upper single digits. I think that's probably what you can expect for the, for the core market in the near term. The good news for us is that as the core market gets back to even mid-single digits, as we grow share, and if you combine that with where we think PDN is going, those things add up to really robust growth rates for us over the next few years that we think are quite possible. We don't need the core market to be a 10% or 15% grower in this case with PDN, and with market share capture. I don't know if, Rod, you wanna fill in any of those blanks or... I think you hit the major topics, both in terms of where our business is right now and where we think it's going. The only thing that I might add is that trials, which are a leading indicator for us, in our core back and leg business, continue to grow sequentially quarter-over-quarter. From Q3 to Q4 on a trial per day basis, we saw that continue to improve and that becomes a real leading indicator for us as we're going into the next year. As you think about the guidance for next year, you said it assumes something like returning to maybe mid-single digit, core market growth for 2023? Yeah. I think I said low single digits. Low single, sorry. an exit pace that would be better than that. What gives you the confidence that we can get there from where we are today to those levels? You know, I can see getting to low single digits pretty easily, but getting back up to the mid requires some not a step function, but definitely continued improvement over the course of the year. I guess, what gives you the confidence from your point of view? I don't know if it's doctor conversations or patient discussions or a backlog that you feel like you can get there. Yeah, I think it's Look, I think it's a lot of things. It's procedure volumes. It's market research. It's a lot of the work we've been doing. It's claims data, and it's a lot of market research, both with patients and with doctors, and actually some with payers as well. I think that's a pretty informed opinion. It doesn't mean it's a crystal ball opinion. I think time will tell, and this has been a tough recovery in this market to predict the pace of. I think if we're projecting a market that's historically grown anywhere from upper single digits to low double digits to return to low single digits based on all the data we're seeing, the trial numbers, claims data numbers, it doesn't feel like an aggressive stretch to us. If I take all that math and put it together, it means, like, there's probably maybe some low single digit declines at the beginning of the year growing to more mid-single digit. Exiting the year? I think we're in. Well, we were in low single digit. We're back up to low single digit decline. Mm-hmm. for the core market overall in Q4. I don't know. We haven't pegged a month for the. Okay. -for the lines to cross. I think you'll see, I think you'll see us get to break even at worst in the first half of the year from a market growth standpoint and then proceed from there. Great. Pause for a second. Anybody have questions in the room? Turning to the PDN market, that's seen nice continued improvement since the launch. Have you seen any impact or any of your competitors out there in the PDN market? Do you feel like you have the vast majority right now? Well I mentioned Medtronic in my slides because they're the only other ones with a label claim, with an FDA-approved indication. That happened early last year. I don't think we've seen much of an impact in the market either good or bad. I just don't think they've been a huge presence in the PDN market. They've got a handful of referral reps out in the field, but I don't think we've seen them do a lot in terms of market expansion. I don't think we've seen them do a lot in terms of market share capture either. I think fortunately for us, our execution, I think, has been on point here in developing the referral base. The data is. The difference in the data and the outcomes is pretty dramatic. We expect to see other competitors come in with label claims. I would expect Abbott to be next. Mm-hmm. given that Medtronic actually used some Abbott data to get their approval. I, and I think Boston Scientific has talked about rather starting a clinical trial, which I think they're in the process of doing now. I expect over time to see all of the SCS. It, it's too promising a market segment for people to not wanna be a part of. When you go out and the reps are in the field, what's the pushback, if any, you get? You know, Like you said, it's such a big market opportunity, you know. What's preventing it from going even faster? Is it just the overall spinal cord stim market today, or is there some level of some roadblock you have to overcome? Honestly, there really isn't a structural roadblock that I can identify. I mean, reimbursement is the same, and it is sufficient to build this market. Outcomes are fantastic. The payers have actually been cooperative in setting this up as a covered category. I think it's just changing standard of care. I think it. As fast as this is growing, I mean, it just takes a little time to get the awareness out. I mean, referring doctors and diabetes patients have never had an interventional option to treat this disorder before, ever. So it's educating referring doctors on, "What does this mean? How? What is this technology? Who do I refer the patient to? Will I get the patient back?" It turns out, obviously, they do. These are all questions that we have to answer that they've never contemplated before, and that's an education effort. I think anytime you're trying to change the standard of care for a population of patients as big, it just takes some time. I mean, there's a lot of patients out there, and it's driving some nice growth. This is kind of what we expected. You have a new platform moving into a full launch very shortly here. Should we think of this as more an incremental type of continuation of the growth, or can we see potentially over time, a more meaningful uptick? Well, we'll see. I mean, Certainly, our guidance contemplates the former. Mm-hmm. We think it's a little bit of a tailwind to market capture in the back and leg market, and probably will end up being a little bit of a tailwind to growing the PDN business. Remember that when a patient turns on and goes into iQ mode in this new product, there is both a back and leg pain mode, and there is a PDN mode. It actually is a different programming algorithm. I think it will help with the referral base, and I think it will help with these patients. Our guidance pretty much contemplates growth levels that aren't really powered or driven by a step change in adoption to this relative to this product. Any questions? There's potentially maybe one competitor coming to the SCS market this year, maybe two over the next year or two. You know, when you came, there was a lot of trialing, a really exciting new platform. Even when NuVectra came in, there was still some trialing amongst doctors that disrupted, not necessarily share gains for you, but for others at the time. When these new competitors come in, what do you think investors should expect from market trialing of the new technologies? Yeah. It is a little bit different where maybe they wanna get their hands on it. Yeah. It's a little different. Keep in mind, there are two companies that are saying they're coming to the market in the case of both of them, they were supposed to be in the market this year. In the case of one of them, they were supposed to be in the market every year for the last three or four years. Mm-hmm. I expect 1 of them to be in the market this year, probably in the first half of the year. The second 1 may end up being the second half of the year. We're not certain at this point. The 1 that's coming in the first half of the year, we've competed against in Europe and Australia for the last probably 3 years. This is an Australian-based company. Keep in mind, in Australia, we have, I think, our highest market share of any market. We're number 1 in Australia with a 40% share, despite them being on the market for the last 3 years. Their market share capture in the European market, I think, has been single digits over that 3-year period. We're not minimizing their entry or taking them lightly. I think we've got a strong enough presence. We can compete very well against that competitor. The second one is really more of another low frequency. I don't wanna compare them to NuVectra 'cause we don't know enough about the product yet. Mm-hmm. I don't think it's a highly differentiated product. I frankly think Given what you have to do to compete in this market, I think they're gonna have a little bit more of a difficult time, and I expect to see them probably later in the year. Okay. Rod, we've seen good expense control over the course of the year. Is that something we can expect going into 2023, given we didn't get formal guidance on it? Yeah. We'll be providing more guidance on how we perform from a profit standpoint on the Q4 call. The short answer is yes. I mean, Keith talked about the Costa Rica manufacturing plant. We anticipate that we'll start to get to scale and volume probably late in the year, definitely in the second half. We won't necessarily see a lot of leverage from that this year. In the ensuing years, we certainly anticipate some margin expansion there, assuming pricing holds roughly flat to where we are now. Also, as he walked through what we're doing from a product standpoint with IQ, the journey that we've been on with HFX Connect a number of years ago, where we've been able to take a lot of that patient remote reprogramming and programming and put it into a different part of our sales channel, sales organization. We've been able to drive a lot of leverage, both from a product enhancement as well as a sales organization structure change. The short answer is yes, that we anticipate that we'll be able to continue to drive leverage this year and over the next number of years. What's some margin expansion? Are we talking 100 basis points, 500 basis points? We've been running in the high 60s and even touching 70 in some quarters. Over the next 3 to 5 years, once again, holding pricing relatively flat, we think that we have pretty good visibility in getting to the mid-70s from a gross margin perspective. Got it. Speaking of pricing, how has pricing trended over the course of 2022? You know, there are a lot of other markets where we're hearing about, not necessarily good pricing, but better pricing. Is this a market where we could see a little firmer pricing in 2023? I can answer that. Yeah. I'll. You want me to go. Yeah, let me take it, and you can fill in the blanks if I leave any. I think, look, the pricing in this space is very dependent on where we are in the life cycle, and where our competitors are. I think we and all of our competitors are sort of at the tail end of a life cycle of product platforms. We've probably seen a little bit more ASP erosion this year than we saw in, say 21. In 22 versus 21. I think in 23, between us and a couple of our competitors, that life cycle will sort of rejuvenate, and I think we'll see a little bit more of an updraft on ASPs. It's a very competitive space. I mean, that's exactly how we tend to see ASPs move. They move up at the beginning of a new product life cycle, then they tend to move down a little bit for a couple of years and then come back up with the next, with the next product platform. Great. Well, unfortunately, we're out of time. Wanna thank you for joining, and thanks everybody for listening. Okay. Thanks, everyone.