Okay, good morning, everyone. Welcome to the last day of our healthcare conference. My name is Nathan Treybeck. I'm one of the medical device analysts at Wells Fargo. I'm pleased to have management from Nevro for this session. With us are Kevin Thornal, President and CEO, and Rod MacLeod, CFO. Thank you for joining us. Thanks for having us, Nathan. Thanks. Great. So I thought we could just start with the strategic review that you just initiated. Kevin, what can you share about the review, and what are some of the options you are evaluating? And then if you could just talk about where you are in the process right now. Yeah. So, we announced it on the last call that we were initiating the strategic review, so we're still in early days here, and we also announced that we're looking at all possibilities, which could be, you know, being acquired by our strategic, could be a merger of equals, could be private equity, could be anything that would occur through there. Could be, you know, opportunities to be able to roll up a couple of smaller assets to diversify quicker. So we're looking at every possibility that would bring back, and bring shareholder value as quickly as possible. Okay. You know, while I appreciate you're not providing timelines right now, should we be thinking about some outcome from this process in twenty twenty-four? I don't know if we'd say twenty-four, but we've said it's months, not years, through here. We don't wanna be stuck in a loop where people think, "What's going on with the process?" forever. So we'll take and evaluate all the opportunities as quickly as possible, see if there's something that brings good shareholder value, and if not, as I said on the call, we feel great about our pipeline and everything we're doing to diversify the business moving forward, but this is, can accelerate the path to that. So we think that within months, we'll let everybody know. It'll be a definitive, "Hey, we've reviewed it, and it didn't wasn't the best for the shareholders, so we're moving forward," or you'll hear an announcement if something comes of it. Okay. In terms of just since you've announced the review, you know, how should we think about, you know, just morale, or have you seen any elevated sales force attrition beyond what we saw earlier when you did the sales force realignment? No, we really haven't, and mainly it's because the way and part of the reason why we went public with it is so that we could talk about it openly with not only investors, but also with our teams, and, you know, the story is, look, we're one of four neuro-- well, five now, neuromodulation companies, but, you know, the fourth largest, and we believe that we have unique capabilities of our engineers, our sales forces, that no matter who were to partner with us, or maybe if it was a strategic that took us underneath their wings, they're gonna need the people that are neuromodulation experts, 'cause there's only four companies in the world that are experts in neuromodulation. So our team feels very, you know, confident that their expertise is gonna be needed. Okay. If there aren't any more questions on the strategic review, I'm just gonna move on to guidance. Okay. So on the Q2 call, you brought down your full year guidance by $35 million-$40 million. Yet, you said you remain optimistic about the business. You noted that PDN was still up year over year and quarter over quarter, so that implies that your core SCS sales were down about 10%. I guess, what is it that gives you optimism about the business? Yeah, I think, you know, obviously, the SCS business has been lumpy for decades. You look at your guys' models, which I was bragging about before, that Larry's been doing forever. You know, you see those quarters and years where you'll see a company that it's negative, negative, flat, negative, then up 20% and then down 5%, then maybe back to 5% growth. We saw that last year with one of our big competitors going double digits for four quarters in a row, then immediately dropped down to 3%, and that's because of new product innovation cycles. This is a business where something new comes out, physicians often split between us. They don't just commit to one vendor, and so during those splitting times, new technology comes out, they're, "Oh, let's try that for a little bit. Okay, now you have something new. I'll go back to you. And so innovation is the lifeblood here. And that's what we ran into in quarter two and then last quarter as well, with some new product introductions. What gives us confidence is that we still are the only company that has large RCT trials, clinical trials in this space that show and have FDA approval with the superiority claim, and we're the only high-frequency company that's there doing paresthesia-free mapping. And so that's something that a lot of physicians. It's really difficult to go back to low frequency when you've experienced the benefits of high frequency. The other part is we have a few tailwinds coming. We have our SI joint acquisition that is still you know, we're getting over the humps of some of the manufacturing uplift. We still don't have enough trays for all of our sales reps to have one to do procedures, so they're still trading them out amongst each other. We knew that going in. We also, as I talked about two quarters ago and then this quarter, as a company, Nevro's never benefited from an annuity that the other three have, which is replacements. And replacements are, these batteries last about 10 years for rechargeable batteries, and that's about how old Nevro is. And so we're just now starting to see the early signs of patients that were installed with our first-generation product come back. We know that from hiring competitive reps and people that work for us, that sometimes quarters where 20%-40% of the revenue for some of our competitors are replacements, and that's because the leads are already in the patient, and when they come back, you'd rather not pull those leads and just connect it to another battery, and then keep that patient on the same therapy for the next 10 years. If you go back and look at our history, when we launched in 2014 in the U.S., we really started gaining scale at the end of 2015 and into 2016 and 2017, where we were implanting 9-10 thousand patients a year. All those patients are now coming up to the time where they need to have replacements. We've not really had any replacement revenue at all. That's all coming up here pretty soon, and that's a big tailwind that a lot of people don't know about Nevro. The last part is when I came to Nevro a little over a year, a year ago, a year and a half now, one of the things that we did is we really diversified our pipeline. Instead of just working on the next generation SCS product, we also started diversifying in other areas in which our engineers are experts on to get us into new revenue streams that we're not enjoying today, but right in the same call point. Those are all coming within our strategic plan period. We just have a few rough quarters here where we're going against some of those new competitive launches. I will say, here, I just talked about it last week for the first time, we will be launching a new version off of our IQ AI platform, here in the coming months, called Amplify AI- Adaptive. Sorry, Adaptiv AI. And with Adaptiv AI, we're getting the full benefit of our 100,000-patient big data set to actually close the loop that really matters. Some of our competitors are talking about a technology of closed loop. Well, technically, it's trying to keep patients out of paresthesia, but it doesn't have anything to do with the patient's pain relief. All it has to do with is the impedance checks along the spinal cord, whereas our loop is the patient's feedback. When the patient gives feedback that it's good or not, our AI automatically changes the algorithm to adapt towards those patients' needs. And so you'll be hearing about this launch here in the next two to three months. Is this a new product or just kind of an additional kind of enhancement to the IQ? Yeah, it's the same IPG with updated software and algorithm and application that the patients will utilize. It also comes with some future enhancements that we can't talk about today, but it's a platform in which the patient, the physicians will be able to monitor their patients in real time and be able to do that remotely. And so again, this is the first time we really talked about it here in this setting, and so we'll be launching that officially here in the next couple months, and you'll see a big splash here soon. Will, will there be a reimbursement component to the remote monitoring? There could be. That's up to the physician's choice. There has traditionally been a reimbursement code in the CRM side of the business, that if you hit a certain number of attributes that you're monitoring from the patient, then you have the ability to be able to do that. Obviously, it's not our decision. We don't advocate what a physician does for their CPT codings, but there, that could be available to them if they choose to do that. Okay, we will touch on the product. Just on the SCS market in general, just looking at it, it looks like it is growing high single digits now over the last six quarters. Do you agree this is kind of an underlying growth or volumes, or is this an ASP mix benefit from the new systems that your competitors launched? Yeah, I think it's obviously all the above. You know, you look at last year, there was one new one of our competitors that launched a product, and they got really two, three uplifts. One is new product technology that people will wanna try, an ASP uplift, and then also changing a lot of patients that were on a non-rechargeable battery that lasts for three to four years and putting them into a rechargeable battery. So that's an uplift. There's a lot of patients come through, and also an uplift in ASP. We also just last quarter saw another one of the competitors launch, and so you can see, you know, sometimes they go negative, then flat, and all of a sudden, plus ten, and that's what we saw from one of our competitors this quarter. However, we have the market pretty close to what you guys' model had in the US, around 4% growth, and that's coming off a high single-digit growth last year. So it has had a few tailwinds here in the Q1 and Q2 of this year, but we say it's mid-single digits growth right now. For underlying volumes or revenue? Um, both. Okay. Do you know what underlying volumes we're growing at? Our competitors don't talk about number of actually implants. We do. So we don't know for sure, but we believe those are probably, you know, mid-single digits as well. You also can just remember, like, last year, a lot, a lot of that growth was from a competitor that had a disproportionately large amount of replacements because they've been selling primary sales for years, and so that obviously was a little bit part of that equation as well. Okay. So I guess from here, you know, I appreciate you're launching kind of a new enhancement to your product, but what is the roadmap for kind of stemming share losses from here? Yeah. As we said on the call, there's obviously we have to do a better job on competing now in the hand-to-hand combat every single day, right? A physician can choose at the moment at a time, am I gonna choose you or one of your competitors? There's almost zero switching costs because it's pretty easy for the physicians to use all providers that are out there, so we have to do better competing there. We also have to make sure that the customers know the benefits of our AI technology and how that plays out over the next ten years for that patients, and that's where with our new launch, Adaptive AI, we think we're gonna be able to have a competitive advantage there. We also talked about replacements, and replacements is where we're starting to see patients come back, needing to have replacements and having those conversations, and then with PDN. PDN, we still are the only company that has a large RCT for PDN, and we stopped and put a pause that was already planned to interim analysis of our Senza study, and we believe we're gonna have the power to start talking about the benefits of that clinical study coming out in early 2025, which could lead to the second RCT and getting us on guidelines for societies like the American Diabetes Association. We'd be the only ones with ten kilohertz that are mentioned in those guidelines. There's a lot of things that are pretty exciting coming up in the next few quarters that we look forward to talking about. ... do you envision, you know, in the SCS market, usually whenever there's a new product, there's a boost, and then another new product comes out, there's another boost. Do you envision a similar cycle with this AI enhancement that you're introducing? Yes, we have adaptive AI coming here. We also announced on our last earnings call, at the first quarter of twenty twenty-six, we'll be launching a brand-new SCS platform. And then, the year after that, we have a new technology that will be hitting the market, and then the year after that, another one. So again, it took a while from when I first got here to change and diversify our R&D pipeline. We now have the SI joint product already in our bag, so that's just taking some time to ramp up. And we also talked about one of the benefits that some of our competitors have, is the ability to be able to go in and do contracting across multiple products at the same time. They may offer ability to do discounts, right? Hey, you know, hospital system, if you buy three of the four things that I offer, here's your pricing across the board." Whereas we've been really just a one-product company with multiple indications. Now, we have SI joint. We'll have another new product here coming out soon, and then another diversified revenue stream, and we feel like that now gives us an ability to bring more value to each of our customer interactions, as well as contracting with some of the larger healthcare systems that's there. That's been sort of the vision on day number one and why they brought me into Nevro was, we need to diversify beyond just spinal cord stimulation, and we can do that by R&D expansion and also M&A when it makes sense for small tuck-ins. Okay. What can you say about the new SCS system? You know, how will it be differentiated from HFX iQ, any color you can give? Yeah, we haven't really talked about that yet. I don't want to give our competitors any of that knowledge 'cause we're literally just went into limited market release yesterday. And so we have implanted into patients. We do know how it's going to work. We feel great about those, but we're gonna make a splash here pretty quickly, but not ready to do that today on the conference. And it's really around how the systems interact with the patients and the ability for our physicians to be able to see all their patients in one screen and be able to determine how they're all doing, and anybody that they need to maybe call back in for some changes in settings or what have you. But most of the time, these patients are gonna answer four questions a day, and the algorithm's gonna magically, as we said, close the loop that matters, which is adapt to their pain relief. Okay. As far as, you know, for post-COVID, the SCS market, there's been an amount of weakness in it. You know, a lot of it was attributed to, I guess, therapeutics earlier in the cycle, the kind of people going back to earlier in the referral cycle. Where do we stand now in that recovery? Yeah. So I think, you know, a lot of times, you look at data and you think, "Oh, I know exactly what the cause of it was." I think a lot of people thought, "Oh, COVID was the reason why SCS lost some of the patients." And while that is true, because a lot of these patients have comorbidities, they were the ones that were least likely to go in to visit their physician because of the comorbidities that they have. It was also during the beginning of the rise of many of these MIS procedures, the minimally invasive procedures that are earlier in that pathway. So there's spinal stenosis procedures, there's procedures for peripheral nerve stimulation and others that it could be earlier into the cycle, and we talked about that in the patient journey, and we talked about that on the last earnings call. And what we see now is we can look at claims data, and we see patients that have had multiple procedures along the way, but eventually still go to spinal cord stimulation to get the overall pain relief that they need. And that's why we jumped into the SI joint market. It's one of the fastest-growing markets in the interventional bag. And we see oftentimes, when we see X-rays and CT scans of our patients, you see the leads put in for spinal cord stim, but you also can see SI joint implant all at the same time. One is addressing the mechanical issues that some people have, the other is the neuropathic causes of pain. And oftentimes patients have both, and the same physician is seeing the same patients that are basically coming in for pain, going, "I don't know what it is. I just know I have pain." And the physicians now, they're calling it the Cadillac, you know, procedure, where you'll take care of the mechanical first, and then you get to the neuropathic second for the best and optimal pain relief, taking care of both. To what extent have therapeutics been an, you know, kind of a headwind to SCS volumes? You know, really, the only thing we see is the patients still have to go through conservative treatment and injections and RF nerve ablations and other things before insurance will cover it. We still see a really good reimbursement and really good patient access for these procedures, particularly on painful diabetic neuropathy, is now covered by all the MACs, and so it just flies through now, so we don't see, like, any kind of injections or any kind of pharmaceuticals. If anything, it's patients are going away from taking opioids and more, you know, going towards, "I need to take care of the source of the problem," versus covering it up. Okay. You know, as a leading indicator of volumes, you know, how have SCS trials been trending? Is there anything to indicate that, you know, the funnel is improving significantly? And how do you regain, I guess, share of trials? Yeah, it's really trials are the same as perms as far as, hey, new technology comes out, and people wanna say, "Oh, I'm gonna try that new one. Let me, let me use the trial system for that." So really, you know, we did lose on trials last quarter. That led into us changing our guidance for the rest of the year, so we've taken that into account with our new guidance. And like I said, you know, we had competitive launches now over the last six quarters, going against two big, large organizations, and we didn't compete to the level that we need to. And so we feel good that we're gonna be launching our new system now here in the next couple of months, and we have to go out there and also compete in for those trials, which then lead to the perms. The trial-to-perm curve has been pretty steady for us for many, many years. So we know that when you get the trials, you get the perm. We also have to start using our full bag now with not only PDN, but also SI joint, to be able to have more mind share with those physicians. And now that we're finally getting up to scale in that part of our business, we're able to have more conversations with competitive doctors versus just our own Nevro physicians, which is who we went out to for the last six, seven months for SI joint. And now we're using it as a little bit of a Trojan horse, where we're now sitting in an OR with a physician that primarily puts in one of our competitors for SCS, but they don't have an SI joint product, so they let us in the door. And of course, our top reps, as soon as you start having those conversations and get a couple of good procedures for SI joint, start asking for some of the procedures for SCS as well. Okay. You know, back to guidance. So, your second half guide assumes revenue down 10-11% in both Q3 and Q4. I guess, why a deceleration from Q2, where you saw a decline of 4%? Yeah, it really takes into account the things we just said. We got to get better from a competitive standpoint. You know, we still, a lot of those reps we brought in towards the end of last year are just now coming in to their time in which they should be able to start ramping. We're expanding our sales force with the ASRs that we hired last year, getting finally ready to get their own territories. We have dealt with competitive launches that we have to fight back and do better to still sell on the clinical benefits of high frequency, which again, is the only RCTs out there to show that it's superior than our competitors. And then we have to make sure that we have those patients through the entire patient journey. We took that into account as we reset guidance for the remainder of the year. We'll see as we exit the next few quarters with trials. We'll start talking about 2025 as we head into Q4. Anything else? Yeah, I mean, really, really, the trial performance in Q2 was our leading indicators. As we go into the second half of the years, and you start to play that out, and we realized we had to bring guidance down. But would you say there's a good amount of conservatism built into this? If I think about the competitive systems that they launched before Q2, I mean, I'm just trying to understand why it decelerates from Q2. Yeah, it really was, you know, the one competitor launch really through Q2, is the last day of Q1, calendar Q1. And so it was the full effect of that launch in the second quarter. And again, we've talked about this. We've seen this over the years, where something new comes out, people try it, and then they go back to what they traditionally utilize. So we know we're going to keep those physicians, and we believe that our Amplify AI will allow us to now have something new to talk about as well, coming on the heels of their launch. So, again, that's why I don't want to talk about too many competitive things that we're doing to fight back there, but we're excited about it. Yeah. Historically, how long does trialing of competitive systems? Is it usually like a couple of months, quarter? It's a few quarters, traditionally. Few quarters. Yeah, I mean, again, you know, one of the things in this space is splitters. If you're doing maybe total knees or spine or other areas of healthcare that I've been in, traditionally, people go, "Hey, I have this whole system. I know how to use it. This is who I use." In this case, you have a lot of the accounts that are splitters, where they give business to multiple accounts based upon maybe the patients or just trying to be fair or what have you, and in those accounts, sometimes one or two trials goes one way versus your way when something's new. But we've seen traditionally, that's bounced back to high frequency pretty quickly. And I think you talked about share pressure mainly coming from, you know, the public competitors. Yeah. But there are private companies that launch into the space as well. Are you seeing any competitive pressure from them? We haven't really seen... I think they're, you know, they're still pretty small. We have a little bit of knowledge about what their revenues are. You know, I think a lot of the revenue for them right now is in clinical study sites that they're trying to ramp up and do clinicals in. But for as far as, you know, our reps coming in saying, "Hey, I can't compete against one of these private companies," that's not been something that's been widespread across the U.S. Okay. Don't forget, some of those private companies have been in Europe and Australia for many years. I'll just share, in Australia, we have 35-40% market share in that other private company's home market, and they've been out there for a long time. We're able to point back to how we've been able to compete against them for many years in other markets. Rod, in terms of gross margins in the second half, you know, revenue coming down significantly, you would imagine would have a pretty significant impact on gross margins. How should we think about the margin side of the business? Yeah. So I mean, we talked about this on the second quarter call. Just to replay that a little bit, we renegotiated one of our major contracts, and we took a $6 million charge in Q2 that, you know, from a just an overall perspective, brought margins down for the second quarter. But if you exclude that, margins were above 70% in the second quarter. And we felt really good about the products we're getting out of Costa Rica, the costs we're getting there, et cetera. You're right, yes, lower volumes generally tends to... lower gross margins, but we've also been talking for the last year about how we also know that we're taking some accounting adjustments here in the second half of the year as well, that are gonna put a little bit of headwinds from a gross margin perspective. So we're really getting more headwinds from that than necessarily just from, you know, bringing guidance down. Yeah, we provided direction on where we think we'll finish for the year, and I think it's pretty easy for people to kind of back into what that means for the second half margins, based upon what we did in the first half of the year. Okay. So, you know, new system launching, product enhancement, should we think about 2025 as a year when you return to growth? Yeah, we're not providing 2025 guidance right now. Let's see how we can perform over the next couple quarters. Let's see this limited market launch to see if it's ready for prime time, here, coming into the end of the year, and let's see how our SI joint business continues to ramp, and then we'll provide guidance for 2025. You know, I believe you mentioned that you don't expect a benefit from the commercial optimization actions you took this year. You don't expect an impact until 2025. I guess, why is it taking so long for that to kind of play out? Yeah, so in this market, it's not just, "Hey, I learned how to do a mechanical procedure, and now I know how to go and guide a customer through this, a physician through this." With neuromodulation, it is an art and a science, and it's around programming the patient right the first time and making sure that you're mapping it with that physician. So it's a longer learning curve for our sales reps to be able to understand, not where to place the leads, but how to make sure that first initial programming is done appropriately. Now, with Amplify AI, we feel good that now the algorithm's gonna do that. And the way that I've been explaining it is, we have one of our chief engineers, who invented high frequency, is the world's leading, you know, premier person to talk scientifically about algorithms and, frequencies. He can program so much better than I'd be able to program. I'm an ex-football player, English major, like, how am I gonna do that? However, with Amplify AI, it brings me up to his level, because now I have the power of the AI and the big data to be able to actually make those decisions based upon just a few inputs. And then once you get on that algorithm, it adapts automatically, and that's why we keep saying it's closing the loop that matters. It's doing it automatically. We don't need closed loop impedance because it's all about pain relief. It now brings every programmer up to that level, and that's why we're really excited about the launch. We have to see it play out first before we start talking about what that means from a revenue perspective. It just takes a little bit longer in this side of the business than it does with maybe if you're doing just a mechanical implant side of the business. If we think just big picture, you know, obviously, there's a pretty significant cash burn in the business right now. How do you... I don't know if the right term is rightsize the business, but how do you get the business to a point where you start to see operating leverage? Is it purely relying on the top line? What can you do on, you know, margins or just leveraging your fixed cost base? Yeah, I'll just from a strategic standpoint, and I'll let Rod talk through the mechanics of that. I mean, don't forget, the first year coming through, we did really three things. One is we acquired a company that only had a handful of people that's come through, so as revenue goes, it doesn't have any real cost. It all drops through because it's into the same sales bag. We refinanced our debt, kicked that out to 2029, and we have restructured the organization. We've taken out more than $35 million, $33-34 million of annual run rate of OpEx. And so you saw just in the second quarter, while we missed our top line number by quite substantially, we still were positive Adjusted EBITDA within the quarter. So you're starting to see that flow through the P&L. I think we're much closer to cash flow break even than most people are modeling out, but we need to make sure we continue to do some work internally to make sure that we get that leverage. Those are the major points I was gonna make as well. So it's the restructuring, leverage on Vyrsa, what we just saw in Q2. You know, if you look at our balance sheet, we've been transitioning from contract manufacturers to our Costa Rica plant, so we're carrying more inventory right now, but we knew we would. So we have a lot of opportunity in working capital to manage that down over the next six to twelve months. So, to Kevin's point, we just turned adjusted EBITDA on a lower revenue number than we thought. You know, we are leaning out the P&L, and then with a lot of working capital room, we've got some pretty good room on the cash flow side as well. Is there a revenue target of which we should be thinking about cash flow positive, for the- You know, we used to talk about... I mean, a number of years ago, we'd said, "Hey, at about $110 million, we were about adjusted EBITDA break even." And then we saw, you know, inflation, merit increases, and that sort, and we kind of hinted that it was probably more in the $115 million range. But we just put up $104 million revenue quarter. We were plus $3 million in adjusted EBITDA. You know, that's based upon Q2. That's saying that, you know, something around $100 million, we're at adjusted EBITDA positive. And then we've got. And obviously, you know, remember, I mean, Q1 is always a big spend quarter for us, so it's a little bit lumpy between quarters. But, you know, I think we've done a pretty decent job of ... of managing that number down over the last couple of years, and then cash flow breakeven, which, you know, that's where we really want to drive this business towards, to where we're controlling our own destiny, from a cash flow-- cash balance and cash flow perspective. Don't forget, our balance sheet right now is $275 million. So we've got enough to be able to operate the business, to be able to invest where we need to go. But this reminder as well, this is why diversification is the right strategy for us. As we drop new products into the same sales force, that gives us ability to diversify not only the revenue streams, but obviously the costs. We were able to leverage our largest asset, which is our over 400 people that we have out in the field, that will allow us to be able to get that new revenue stream without much cost increase. And so that will enable us to get more leverage on the P&L also. Okay. Well, in the last couple of minutes, we can just talk about Vyrsa for a bit. How are you balancing the different priorities between SCS and SI Joint Fusion, and how are you incentivizing your sales force to support, I guess, a recovery in trials? And any color you could give on what the contribution from Vyrsa could be in the second half and maybe in twenty twenty-five? Yeah, like I said, we're still scaling the business. You know, it was a small acquisition. It was a spin-out of a small company there, but we really like the technology, and it's unique, and we're seeing really good patient results. We should have some biomechanical data posted here soon, published soon, and we'll make a big splash with that I think will surprise some people about the ability for stabilization with a posterior approach. We also. Don't forget, this is the exact same call point that we have with our spinal cord stimulation customers. So yes, it's taken our reps a while to be able to look at imaging a little bit differently from a mechanical standpoint instead of neuropathic standpoint. So now we're getting our physicians and also our reps up to speed on that curve. You know, again, we believe that while it may be a little bit of a distraction, as those patients and the physicians we're learning, it is the same call point. It's the same physicians that they've known for years, that they traditionally spend time with. And so we see that as a good tailwind moving forward. Have you seen increased utilization among the first kind of cohorts of people who are using Vyrsa? Yeah, I mean, almost every month, even though, you know, we did go from a distributor model to a direct model with us, so we went backwards before we went forwards a bit here, but over the previous quarters, up until, you know, we don't have all the results for last month, but it's been up and to the right every single month, and we see physicians that did one a month up front, are now doing, you know, one a week type thing, and so we see some of these physicians. Don't forget, these are physicians that have seen the patients for many years, but they were referring those patients to maybe a spine or a neurosurgeon, and now they're excited about, "Hey, I can keep this patient in my practice and be able to take care of them myself, because this is a procedure and approach that I can do in my own ambulatory surgery center." We see sort of those physicians are building their practice for SI joint for the first time. A lot of those patients, you still have to do injections and have failed injections before you can go on to put in the implant. But we see that growing, and we see a lot of physicians excited about putting this into their practice. Has clinical data been an impediment to adoption? And do you envision kind of building out you know, Nevro is known for building out clinical data. Is this kind of path you're pursuing with Vyrsa? Yeah. So you'll see just here, and we don't know when things are published, but it was already accepted for publication. We'll see our first one out here soon, and then we have clinical work already being done. That does take some time to be able to do that, so we will continue to be the leader in clinical studies. Don't forget, though, also, when a physician says, "Hey, I need your clinical studies," and I say: "Oh, really? So you make decisions off FDA-approved clinical studies?" And they say, "Yes." I'm like: "Oh, okay, so you're switching to Nevro spinal cord stimulation then, because we're the only company that has three large RCTs in the space." And so they're like, "Yeah, that's true, I should." And so, you know, if that's the way you make decisions, then you're definitely going to choose us for the spinal cord stimulation side. Okay, great. Well, I think that's time. Kevin, Rod, thank you so much. Thank you. Appreciate it.