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Operator
Ladies and gentlemen, thank you for your patience. You are holding for today's Census Healthcare 4Q 2021 earnings call. At this time, we are gathering additional participants and will begin momentarily. We appreciate your patience and ask that you please continue to hold. Good day and welcome to your Census Healthcare 4Q 2021 Earnings Conference Call. All lines have been placed on a listen-only mode and the floor will be open for your questions and comments following the presentation. If you should require assistance throughout the conference, please press star zero to reach a live operator. At this time, it is my pleasure to turn the floor over to Kim Golodets. Ma'am, the floor is yours.
Kim Golodets
Thank you. This is Kim Galades with LHA. Thank you all for participating in today's call. Joining me from Census Healthcare are Joe Sardano, Chief Executive Officer, and Javier Rampolla, Chief Financial Officer. In addition, Michael Sardano, President and General Counsel, will be available during the Q&A portion of this call. As a reminder, some of the matters that will be discussed during today's call contain forward-looking statements within the meaning of federal securities laws. All statements other than historical facts that address activities Census Health Care assumes, plans, expects, believes, intends, or anticipates, or other similar expressions, will, should, or may occur in the future are forward-looking statements. The forward-looking statements are management's beliefs based on currently available information. Census Health Care undertakes no obligation to update or revise any forward-looking statements except as required by law. All forward-looking statements are subject to risks and uncertainties, including the continuation and severity of the COVID-19 pandemic and its impact on sales and marketing, as described in the company's forms 10-K and 10-Q. During today's call, there will also be reference to certain non-GAAP financial measures. Census believes these measures provide useful information for investors, yet should not be considered as a substitute for GAAP, nor should they be viewed as a substitute for operating results determined in accordance with GAAP. A reconciliation of non-GAAP to GAAP results is included in today's financial results press release. With that said, I'd like to turn the call over to Joe Sardana. Joe?
Kim Galades
Thank you, Kim, and good afternoon, everyone. I'm delighted to be reporting record revenues and earnings for the fourth quarter of 2021 and congratulate the entire Census team on this achievement. As I mentioned during our last conference call in November and then again in the press release issued in early January, our fourth quarter was so strong that we're reporting positive earnings for the full year. Specifically, revenues for 2021 were $27 million, up 182% over 2020, and we earned $0.25 per share. During Q4, we shipped a record 35 units, including three to China. China remains an important avenue for growth, which I'll discuss in just a moment. I'm confident we have the momentum to continue year-over-year revenue growth and positive net income in the coming quarters. A number of forces came together that allowed us to regain our growth trajectory after a few challenging quarters caused by the economic shutdown owing to the COVID-19 pandemic. The most important was the increase in CMS reimbursement for superficial radiation therapy that became effective as of January 2021. The delivery code for SRT, along with other codes associated with SRT, were revalued upward. These changes have had a direct and positive impact for patients' access to care. Leading to charge to get these revaluations was Michael Sardano, who recently was promoted to President and General Counsel. Michael's experience on Capitol Hill was invaluable as he helped us to navigate the complexities of government and to tirelessly knock on the appropriate doors. In addition, the company's Sentinel IT software technology embedded into our new products allows the physician to easily and accurately document which codes they are billing and state the medical necessity for the treatments. Sentinel has proven to be extremely helpful for the operation of SRT in a physician's practice, and we have begun implementing this exclusive technology into all future census products. Our recent sales growth reflects our ability to effectively introduce the attributes of our SRT systems combined with the fair market value leasing program as we continue to educate the market on these new CMS reimbursement schedules. We are also seeing growing patient volumes at customer sites, in part because SRT became so much more prominent in the midst of the pandemic, while surgeries were kept to a minimum. We believe this positive shift resulted in a best practice migration towards SRT that will not only be a permanent gain for Census, but will continue to grow demand for non-invasive treatment approach. While instituting a new fair market value leasing program, we continue to be highly encouraged by the initial reception. Growing numbers of our physician customers have taken advantage of this program and appreciate its ability to provide a positive ROI for the SRT vision by treating just two patients per month. Recall that the vision has several premium features. Along with image-guided ultrasound capabilities, the vision includes Sentinel, a powerful IT platform that provide census with the opportunity for remote diagnostics while providing customers with asset management capabilities as well as HIPAA-compliant patient data collection for accurate recordings of patient conditions and treatments. As we plan for future growth, we are mindful of the ways to leverage one of our core competencies, our sales organization, with a view toward adding another product that would be of great interest to our customers we entered into an exclusive U.S. distribution agreement for a non-invasive drug delivery system, which we have branded as the Transdermal Infusion System. This system is cleared by the U.S. FDA for the local administration of ionic drug solutions into the body for medical purposes and can be used as an alternative to injections, offering patient treatments with no pain, no needles, and no downtime. We have begun marketing the system for skin rejuvenation treatments, pre-laser treatments, pre- and post-plastic surgery, hair restoration, and other applications. The transdermal infusion system is remarkable in that it allows drugs to penetrate the skin's innermost hypodermic layer by increasing permeability. It's faster than traditional iantifluorescence and allows delivery of drugs that are otherwise not able to be absorbed, including Botox, hyaluronic acid, lidocaine, collagen, and others typically used in aesthetic procedures. This system was demonstrated by several KOLs at the Winder Clinical in Hawaii and discussed how to integrate into a typical dermatology practice. We were delighted with the reception the system received and are working to pursue the sales leads generated at the conference. We're looking forward to the American Academy of Dermatology annual meeting to be held in Boston at the end of March, where we'll also be demonstrating the transdermal infusion system. Of course, we'll also be demonstrating our SRT systems and highlighting SRT's impact on treating non-melanoma skin cancer and keloids, as well as the new fair market value leasing programs. We'll have more information for you on KOL presentations as we approach the date of the meeting. Turning now to international markets, sales in China continue to be promising, and as I mentioned, we sold three systems there in the fourth quarter for a total of nine during 2021. Our new distribution partner that we engaged in late 2020 by our VP of International Sales, Benson Swen, are doing a terrific job. During Q4, the Ministry of Health of the People's Republic of China renewed our license to market the SRT100 system for an additional five years. This new license runs through December 2026 and covers the sale of our superficial radiation therapy to treat non-melanoma skin cancers and keloids. China is an important market for our products, accounting for 20% of the world's population. The indication for SRT100 to treat keloids, which we received in 2017, is of particular interest to women and their physicians to prevent and treat keloids following cesarean section. We currently have over 50 systems installed in hospitals and clinics throughout China. In yet another area of our business, our relationship with Colorado State University Veterinary School continues to evolve, and we've been told that they are using our SRT system to treat not only cats and dogs, but also horses. The school has an affiliation with the Denver Zoo and the zoo has called upon CSU to use SRT to treat some of their rarest animals. We will have further data from CSU later in the year. As discussed during last quarter's conference call, we expanded into the aesthetic laser business with the formation of Census Laser Aesthetic Solutions. SLAS, as we call it, is comprised of mobile laser services in central and northern Florida. The rationale is to use SLAS to expand our customer base provide a beachhead for further acquisitions, and improve access to laser technology. We provide customers with both short- and long-term laser rentals by delivering these lasers on an as-needed basis to treat their patients. The integration of our proprietary Sentinel IT solution software into our new Sensus smart lasers is complete, and these lasers are now available through our direct sales force and SLAS. We implemented creative rental and leasing options for our lasers and believe the combination of Sentinel technology, which provides asset management and HIPAA-compliant patient data and storage capability, and also contains the software to support shared service models, including direct patient billing, is an important avenue for growth. We've been actively evaluating expansion of our mobile aesthetic laser business beyond Florida via strategic transactions and geographies where we have an existing SRT customer base. Over the long term, we expect SLAS to become a meaningful source of recurring revenue for the company. Before I turn the call over to Javier to review our financial results in more detail, I want to reiterate how delighted I am with our quarter and record sales. With the pandemic increasingly behind us, a robust backlog of orders, expectations for expansion of sales and marketing this year, and our keen focus on expenses senses the position for continued profitability this year, noting the typical pattern of sales seasonality. With that, I'll turn it over to Javier.
Kim
Thanks, Joe. It's a pleasure to be speaking with all of you this afternoon. As Joe mentioned, Revenues for the fourth quarter of 2021 were a record $13 million, and this compares with revenues of $5.1 million for the fourth quarter of 2020, which was impacted by the COVID-19 pandemic. Revenues for the 2021 quarter reflect the sales of 35 SRT systems, including three SRT100 systems shipped to China, as well as revenue from service contracts and our new mobile ledger business. Although the pandemic continues, and we're mindful that its course is difficult to predict, it appears that its negative impact is largely behind us. Gross profit for Q4 of 2021 was $8.9 million, or 68% of revenue, and this compares with gross profit of $3.2 million, or 63.4% of revenue, for the prior year quarter. The increases were primarily driven by the higher number of units sold in 2021, service revenue on installed units, and the impact of COVID-19 on the 2020 quarter. Selling and marketing expense for the fourth quarter of 2021 was $1.3 million, unchanged from the fourth quarter of 2020. General administrative expense for the Q4 of 2021 was $1.1 million, compared with 0.8 million for the fourth quarter of 2020. The increase was primarily due to higher compensation expense and higher bad debt expense due to write-off of all receivables. Research and development expense for the fourth quarter of 2021 was 1.1 million, compared with 0.8 million for the prior year quarter, with the increase mainly due to higher regulatory consulting fees. Net income for the fourth quarter of 2021 was $5.3 million, or $0.32 per diluted share, and this compares with a net income of $1 million, or $0.06 per diluted share, for the fourth quarter of 2020. Adjusted EBITDA, which is defined as earnings before interest, taxes, depreciation, amortization, and stock compensation expense, was a positive $5.6 million for 2021 fourth quarter. compared with 1.3 million for the fourth quarter of last year. I will briefly review our full year 2021 financial results. Revenues for the 2021 were 27 million, and this compares with 9.6 million for 2020. The 182% increase was primarily driven by the high number of units sold in 2021. service revenue on installed units, and the impact of COVID-19 on 2020 results. Gross profit for 2021 was $17 million or 68.2% of revenue, compared with $5.2 million or 54.8% of revenue for 2020. The increases were primarily driven by the higher number of units sold in 2021, service revenue on installed units, and the impact of COVID-19 on 2020 results. We believe that maintaining this level of gross margin is largely dependent upon the market's response to the ongoing COVID-19 pandemic. Selling and marketing expense was $4.8 million for 2021, compared with $5.3 million for 2020. The decrease was primarily attributable to reduced spending on marketing activities and headcount. General administrative expense was $4.6 million for 2021, compared with $4 million for the prior year, with an increase primarily due to higher professional fees and insurance premium costs. Riches on development expense for 2021 was $3.4 million, down from $4.2 million in 2020, reflecting lower spending as the SCUPTURA project entered the production phase during 2020. Net income for 2021 was 4.1 million or 25 cents per diluted share compared with a net loss for 2020 of 6.8 million or a loss of 42 cents per share. Adjusted EBITDA for 2021 was 5.1 million compared with a negative 5.8 million for 2020. Turning now to our balance sheet. Cash and investments as of December 31, 2021, were $14.5 million, and this compares to $14.9 million as of December 31, 2020. The company had no outstanding borrowings under its revolving line of credit during either year. We're confident that with our ongoing attention to expense management, along with the current cash and access to our existing line of credit, we continue to be well positioned to support expected growth for 2022 and beyond. As a final comment, please see the table in the news release we issued earlier today for the reconciliation of GAAP to non-GAAP financial measures. With that, I'll turn the call back over to Joe.
Kim Galades
Thank you, Javier. As I've said before, I'm very proud of our entire sales team. census team and the way they've navigated through the pandemic to post-record sales for the fourth quarter and the year. Their work to keep the census name in front of existing and potential customers is paying off, and I expect it will continue to do so throughout 2022 and beyond. Our SRT systems are well-positioned in a large market consisting of some 14,000 dermatologists and 1,000 Mohs surgeons in the U.S., representing more than 7,500 offices, not to mention a further 6,500 plastic surgeons and 5,500 radiation oncologists. Our systems provide a compelling alternative to surgery for millions of patients and arguably the only solution to prevent the recurrence of keloids following surgical excision. I'd like to note the recently announced retirement of our co-founder and my dear friend, Steve Cohen. Steve has adeptly led the sales and marketing team at Census, and on a personal note, I will miss him greatly. He leaves the company in great hands with the well-deserved promotion of two tenured region managers to vice presidents, with Chris McKusack, now vice president of sales for the West Coast region, and Jeff Starling, now vice president of sales for the East Coast region. These promotions had already been contemplated for some time as a major strategy to expand our business, with our new products and continuing to grow our relationships in our market. Both Chris and Jeff have played a significant role in making that happen for Census. Before we open the call for questions, I want to flag that we have a business schedule of investment conferences ahead of us. We'll be at the 34th Annual Roth Conference in Dana Point, California, March 13th through the 15th. We'll be participating in Maxim's second annual virtual growth conference being held March 28th and 29th where I'll be sitting on an aesthetic medicine panel. And we'll also be at the H.C. Wainwright Global Investment Conference being held in Miami Beach, May 23rd to 25th. I hope to see some of you there. With those comments, I thank you for your time and attention. And now, operator, we're ready to take questions.
Operator
Thank you. The floor is now open for questions. If you do have a question, please press star 1 on your telephone keypad at this time. If you're using a speaker phone, we ask that while posing your question, you pick up your handset to provide the best sound quality. Again, if you do have a question or comment, please press star 1 on your telephone keypad at this time. We'll take our first question from Alex Nowak with Craig Hallam Capital. Please go ahead.
Alex Nowak
Great. Good afternoon, everyone. After an impressive year here, a great Q4, I'm just curious how you're thinking about growth into 2022. I know profitability certainly, as you mentioned, the press release is going to be a big component of it. But perhaps comment how you're thinking about Q1 2022 and then maybe give a little bit of color on the backlog that you see in the SRT 100 systems today. Compare that to last year in 2021.
Kim Galades
Sure. Thanks, first of all, for being on the call, Alex. We appreciate it. You know, we're very, very hopeful for 2022 that the momentum that we've gathered through the last – Three quarters of 2021 will continue on beyond quarter one because we feel quarter one will have a great start. So the rest of the year, I believe, will follow. So we're very, very excited to go after the profitability in each and every quarter that will work throughout 2022. Numbers yet to be determined, but backlog coming into the new year is very, very strong. And I think that that will continue based on the demand that we have from our customers throughout 2022. I think the momentum will continue to grow as the year grows on.
Alex Nowak
That acceleration of demand for the SRT system, can you call out if it's all coming from the better CMS reimbursement? Or are you starting to see this sea change in how non-non-aluminum skin cancer is being treated now?
Kim Galades
Well, I think it's a combination of both. Number one, the increase in reimbursement certainly helps, but you still have to get in front of the customer or the client and prospect, and you still have to explain what that means to them, and you have to help them understand how it fits into their practice. Obviously, the increase in reimbursement helps them pay more attention to it, and then when you combine that with the fair market value lease that we brought in, which allows them to experience perhaps a better ROI on their total investment is also real important. But I think the main factor here for a lot of it has to be what everybody went through because of COVID. If you recall, during the time of COVID, there was a period of anywhere between eight to 12 weeks where a lot of the clinics across the country were shut down. And the American Academy of Dermatology even recommended to the physicians that they should cease all Mohs surgery, if you will. And at that time, I made the statement that the last machine that was turned off when they shut down their offices was the SRT machine, and the first machine they turned back on was the SRT machine when they reopened. So those best practices, I think, will continue, and I think that the doctors really respect the fact that COVID is developing a new standard for everybody. It's a new normal, and I don't think you're going to see people piled up in the waiting rooms and the back rooms being ready for most surgery with the responsibility of social distancing, and I think the doctors have also seen, you know, how... how good it is for the patient and how successful their outcomes are in using SRT. And the fact that they're getting paid for all these things, I think, is a combination of the three things that happen, COVID, increase in reimbursement, fair market value lease. I think that, quite frankly, is the holy triangle, if you will, for the success that we've had. And the more that we're able to get in front of prospects, customers in front of the diagnostic or the dermatology community, I think the word is going to get out. You have to remember that after what we've accomplished in 2022, we really had no trade shows to go to. So the face-to-face interaction of the masses was done, I would say, in hand-to-hand combat, knocking on doors, kicking things down, and being able to talk to the physicians one by one. So I think as we open up the doors to more trade shows with the upcoming American Academy of Dermatology, followed by Scale in May, which is in Nashville, followed by the aesthetic show in Las Vegas, and then the fall clinical. Again, all these things opening up and being face-to-face with customers, I think, are only going to make it better for us.
Alex Nowak
That's great to hear. On the transdermal system, can you Maybe talk about the commercialization plan there. Is this going to be a capital or recurring model? Just how to think about potential revenue contribution from each system, the launch of the sales force. Just some more details around how to commercialize it.
Kim Galades
The principle model is going to be the capital element to it, so it's really a capital model, although there is very strong possibility for a recurring revenue. We will be providing patients or the customers with some of the toxins that they may be looking at, although we don't want to become competitors to some of the bigger companies that provide that, so we'll be anxious to work with many of them with our doctors who already have relationships in that area. There's also some smaller components that we'll be able to include with each one of the products that the customers will have to buy. So there is a component that is a recurring revenue, although the main component is going to be the capital sale, which is going to be the model. But we'll see how big the recurring revenue piece gets because the There's unlimited potential there, and we'll pursue every opportunity that we have, especially working with some of the big companies out there that provide the fillers, the Botoxes, and things like that, and some of the other things that they use.
Alex Nowak
All right, understood. And then just lastly for me, just congrats to Michael on the promotion there. But can you just talk to the changes in the president's title, just what that means for the company?
Kim Galades
Thanks, Alex. Well, you know, it's something that we were looking at over the last year or two. And then with Steve's retirement, I think the board felt that since we were going to do it at some point, in the very near future that the time was now to make that happen. It helps for secession, not that I'm going anywhere, but I step in front of a lot of buses sometimes, and they're not looking where they're going, so I have to dodge them. But you never know what those things do, and I think it's always good to have the people in place to make sure that everything stays the way it can be or even improves. So we have a very strong team of people that are able to step up, namely the two people that we promoted into the sales function. I think that we're going to be stronger because we're going to be closer to our customers and to our prospects. So all of that bodes well for the future of the company, and we're very, very excited for the youthfulness and for the eagerness that we have and the energy that everybody's bringing.
Alex Nowak
That's fantastic. Appreciate the update. Thank you.
Kim Galades
Thank you.
Alex Nowak
Thanks again, Alex. Appreciate it.
Operator
We'll take our next question from Anthony Vendetti with Maxim Group. Please go ahead.
Anthony Vendetti
Thanks. Thanks. Let me extend my congratulations to Michael, too. I've met him, so I think it's a well-deserved promotion. I know he worked very hard on the CMS reimbursement.
Michael
Thanks so much, Anthony. I look forward to seeing you soon.
Anthony Vendetti
Yes, that'd be great. But on the other note there, Joe, I would hope that you figure out a way to stay out of the way of those buses.
Kim Galades
So far, I'm still faster than they are.
Anthony Vendetti
I've saved them a few times last year. Based on what I've heard, I imagine that is true. Yeah. So just to the questions, clearly the CMS reimbursement increase has helped, but like you said, you still have to go out there and sell. And during COVID, you know, it was obviously difficult to do that. You figured out how to do that as practices opened back up as evidenced by the really strong fourth quarter. But it seems like also the idea of selling the SRT for a fair market lease has also really helped because as you said, all the practitioner has to do is do two procedures for a month and the system pays for itself. Can you talk a little bit about the impact you think that's had? I know it's probably going to be hard to quantify directly, but how much do you think that's helped? And then out of the sales in the fourth quarter, approximately what percent was an outright sale versus a lease?
Kim Galades
That's a good perspective. First of all, let me say this. The fair market value lease is very common with medical devices and big capital equipment in the hospital world. Hospitals will do everything to make sure that their monthly payments or their costs on a with break-evens as well as profitability. So when they buy an MRI or a PET-CT scanner or an x-ray equipment or anything like that, it's usually with a fair market value lease. I believe that we're the first company to bring fair market value leases into the dermatology world. And we started working on this, quite frankly, at the end of 2020 before it really became something that we were able to present. And when I say the end of 2020 was more like the beginning of 2020 when we started talking to our bankers and providing that solution for our customers. So I think it's really, really important. Now, I would say that, you know, out of all the orders that we took in the fourth quarter, there was only one customer that decided in the end to pay cash. And he was upgrading his SRT system that he'd been using for three or four years to the Vision product. Everybody else was encouraged and did take advantage of the fair market value lease rather than pulling the cash out of their pockets. Now, prior to that, I would tell you that out of all the units that we would sell, about 50% was leased and the other 50% was cash out of pocket. So I think we're seeing a change in perspective with the fair market value lease encouraging the physicians to to buy the vision product versus the SRT because the vision clearly with all its features and benefits provides that the doctors, each one of the doctors with added reimbursement opportunities and therefore added revenue. So, um, I think it's a win, win, win for everybody.
Anthony Vendetti
That's helpful color. Um, just in terms of, you know, a lot of companies obviously dealing with supply chain issues, some with, uh, raw material, increased costs in raw materials. Are you seeing any of that in your business at this time, or you've been able to mitigate that?
Kim Galades
Well, I think one of the advantages that we had, again, with our team, with our COO, Javier, myself, we started getting involved with our supply chain back in April of 2021. We started hearing about all these situations with other companies, and we wanted to make sure that our contract manufacturer didn't have those problems. So we immediately were in contact with them and trying to understand what the problems could be in resourcing any of the components that they were looking at. Now, one of the things that helped was the fact that about 95% of the components that we have are all made in the USA. And so that was a major, major opportunity that we had. Two of the other major components that we have are manufactured in Europe. And early on, we started speaking to either the CEOs, the presidents, and other business leaders within those organizations to make sure that those principal components which are mainly used in the vision product, were readily available, and they went out of their way to make sure that we had product. Now, everybody that we ever talked to for those resources were always worried that every conversation that they had with their suppliers could bring up another situation that they weren't prepared for. But since we had started so early in April and that we were able to work with our customers to gain a relative good picture of what the volumes could be with our forecasts, we took the chance of ordering a lot of things in advance, recognizing the opportunities that we had, and therefore we're able to get ahead of it. So there's two keys for the future here with regard to supply chain. Number one, we have to continue to have the conversation with all of the supply chain people, including the resources that our contract manufacturer has, which we will continue to do. We've been on a rhythm call, if you will, on a bimonthly and now a monthly call because we feel comfortable, they feel comfortable with everything. But the key to everything to stay ahead of things in order to make sure that we have product for our customers is to provide our contract manufacturer with as good a forecast and as good an order as soon as possible in order to stay ahead of the game. Because if we get caught behind, that's where the tough part is. We might not be able to catch up. So I credit the management team here for staying ahead of it and being on top of it before it became a problem. But I think the key here is we have to continue to do that so that it doesn't become a problem with the demand that we're anticipating.
Anthony Vendetti
No, that's great. You've been able to navigate that and anticipate it. Just lastly, and then I'll hop back in the queue, on the transdermal infusion system where you have now exclusive rights here in the U.S., what's the timeline for rolling out that device, and what's your expectation in terms of generating material revenues this year?
Kim Galades
We're currently rolling it out to several KOLs in the market who are extremely interested in working with the device because of the applications that it represents. We're working with the manufacturer to make sure that we have all the products in place. The biggest situation for us in this is working on all of the collateral that we need in setting up a marketing plan for it. We want to make sure that we have all those materials in advance so that our sales force is completely prepared every time they get in front of a potential customer with training products. We have demo products that are already going into the field for demonstrations, and we're working with KOLs all over the country that are extremely interested in the product. So if you look back at the situation in Europe, Europe, especially Italy, is just coming out of a second COVID, let's say, lockdown. And so things are getting back to work. And this is a fairly routine product for them to manufacture. So we don't expect many delays for any length of period. And we're excited for being able to present this product at the American Academy of Dermatology, which is literally in about five weeks. And customers will be able to get a hands-on demonstration in mass at the American Academy of Dermatology, where I think that we'll have a huge impact with the device. This is a device that is not very expensive for the customers to use, but has a whole huge pile of applications that the customer can use with their patients. And, I mean, just imagine everything that you use with needles, and now you don't have to use a needle, which means there's no pain. there's literally no downtime for the patient, and it's just a much better way of applying all these toxins that the patients are demanding and that the doctors are looking to use. So we're excited for the opportunity.
Anthony Vendetti
That sounds great. Okay. I'll hop back in the queue. Thanks again. Appreciate it. Thank you, Anthony.
Operator
As a reminder, if you do have a question or comment, please press star 1 on your telephone keypad at this time. We'll take our next question from Yi Chen with HC Wainwright. Please go ahead.
Yi Chen
Thank you for taking my questions. Could you comment on the expectation for the frequency of orders from the Chinese market? Do you expect it to be relatively stable from quarter to quarter or it could be volatile in the coming quarters?
Kim Galades
Well, anything outside of our country could be volatile. We have to understand that the pandemic in China is alive and well. It's being very aggressively pursued there with a lot of people that have COVID conditions, so there's even cities that are shut down. However, Benson has done a very, very good job in navigating through those situations with our distribution partner there. We sold nine systems, as was mentioned in the preliminary presentation, for 2021, which is a big year for us and really the first year that we've been able to get back to that number for the last four or five years. I expect us to surpass that in 2022. I don't know what number that will be, but I expect to surpass it in 2022. Plus, we have to consider that we have a couple of other countries that we've opened up, like Taiwan, for instance, and I'm fully expecting some orders out of Taiwan for this year as well. So we're excited for that opportunity. It's a valuable market for us, and we cherish it very, very much, and we want to pay attention to it and give it the attention it deserves.
Yi Chen
Got it. Thank you. And next question, could you comment on how many sales reps you currently have and whether you expect to increase the sales force during the rest of 2022, specifically with respect to the marketing of the transdermal infusion system?
Kim Galades
Yeah, the total market reps or people that are involved in our sales department is about 20 right now. We want to increase that. We hired an extra person today. We're looking to add three to four more people before the end of the quarter. I would like us to see being between 25 and 30 people before the end of the year and possibly before the end of the first half of the year. I think that we need to be ready to gear up. We don't have to add any other people because of transdermal. That's going to go through the existing sales pipeline that we have in channel. So that's the nice thing about it is that we don't have to add any extra people. We can work through the channel that we already have.
Yi Chen
Got it. Thank you.
Kim Galades
Thank you, Yi.
Operator
We'll take our next question from Ben Hainer with Alliance Global Partners. Please go ahead.
Ben Hainer
Good afternoon, guys. Congrats on the quarter, and congrats, Michael, on the promotion. Just had a quick one for you, Michael. I know you have been fairly busy keeping your CEO out of traffic, but obviously you've done a lot of work on the CMS front, and I know there's a lot of credit – that accrues to you for that. But can you talk a little bit about some of the efforts that went into that and the activities that you're involved in to ultimately secure the CMS reimbursement boost?
Michael
Well, thanks, Ben. And first off, I appreciate the question. I was beginning to think I wasn't going to get one, so that's thrilling to have one. Good talking to you again. So I've been with Census for about a decade, and I know that since we started here, we've been working on reimbursement codes. So when I was on the Hill with Senator Lamar Alexander's office, luckily I still had some contacts in his office, and he went over to the HELP Committee, which is the Health, Education, Labor, and Pension Committee of the Senate. So I was very fortunate to have those contacts, and I was able to utilize them for Census's benefit, really. There's still some upside on the reimbursement side of things, and we're hoping to capture that as well, of course.
Ben Hainer
And is that going to – I mean, do you get the sense that that could happen on a more accelerated timeframe than the initial battle they fought to get it boosted?
Michael
Yeah, I do think so because we were able to have so many inways on the Hill and really convince them that SRT in general is a great technology and it needs to be offered to the patients. We've convinced a lot of the people at CMS, AMA, et cetera, including the AAD as well, that this technology is here to stay. And we're very, very fortunate to have been heard by those people. And I really don't think that it would take seven years again to ensure our upside.
Ben Hainer
Okay. And then I think it was in the prepared remarks, but the best practice, you mentioned the best practice is sort of moving towards SRT. I would imagine that you guys believe that that helps you You know, ultimately with the payers.
Kim Galades
You know, I think one of the things, Ben, that everybody identifies with in healthcare is that in every other part of healthcare, surgery is usually the last resort and everything else is usually done in advance. there hasn't been a whole lot of technology that's come into dermatology in the last 60 years until SRT reappeared, if you will. And so I think that recognizing the needs of the patients and the growing population of our elderly folks that are coming into more contact with skin cancer, I think that we're going to see, you know, within the next 24 to 36 months that patients being treated on SRT are probably going to overcome being treated surgically. And so, you know, when I look back in the 70s when they really started to work on Mohs and Dr. Frederick Mohs when he developed his practice or his technique, one in 1,500 people had skin cancer. Today it's one in seven. So there's a huge difference on how you have to treat patients.
Kim Golodets
There's a lot more patients than there are doctors, and therefore they have to have better ways to
Kim Galades
and means to help these patients because of preexisting conditions and things like that. So I think that it's inevitable that physicians are going to lean a lot more in the future on SRT. And I made the statement that it took us 10 years to have a little over 500 units installed, and I think that it will be half that time to get another 500 units installed.
Ben Hainer
Okay. Great. That color is definitely helpful. And then I guess on the unit front, you know, maybe I missed this or misunderstood it, but a couple things. It sounds like the vast, vast majority are taking advantage of the FMV lease, and consequently most of them are choosing the division. So of the, you know, 32 or so non-Chinese units, our non-Chinese systems, you know, what was kind of the breakdown between Vision and SRT 100? It was about 80%. Okay. Okay. That makes sense. And presumably that's kind of the mix that you would expect going forward just based upon what you're seeing now.
Kim Galades
Yep. You know, the reimbursement as well as the fair market value lease certainly drives the customer to think more about the vision product and then keep in mind because of the increase in reimbursements, they have access to more dollars in their treatments as well.
Ben Hainer
Yeah. Yeah, makes sense. Good deal. Well, that's all I had, gentlemen. Congrats again on the promotion and the quarter. Thanks a lot. Ben, thank you so much. Appreciate it.
Operator
There appear to be no further questions at this time. I would now like to turn the call back over to Mr. Sardano for closing remarks.
Kim Galades
Thank you, Taryn. So in closing, I want to thank everybody for their questions and being on the call today. Thank you once again for your time this afternoon and for your interest in census health care. We look forward to our next financial results conference when we report our first quarter results in early May. Be well, everybody. Thank you.
Operator
This does conclude today's teleconference. We thank you again for your participation. You may disconnect your lines at this time and have a great day.
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