Milestone Scientific Inc.

Good day, ladies and gentlemen, and welcome to the Milestone Scientific Third Quarter 2022 Business Update Call. At this time, all participants have been placed on a listen-only mode, and the floor will be open for questions and comments after the presentation. It is now my pleasure to turn the floor over to your host, David Waldman, Investor Relations. Sir, the floor is yours.

Good morning and thank you for joining Milestone Scientific's third quarter 2022 financial results conference call. The company issued a press release this morning containing third quarter 2022 financial results, which is also posted on the company's website. If you have any questions after the call or would like any additional information about the company, please contact Crescendo Communications at 212-671-1020. On the call with us today is Ariane Haberhals, Chief Executive Officer who will provide an overview of the financial results and recent developments for the third quarter ended September 30th, 2022. Due to personal conflict, Keisha Harcum, controller of Milestone Scientific, is unable to join the call today. So Mr. Hauerhals will also be covering the detailed financial discussion. Before we get started, we would like to remind everyone that during this conference call, we may make forward-looking statements regarding the timing and financial impact of Milestone's ability to implement its business plan, expected revenues, and future success. These statements involve a number of risks and uncertainties and are based on assumptions involving judgments with respect to future economic competitive and market conditions and future business decisions, all of which are difficult or impossible to predict accurately, and many of which are beyond milestones control. Some of the important factors that could cause actual results differ materially from those indicated by the forward-looking statements are general economic conditions, failure to achieve expected revenue growth, changes in our operating expenses, adverse patent rulings, FDA or legal developments, competitive pressures, changes in customer and market requirements and standards, and the risk factors detailed from time to time in Milestone's periodic filings with the Securities and Exchange Commission, including without limitation Milestone's report on Form 10-K for the year ended December 31, 2021, and Milestone's report on Form 10-Q for the third quarter ended September 30, 2022. The forward-looking statements made during this call are based upon management's reasonable belief as of today's date, November 15, 2022. Milestone undertakes no obligation to revise or publicly update any forward-looking statements for any reason. With that, we'll now turn the call over to Aryan Haverhals, Chief Executive Officer. Please go ahead, Aryan.

Thank you, David, and thanks to everyone for joining us today. I'm pleased to report we are back on a solid growth trajectory in the third quarter with sequential sales growth of 34.4% over the second quarter of 2022. In addition, our revenue for the third quarter of 2022 increased 28.6% over the same period last year, without the benefit of sales to China. As we discussed last quarter, our dental segment faced temporary challenges in the second quarter of this year, due in part to the challenging situation in China and the Russia-Ukraine war. We believe we have in large part overcome these challenges as illustrated by the fact we achieved both sequential and year-over-year revenue growth for third quarter of 2022. The growth in revenue on both the domestic and international fronts reflects our successful decentralized multi-channel sales strategy. Importantly, we continue to add third-party dental distributors in international markets, which we believe will help further accelerate our growth. We look forward to announcing additional international distribution agreements as we continue to build our network across Asia, Africa, South America, and Europe. In the United States, we are working to bring on new strategic distribution and channel partners that sell through their respective networks of dental customers, especially in specialized areas of dentistry, such as implant dentistry and aesthetics, as well as large dental service organizations, or DSOs. DSOs play an increasingly important role within the domestic dental market. The current DSO market penetration of approximately 30 to 32% is expected to grow to 75 to 80% over the next 10 years. So to summarize, within our dental business, we continue to generate solid cash flow on a standalone basis. As we continue to grow our revenues, we expect to benefit from economies of scale due to the recurring nature and high margins on our disposables. Overall, our dental business remains strong We are encouraged by the increased interest in our dental instruments and expect our momentum to continue. Turning to our medical segment, we continued to advance our commercial efforts around the CompuFlow Epidural Instrument and the cath check verification system. As a result of our focused sales and marketing activities, we have trialed our CompuFlow Epidural System in key hospitals, healthcare systems, and pain management clinics. As an example, in August, we announced the adoption of the CompuFlow epidural system and its cath check capability at the University of Health, a leading academy health system based in Louisville, Kentucky. We are introducing CompuFlow across three distinct departments, labor and delivery, acute pain, and in the operating room. UofL Health owns and operates six hospitals and four medical centers, providing patient care to more than 1.5 million patients each year in the state of Kentucky. This is another important validation by a leading medical institution as we execute our strategy to become the new standard of care. With each health system we sign, we benefit not only from the sales, but also growing validation within the market. As part of our sales strategy, we are targeting several tier one university teaching hospitals. Some of these hospitals are among the top 20 in the nation. We believe that as we begin to penetrate some of these larger, more recognized names, it will add greater credibility and reduce the sales cycle with smaller institutions. Our sales pipeline is solid and we are advancing discussions with a number of hospitals and healthcare institutions. We will provide further updates as soon as we commence formal commercial sales with these respective institutions. We also continue to introduce our CompuFlow epidural system targeting the pain management market, which not only includes hospitals, but also specialty centers, outpatient centers, and sports medicine centers. With over 11 million reported epidural procedures each year, the pain market segment is more than twice the size of the labor and delivery market segment. Importantly, we recently announced the issuance of a CPT code from the American Medical Association. This code goes into effect on January 1st, 2023. The code will allow billing and payment pathways for healthcare personnel who choose to use our technology for coverage and discretionary payment by payers such as Medicare and Medicaid, as well as commercial health plans. Specifically, we believe that reimbursement will accelerate our commercial rollout by aiding in the financial decision process, within particular private pain clinics. we are actively preparing our reimbursement plan to take advantage of this new AMA cleared CPT code that will be implemented in the first quarter of 2023. In addition to our direct sales channels, we are also expanding our network of distribution partners. On the heels of receiving the CPT code, in August we announced our partnership with CTI a leading specialty distributor of medical products in the Midwest and East Coast regions of the United States. We believe CTI is an ideal partner, bringing a sizable Midwest and East Coast sales force, extensive relationships with physicians, pain clinics, and hospitals, as well as a proven track record of introducing new medical devices. In Greece, our new partner, FNM Feed, is a leading provider of medical equipment, devices, and consumables. They bring over 40 years of experience in the field of healthcare, having a successful track record, launching new medical devices and equipment. We look forward to announcing additional international distributors as we advance our commercial rollout. We also have invested heavily in our marketing initiatives to build brand awareness for the Compuflow Epidural and CatCheck system and provide our sales representatives with the tools to be much more effective, including training videos, corporate brand videos, education literature, digital marketing materials, and more. We continue to believe the medical segment represents a large addressable market not only driven by cost and convenience for the provider, but driven by the safety considerations and cost savings. These factors, coupled with the recent issuance of a CPT code, will ultimately lead to the CompyFlow becoming the standard of care. Let me now take a moment to discuss some important financial initiatives we have undertaken. As announced last quarter, we continue to reallocate additional resources towards our medical segment, which we believe represents the future of the company, while increasing our focus on DSO and third-party avenues of distribution in the dental segment. At the same time, we have reduced a number of operating expenses and certain corporate overhead in the third quarter, which is evident in the reduction in our burn rate. We expect to see the continued benefits of these cost reductions in the coming quarters, which should help drive us towards improved performance as we continue to grow revenue. Combined with our disposables, which provide high margin recurring revenue, we believe we are well positioned to drive significant shareholder value for years to come. We ended the quarter with approximately $9.8 million of cash on hand and no long-term debt, which provides us sufficient capital to continue executing our business strategy, including accelerating market activities around both our dental and medical instruments. Given our strong cash position, we are also planning to launch new instruments and are pursuing new indications. So to summarize, we have positioned our company for positive growth in the coming quarters. We remain confident in the market potential of the Comfiflow Epidural System, which we believe will transform the industry and ultimately become the standard of care for epidural procedures in labor and delivery as well as pain management by providing patients with effective pain relief while reducing the significant risk of complications with the associated costs. Importantly, we have begun seeding the market with our CompuFlow epidural instrument within a number of key hospitals, medical centers, and pain management clinics in the United States and Europe, and believe the issuance of CPT, along with other steps we are undertaking, will contribute to our long-term success. At this point, I'd like to provide a quick financial recap of our financial results for the three months. For a more detailed discussion, including our nine month results, please refer to our form 10Q, which has been filed with the Securities and Exchange Commission. Total consolidated revenue for the three months ended September 30th, 2022 was approximately 2.2 million versus 2.1 million for the same period last year. Dental revenue increased approximately $130,000 as we expanded the partnership with new domestic and global distributors. Dental domestic revenue increased approximately $88,000 and dental international revenue, excluding the Chinese market, increased approximately $403,000 compared to September 30th, 2021. The company recorded no revenue from China in the third quarter 2022 as compared to approximately $360,000 for the third quarter of 2021. Medical revenue decreased approximately $23,000. Consolidated gross profit for the three months ended September 30th, 2022 increased to approximately $1.5 million versus $1.4 million for the third quarter of 2021. Consolidated selling General and administrative expenses for the three months ended September 30th, 2022 and 2021 were approximately $3.3 million and $3 million respectively. The increase of approximately $315,000 was a result of the increase in warehousing, quality control, and professional fees for regulatory and other services. At the same time, we reduced employee salaries and related expenses, as well as certain marketing and other expenses, which also decreased during the period. As I mentioned earlier, we have increased our focus in dental on third-party distributors and reallocated additional resources towards our medical segment. Consolidated research and development expenses for the three months ended September 30th, 2022, and 2021 were approximately $166,000 and $356,000, respectively. The decrease of approximately $190,000 is related to the delay of certain enhancement to the SDA single-tooth anesthesia system. The loss from operations was approximately $2 million for the three months ending September 30, 2022 and 2021, respectively. The net loss was approximately 2 million or 3 cents per share for the three months ending September 30th, 2022 and 2021 respectively. On September the 30th, 2022, Milestone Scientific had cash and cash equivalents of approximately $9.8 million and working capital of approximately $10.8 million versus working capital of $15.8 million on December 31st, 2021. For the nine months ended September 30th, 2022 and 2021, we have cash flows used in operating activities of approximately $4.9 million and $3.6 million respectively. So to wrap up, we believe we have developed a cost-effective and highly scalable platform to drive growth within both our dental and medical divisions. We are witnessing growing interest in both our instrument and our disposables, and we believe we are well positioned to take advantage of the opportunities available in the market. Within our dental segment, we are back on the solid growth trajectory with sequential sales growth of 34.4% in the third quarter compared to the second quarter of 2022. Year over year, revenue for the third quarter of 2022 increased 28.6% over the same period last year, excluding sales to China. As you can see, we continue to grow our dental segment and believe this business will not only contribute to our revenue growth, but also provide a steady stream of cash flow that will continue to help fund our initiatives within the medical segment until that becomes self-sustaining on a standalone basis. Within our medical segment, we have built a solid sales pipeline, added hospitals, expanded orders on our distribution partners, and look forward to formal implementation of the new CPT code, which will support planned initiatives on the reimbursement front. At the same time, we continue to streamline our operating structure, and remain committed to driving shareholder value. We are encouraged by the outlook of the business and look forward to providing further updates as developments unfold. I'd like to thank you for joining the call today. At this point, we would like to open the call up to questions. Operator?

Ladies and gentlemen, the floor is now open for questions. If you have any questions or comments, please press star one on your phone at this time. We ask that while posing your question, you please pick up your handset if listening on speakerphone to provide optimum sound quality. Please hold while we poll for questions. Your first question for today is coming from Anthony Vendetti at Maxim Group.

Thank you. Thank you, Arianne. I was wondering if you could talk a little bit more. I think it's a major deal to have a CPT code for the epidural. It goes into effect January 3rd, so right around the corner here.

Can you tell us what the actual code is? Is it a temporary code that's good for five years and what the reimbursement amount is going to be at this point?

Thank you for your question, Anthony, and good morning. So the reimbursement code is defined as a pressure sensing guiding system during epidural analgesia. So what I'm always explaining is that we have been fathered a technology code, which is then called a category three code, which is a temporary code. And to your point, yes, the trajectory is normally one to five years to make that from a category three code, a category one code. The beauty is that the healthcare personnel and providers that want to use our technology and sending in, you know, the billing and the coding based on their cost structure, they can already apply for a billing and a coding to their local insurance company, so the Medicare, Medicaid, and the private insurance company. Now, in particular, what we do is in that whole process of the temporary code, which is, of course, a unique opportunity for the company moving forward because the future is extremely important and bright if I look at just the simple fact that we have been issued and granted to that extent the technology code. But what we are doing then is with a number of clinicians that we are going to work with is providing them with all the information that they need to be able to send it into the local insurance company. that is, for example, paperwork that is needed like a letter of medical necessity, a letter of justification because it is a new technology. You have to explain to the clinicians and the insurance companies what the benefits are of this technology compared to existing technologies. and also why it is so important to use our technology compared to existing technologies. Now, to your second part of your question, the pricing. We as a company, we cannot set the price to that extent. That is what the clinicians will do in their discussions with the health insurance company, but we can give guidance on, again, on the paperwork that we are providing, and the goal is that they get, you know, a recovering of the cost of the consumables plus something extra, and that something extra needs to be defined. What I can explain to you is if you look at the current reimbursement policies and the reimbursement fees, For example, Medicare in the New Jersey area for the private pain clinic, Medicare is reimbursing $304 for an epidural procedure. On top of that, in addition to that, when the clinician is using fluoroscopy in that procedure, the clinician gets an additional $150. So our goal is to so to say, position ourselves between that $150 and $300, if everything works out to that extent, so that the private pain clinics or the clinicians in the private pain clinics get an additional opportunity to reimburse and to send in our documentation to the insurance company, i.e., are able to make more money. It is important for everybody to understand that because the issue really here is today in healthcare environment, everybody knows that just having a more efficient or safer technology is not sufficient to get adoption in the marketplace because Clinicians need to have an opportunity as well to make money with the new technology. So that is the whole area and scale of where the CPT code and the CPT code reimbursement comes in. So we are working hard in prepping all the paperwork and the documentation that we are needed. For example, We also will establish a hotline because if the clinician, when the clinician sends in the documentation to the healthcare insurance companies, to the healthcare insurance providers, you get either an acceptance or a denial. Now, we as a company are not allowed to, negotiate with the insurance company directly about that denial or that acceptance of the insurance company the only thing that we are able to do is provide services to the clinicians enabling him to come up with the right argumentation to make a denial an acceptance when he has sent in his papers for reimbursement what we called the billing and the coding that he needs to submit to the healthcare provider. So it is a rather interesting area. It is a fantastic area for the company moving forward. It is a journey to that extent because things will change over time. But what is important for us is that we are able to set ourselves up to provide the right services to the private pain clinicians and, yeah, physicians. Does that answer your question, Anthony?

Yeah, sorry. No, that's great. And it sounds like you're doing everything from your end, providing the paperwork as well as a hotline for providers as they go through it because it's a new process for them with this particular, with your particular device. So, yeah, helping them to make sure that they get properly reimbursed makes a lot of sense. In terms of now negotiations with customers, has that sort of paved the way or made it easier, at least, I know it's early, but at least from initial conversations, has it made it easier to sell products the copy flow system now that there's a code, you know, right around the corner here?

Yeah, thank you for your question. Yeah, I've been, as I always do, I've been pretty extensive in the fields as well. So I enjoyed several meetings during weekends. There was the American Society of Anesthesiology. Ten days ago, there was the New York, New Jersey American Society of Interventional Pain Physicians. But I can share with you just a simple fact that we were able to announce that we have a temporary code, the code, it's called 0777, which I already explained earlier, is opening doors that normally are staying closed. People, just a simple fact that we are having clinicians also You know the industry in general is looking at us and is impressed that we as a smaller entity have been able to get awarded that that the temporary code now the second part of course is yes, it will definitely open up a lot of opportunities with some ASC's so ambulatory surgical centers as well as private pain clinics and It also opens up to work together with them because they are eager and enthusiastic to be part of establishing a reimbursable fee for this technology to be used within their practices. So it's definitely, I would say, it's definitely a win-win for both the company and the clinicians, but more importantly, of course, for the patient because at the end of the day, you know, improving quality of life for patients that is still, you know, one of the main, yeah, motivation factors for our company and every person that is working and representing Milestone Scientific.

Yeah, no, I agree. I mean, it should become the standard of care. Just lastly, you said you have enough cash to explore new products and applications. I know we've discussed in the past. I was wondering if you can remind us which applications might be at the forefront now. Which ones are you starting to contemplate pursuing at this point?

Yeah, so the applications, like I explained several times as well, they are numerous, right, as we speak. We get requests from other companies to look into, you know, different areas. We have been granted a patent in peripheral nerve block in Europe. We recently also have been granted a patent in the US for peripheral nerve block. So peripheral nerve block is potentially on our radar screen. We talked about neurology in general for spasticity. We have a cosmetic patent for botulinum toxin in cosmetic medicine applications. We have, of course, intraarticular. So the opportunities are numerous here. I also do believe that there could potentially be interesting areas to further discuss with potential cooperation partners, not that we have identified them, to further explore these opportunities. One thing, of course, is developing a new technology within a certain indication area, but we also have to make sure that you have the means to sell the products that come out of that research and development pipeline and that you are able to commercialize that and launch that and can enjoy the revenues for that. So the only thing that we have said in the current queue, and you've heard my comments this morning, short term we are looking at some enhancements of the SDA dental instrument. We have not kicked off a major R&D project within the medical area, and like I said, we are still looking into yeah, the potential and the high priorities and prioritizing the several opportunities. I also would like to bear in mind of everybody joining us on this call, of course, is, you know, we still remain a smaller sized company where each employee is wearing three to five hats. So I always say to my team, we better execute on the things that we can execute on and we do it right instead of taking too many things on our plate that would be difficult to execute on within the given time frames.

Okay, thank you for all that, Kala, Ari, and I'll hop back in the queue.

Thank you. Thank you, Anthony.

Once again, if there are any questions or comments, please press star 1 on your phone at this time. Your next question is coming from John Korb, a private investor.

Hello. Good morning, John.

Good morning, Alan. How are you?

I'm doing well.

Good. I wonder if you could help me understand where Milestone is as a company and how this rollout might impact have changed and how your expectations in the beginning were maybe not correct because you went from 10 salesmen to five. I'm not sure if you even have the five. What happened there and how has your view going forward changed from the original time when you started out with that sales force of 10, and then it kind of dragged on and on, and then you cut back to marshal your resources and save costs. And where are we now? I have a bunch of questions, and I don't want to jump them all up, but help me understand. Let's say you go into the university, the system in Louisville. Introduce it. Then what happens? Does it just sit in the hands of one person? Are they actually using this CompuFlow system, or where does that go when a hospital accepts your technology? Do they say, we can't do anything, can we get the code? Help me understand where we are with all that, please.

Absolutely, and thank you for your question, John. So, in a way, you asked two questions. Let me start with the first one. You're absolutely correct that my initial vision was to build up a direct sales force with 10 people. At a certain moment, we had 11. And then, as I announced in the prior quarter, we parted ways. We did not only in light of cost measurements, but more importantly, also of performance issues. taking too much time, not necessarily having the right attitude and the right skill set to sell the products directly. Now, what we should not forget at that time, we also were able to do that because we liaised with CTI. And CTI has presence in 22 states. They have about 32 sales reps. We have trained the entire organization of CTI. So instead of you know, having 10 direct sales reps in my organization. I now still have four, and I have a group of 30 plus, you know, feet on the ground through CTI that are representing us, and that will definitely help us not only with the penetration in the marketplace, but also on our cost side on the balance sheet, right? So that's one part of the comment. Your second question For example, University of Louisville in Kentucky, the process is absolutely our person in the field. He has done a tremendous job in being very persistent. Just to give you again a flavor, that is a process of getting eight weeks prior to getting a trial. We've done the trial with them at that time. We were vetted. We have had meetings with the CFO of that hospital. and we were able, and they were pleased with our technology, and we were able to be approved in that hospital. Now, the process, of course, is, and your question is, how will that look like from an ordering pattern point of view? In this case, the University of Louisville, Kentucky, they placed an initial order, which I would call a high-volume order. So they started in August, and they placed an order of 200 consumables. So, in other words, 200 procedures they immediately committed to, and they are working through that volume. In the first two and a half weeks, they did about three and a half, no, in the first two and a half weeks, sorry, they did about 30 cases in the ramp up, and normally what you see in these hospitals They will use it for the typical cases in complications, so either patients with a high BMI or other patients that have complications with epidural procedures, and then roll it out to a higher acceleration pattern for daily clinical routine use. That's where our salespeople come in, in making sure that there's enough product on the shelves and that they continue to use our products every time when a patient comes in. So what people always ask me, you know, why is it not that they go from one day to the other day and penetrate for 100% their clinical department? The anesthesiology department, probably everything between 10 to 15 anesthesiologist you normally have two to four champions that are championing and using the technology so when our sales guy has been able to get it approved in the department he still has to work also with the other anesthesiologist thereby increasing the volume but the University of Louisville Kentucky using it in the OR room in labor and delivery and in pain, that's of course gigantic for the company and also very positive with what I expect for the next purchase orders that are coming their way, our way, sorry. A good example also is UTMB, where they a year ago initially got it approved for patients with high BMI. So they went the route that they wanted to have it in their teaching institution facilities. And now after they have done that, now they can enter that area where they can use our product for daily clinical routine use. So I hope that that answers your questions and shines some light on the question that you post.

It does. Thank you. I have an additional question. You have used the word, and I believe this is how it might play out, you've used the word snowballing, that to get it started in various places is the most difficult, and then it might snowball because new prospects are told, well, Louisville's using it and others are using it. Contact them and find out how they like it. and then the sales are easier and they're beginning to grow in a hockey stick effect. Is that still what you're looking for?

Yes, but let me explain it in more detail. Absolutely. Do I believe in the snowballing effect or the domino effect when we get institutions like Louisville or larger institutions that we are working with also close in the area where we are situated in? Absolutely, I believe in that. What we should never forget is the long decision-making process that is taking place in these hospitals. We were recently in Texas. It took us nine weeks just to get registered to be able to do a trial. So, yes, I do believe in the snowball effect if we are and when we are able to get more institutions that are supporting and are using our product. Absolutely. However, what is even more importantly, I strongly believe in, that we have a second pathway or a third pathway. The second pathway being with the reimbursement code, the entrance of the paying market segment. That will definitely be a very important driver for growth for the company moving forward. And why is that? You do not have that decision-making process from, let's say, six to nine months. You do not have to go through a committee. The owner of a pain clinic can make the decision right away. There are no necessarily immediately financial constraints. And thirdly, the direct benefit for the private pain clinic is that he can make money with a technology that we are offering. So all in all, let's say a year ago, we were very much so dependent on one road to market, I always call it, which was labor and delivery in the hospital centers, in the midsize, the larger, the regional hospitals with their longer decision-making process. A year later, thanks to CPT code and thanks to other things that we have undertaken, and thanks to being granted that code, we are now in an opportunity to have a really, really unique selling proposition for the private physicians and the private clinicians. Now, to your point, to that hockey stick, at a certain moment in time, in 2023, there, expect to see then that uptake of all these parameters going together and the execution of the strategy that we are currently undertaking that will then result in the medical revenues of the company. So I do believe that apart from the snowball effect that I probably mentioned in one of my earlier calls, that snowball, the initial size of the snowball is getting bigger and I expect much more out of that in 2023.

So then, if I understand you correctly, the immediate hope and thrust of Milestone is to work with pain clinics and get that going to a great degree, and the epidural and hospitals might take a little longer. Do I understand you correctly?

Yes, but don't forget that we already have been in these hospitals, so we will continue working with the hospitals, and we have a number of hospitals right now where we are in trialing and evaluation. So I'm not saying we give up labor and delivery, absolutely not. My point is just that we are going to do that in parallel, and both of them are important, but short-term decision-making processes is definitely an advantage in the private pain clinics compared to the hospital. So I would expect that we have faster results within a private pain clinic as there is a shorter decision-making process than in the hospitals for labor and delivery. And of course, in the hospitals, we will also go into the pain clinics and into the operatory room. It is just the process internally is different between these two entities. That's more my point. So one does not exclude the other, not at all. But we are better positioned to take more benefit of both market segments compared to a year ago.

Okay. I guess I understand a little better. I must say I'm a little disappointed in the – length of time the rollout is taken and maybe you are too I'm not sure but as a firm believer in this product I guess as a long time shareholder I expected the embracing of this new technology to be at a faster track are we on the threshold maybe of that in the coming year or so or is it still going to be more of a drawn out process How do you envision it?

No, I think that we are in a, like I said during this call this morning, I think we are in a good position. I think we are in a better position than, if I am allowed to say so, a couple of years ago as we have more arguments, initiatives, and strategic options at our hand. We should also not forget that we have submitted an FDA for an indication widening so that we are not only focusing on lumbar and thoracic and cervical. Of course, it's out of our control, the timing of the FDA and what they will come up with, but those things are important because the unique benefit of our technology in the lumbar spine uh are known but the benefits of our technology in the thoracic and the cervical spine are even higher and everybody understands that immediately because the mobility rates are much higher the higher you uh enter the uh the spine right lumbar spine mobility rates are five percent uh thoracic 17 percent uh and cervical uh is 30 to 32 percent so that That gives us also unique opportunities. You mentioned that you were disappointed that it took a little bit of time. I would say I'm pleased with what we have been able to achieve, in particular in the last year, compared to where we were a year ago with the opportunities we have in the marketplace.

There are no further questions in queue. I would like to turn the floor back to Mr. Haverhals for any closing remarks.

Yes, well thank you very much for your time and I enjoyed the questions and the sessions and please do not hesitate to contact me personally in case you have additional questions and like I said, I think we are in a good position to continue to create shareholder value in the coming months and years, and I wish you a very good Tuesday. Please stay safe, and I'm sure that we will meet again and talk to you soon. All the best. Bye-bye.

Thank you, ladies and gentlemen. This does conclude today's conference call. You may disconnect your phone lines at this time and have a wonderful day. Thank you for your participation.