VVOS

Good day everyone, and welcome to the Vivos Therapeutics second quarter 2026 conference call. At this time, all participants are in a listen-only mode. A question and answer session will follow management's remarks. This conference call is being recorded, and a replay of today's call will be available on the investor relations section of Vivos's website and will remain posted there for the next 30 days. I would now like to hand the conference over to Brad Amman, Principal Accounting Officer and former CFO, for introductions and the reading of the safe harbor statement. Please go ahead.

Thank you, Ludy. Hello everyone, and welcome to our conference call. A copy of our earnings press release is available on the investor relations section of our website at www.vivos.com. With me on the call today is Kirk Huntsman, Vivos Chairman and Chief Executive Officer, and Roman Franklin, Vivos Chief Financial Officer and Principal Financial Officer. Today, we will review the financial results of the second quarter of 2026, as well as more recent developments in Vivos's plans for the rest of the year 2026 and beyond. Following these formal remarks, we will be happy to take questions. I would also like to remind everyone that today's call will contain certain forward-looking statements from our management made within the meaning of Section 27A of the Securities Act of 1933 as amended, and Section 21E of the Securities Exchange Act of 1934 as amended, concerning future events.

Words such as aim, may, could, should, projects, expects, intends, plans, believes, anticipates, hopes, estimates, goal, and variations of such words and similar expressions are intended to identify forward-looking statements. These statements involve significant known and unknown risks and are based upon a number of assumptions and estimates which are inherently subject to significant risks, uncertainties, and contingencies, many of which are beyond the company's control.

Actual results, including without limitation the results of Vivos's growth strategies, operational plans, including sales, marketing, distribution, medical sleep provider acquisition and integration, research and development, regulatory initiatives, cost savings plans, and plans to generate revenue, as well as future potential results of operations or operating metrics such as the potential for Vivos to achieve future positive cash flows or profitability and other matters to be addressed by Vivos management in this conference call, may differ materially and adversely from those expressed or implied by such forward-looking statements.

Factors that could cause actual results to differ materially include, but are not limited to, the risk factors described and other disclosures contained in Vivos's filings with the Securities and Exchange Commission, including the risk factors and other disclosures in our Form 10-K for the year ended December 31st, 2025, and our other filings with the SEC, including our second quarter 10-Q filed with the SEC today, all of which are or will be accessible on the investor relations section of the Vivos website as well as the SEC's website. Except to the extent required by law, Vivos assumes no obligation to update statements as circumstances change. Finally, please be aware that the U.S. Food and Drug Administration has given certain specific Vivos appliances 510(k) clearance to treat mild to severe OSA in adults.

With the FDA clearance of certain Vivos products for severe OSA in November of 2023, treatment of patients with severe OSA with these specific appliances is no longer needed to be performed off-label at the clinical discretion of the treating doctor and is now an integral part of the Vivos treatment protocol. Treatment of OSA of any severity or any other condition with any other of Vivos FDA-cleared devices remains at the clinical discretion of the treating doctor. For further information on our results for the three-month period ended June 30th, 2026, please see our earnings release, which was distributed earlier today, and our quarterly report on Form 10-Q, which is available on the SEC Filings portion of the investor relations section of our website.

In the second quarter of 2026, Vivos completed its fourth full quarter of activity, following our June 10th acquisition in 2025 of The Sleep Center of Nevada, demonstrating that the pivot in our sales, marketing, and distribution model has taken hold. Revenue increased by approximately $1.3 million, or 35%, to $5.2 million for the three months ended June 30th, 2026, compared to $3.8 million for the three months ended June 30th, 2025. The increase in total revenue during the second quarter of 2026 was impacted by an increase of $1.9 million in service revenue and a decrease of a $500,000 in product revenue to our VIPs.

The increase in product revenue is attributable to a decrease in appliance sales of $1.1 million as a result of our strategic pivot away from VIPs to sleep centers, which is reported as treatment revenue under service revenue, offset by a decrease of a $500,000 in discounts offered. The increase in service revenue is attributable to $1.5 million in sleep testing services, primarily generated from SCN and an increase of $800,000 in revenue generated from Vivos treatment to patients launched at two SCN locations, offset by a decrease of $100,000 in VIP enrollment revenue and $100,000 from sponsorship, seminar, and other service revenue. For the six months ended June 30th, revenue increased by $3.5 million, or 51%, to $10.3 million, compared to $6.8 million for the six months ended last year.

The increase in total revenue during the period was impacted by an increase in $4.4 million in service revenue and a decrease of $900,000 in product revenue. The decrease in product revenue is attributable to a decrease in appliance sales to VIPs of $2.1 million, again, due to our strategic pivot, offset by a decrease of $200,000 in discounts offered. The increase in service revenue is attributable to $3.5 million of sleep testing services, primarily generated from SCN, and an increase of $1.4 million of revenue generated from Vivos treatment to patients launched at two SCN locations, offset by a decrease of $300,000 in VIP enrollment revenue.

For the three months ended June 30th, 2026, we sold 5,180 oral appliance arches for a total of approximately $1.4 million, a 28% decrease in revenue from the three months ended June 30th, 2025, when we sold 4,116 oral appliance arches for a total of $1.9 million. The decrease is directly attributable to a higher volume mix of preformed appliance sales, which are lower revenue-generating products when compared to Vivos CARE appliances. For the six months ended June 30th, 2026, we sold 10,484 oral appliance arches for a total of $2.8 million, a 24% decrease in revenue from the six months ended June 30th of last year, when we sold 7,852 arches for a total of $3.7 million. The decrease is directly attributable to higher volume mix of the preformed appliance sales, which are lower revenue-generating products compared to our CARE devices, as I mentioned earlier.

Cost of sales increased to $500,000, or 29%, to $2.2 million for the three months ended June 30th, compared to $1.7 million for the same period in 2025. This was primarily attributable to higher costs associated with diagnostic services and patient therapy, including the addition of staff at the Vivos treatment centers. For the six months ended June 30th, 2026, cost of sales increased $1.1 million, or 33%, to $4.3 million, compared to $3.2 million for the six months ended June 30th, 2025. This was primarily related to the higher costs associated with diagnostic services, patient therapy, including additional staff at the Vivos treatment centers. For the three months ended June 30th, 2026, gross profit increased by $800,000 to $3 million. This increase was attributable to the increase in revenue of $1.3 million and an increase of cost of sales of $500,000.

Gross margin increased to 57% for the three months ended June 30th, 2026, compared to 55% for the three months ended June 30th, 2025, due to the increase in both revenue and cost of sales. For the six months ended June 30th, 2026, gross profit increased by $2.4 million to $6 million. This increase was attributable to the increase in revenue of $3.5 million and an increase in cost of sales of $1.1 million. Gross margin increased to 58% for the six months ended June 30th of this year, compared to 53% for the six months ended last year, due to the increase in revenue and smaller increase in cost of sales. General and administrative expenses increased $700,000, or 11%, to approximately $7.1 million for the three months ended June 30th, 2026, as compared to $6.4 million for the three months ended June 30th, 2025.

The primary cause of this increase was $600,000 in salary and wages related to the acquisition of SCN and the opening of Vivos treatment centers, and $300,000 in higher rent expense, offset by a reduction of $200,000 in bad debt and allowances. For the six months ended this year, general administrative expenses increased $4.8 million, or 42%, to $6.1 million, as compared to $11.3 million for the six months ended last year. The primary driver of this increase related to the cost associated with acquiring and integrating SCN and establishing the Vivos treatment centers, including an increase in salaries and related compensation of $3 million for hiring additional staff, an increase of $900,000 for professional fees, an increase in rent of $600,000, and other costs of $300,000.

Sales and marketing expenses decreased $100,000 to $200,000 for the three months ended June 30th of this year, compared to $300,000 for the three months ended June 30th of 2025. This is attributable in significant part to our focus on reducing costs. Sales and marketing expense decreased $200,000 to $400,000 for the six months ended June 30th, 2026, compared to $600,000 for the six months ended June 30th, 2025. This decrease was primarily driven by our decrease in sales and marketing campaigns, lower commissions paid to our employees, digital media services, and reduction in use of marketing supplies due to our pivot. Depreciation and amortization expense increased $200,000 for the three months ended June 30th, 2026, and depreciation and amortization expense increased $500,000 to $1 million for the six months ended June 30th, 2026. Depreciation and amortization increased due to assets being placed into service during the period.

Other expense increased $900,000 for the quarter and $2 million year to date, due to additional interest expense on a note during the three and six months ended June 30th, 2026. This was offset by an increase in other income of $300,000 during the three and six months ended June 30th, 2026, related to the valuation change in an earn-out related to the acquisition of SCN. The financial statements have been prepared in conformity with GAAP, which contemplate continuation of the company as a going concern. We have incurred losses since inception, including $5.5 million and $5 million for the three months ended June 30th, 2026, and 2025, respectively, and $13.3 million and $8.9 million for the six months ended June 30th, 2026, and 2025, respectively, resulting in an accumulated deficit of $138 million as of June 30th, 2026.

Net cash used in operating activities amounted to approximately $9.2 million and $7.3 million for the six months ended June 30th, 2026, and 2025, respectively. As of June 30th, 2026, we had total liabilities of approximately $28.1 million. As of June 30th, 2026, we had approximately $1.8 million in cash and cash equivalents, which will not be sufficient to fund operations and strategic objectives over the next 12 months from the date of issuance of these financial statements. Without additional financing, these factors raise substantial doubt regarding the company's ability to continue as a going concern. We have implemented cost savings measures in our legacy business that have reduced cash in operations. During the first six months of 2025, many one-time costs related to the acquisition of SCN were recognized and were not reoccurring in 2026.

As such, we have funded our operations through equity raises. In the period ending June 30th, 2026, and fiscal year ended December 31st, 2025, we were required to obtain additional financing to satisfy our cash needs, including funding the SCN acquisition and increasing our stockholders' equity for Nasdaq compliance purposes, as we seek to increase revenue with a view toward ultimately achieving positive cash flow from operations. During the six months ended June 30th, 2026, the company sold an aggregate of 694,564 ATM shares at an average price of $0.69 per share through the ATM sales agreement, resulting in proceeds of approximately a $500,000 net of commissions. Under the ATM offering, $2.3 million remain available for future sales as of June 30th, 2026. However, the company is not obligated to make any sales under this program.

Given that our stockholders' equity at December 31st, 2025, and June 30th, 2026, was less than $2.5 million, we are presently not in compliance with Nasdaq stock market minimum stockholders' equity requirement. We are seeking to regain compliance by raising new funding in the form of equity and reducing our costs. However, we will be faced with delisting proceedings, which will distract management and cost resources to remedy if we don't remedy the $2.5 million stockholder equity requirement. In summary, we're seeing significant increases in revenue reflecting the acquisition of SCN, which has now contributed a full year of operations to our results. In partnerships with two additional groups as well as related treatment revenue from providing patients with OSA treatment options, all of which is extremely encouraging. We are also seeing higher costs associated with diagnostic services and patient therapy, including addition of staff at the Vivos treatment centers.

We believe the strategic move to acquire SCN to establish other affiliate alliances sets the stage for stronger performance in the upcoming quarters. For more detailed information, I refer you to our earnings release in our full Form 10-Q filed earlier today. With that, I'll hand the call over to our Chairman and CEO, Kirk Huntsman, to discuss the progress we have made to date on SCN and on Vivos.

Thanks, Brad. Good afternoon, everyone, and thank you for joining us. I'd like to thank Brad Amman, in particular today, for his time here at Vivos and his service to this company over the course of the last six or seven years. Brad has been a key part of our management team, and we're going to miss him. I want to spend a few minutes, if I may today, talking about the operational progress we're making within The Sleep Center of Nevada, something we refer to as SCN, and also discuss several related strategic initiatives, because I think it's important for you to understand how these pieces fit together and what they could mean for Vivos over time. When we first acquired SCN a little over a year ago, we saw an opportunity that went far beyond adding another source of revenue.

We saw the potential to build a broader clinical platform around a growing patient population to provide more services to those patients, to add recurring sources of revenue, expand our capacity, and when clinically appropriate, create additional pathways into the Vivos CARE model. In the second quarter, we saw that strategy beginning to take shape. As SCN patient volume continues to grow, we have seen more opportunities to generate revenue both within SCN itself, where most of the diagnostic services are rendered, and also at our strategically located Sleep and Airway Medicine Centers, what we typically refer to as our SAMC centers, where most of the actual treatment takes place. That connection is important. At SCN, medical doctors and nurse practitioners conduct a variety of diagnostic tests and patient consultations, and then refer patients out for treatment where medically necessary.

At SAMC, SCN and other independent physician-referred patients with sleep and breathing disorders are provided a full and complete range of treatment options, from CPAP to lasers to oral appliances and other adjunctive treatments, including Vivos' proprietary rehabilitation and restorative care devices cleared by the FDA to treat all levels of obstructive sleep apnea severity, including severe OSA. Thus, SCN is far more than just a business that simply sits next to Vivos and SAMC. To ensure optimal clinical outcomes for patients, these two independent groups must fully communicate and support one another. This synergy closes a significant gap in traditional care models throughout sleep medicine today, where there is a significant patient fallout rate due to the roadblocks encountered by patients as they navigate multiple providers and services. I would now like to discuss the clinical and service initiatives to enhance patient care and revenue growth here at Vivos.

To further drive top-line revenue growth, over the course of the second quarter, Vivos management has launched or expanded several key initiatives across multiple markets. These initiatives include, one of the most important clinical initiatives that we're actively pursuing is remote patient monitoring of patients on CPAP. Based on the preliminary data currently available to us, we estimate an addressable population of approximately 16,000 existing CPAP patients from SCN's legacy CPAP patient population. Under our current eligibility and enrollment estimates, based on industry standard adoption metrics obtained from our contract service providers, we estimate that approximately 5,000-7,500 of those patients could be candidates for enrollment over the next six to 12 months, subject to clinical appropriateness, patient consent, coverage, and enrollment.

Based on extensive discussions and negotiations with our service provider, we estimate net revenue per patient per night to come in at between $40 and $50 each. That gives us a sizable existing patient platform population from which to build a strong recurring revenue program. To be sure, we are still early in this process, and the pace of adoption will depend on enrollment, reimbursement, implementation, and our ability to execute. But this is exactly the type of opportunity we want to develop within Sleep Centers of Nevada, a recurring revenue service built around a patient population that is already there. Second, separately, we are targeting a phased launch of a wholly owned DME-based CPAP program in early fourth quarter of this year.

Based on preliminary vendor discussions and our current planning assumptions, if the program reaches the level of scale we are contemplating, we estimate it could generate between approximately $150,000-$250,000 per month in contribution margin. Actual results will depend on successful implementation, patient volumes, reimbursement, vendor economics, and operating execution. If we execute well, this has the potential to add yet another recurring revenue stream to our operations at The Sleep Center of Nevada. Third, we continue to execute and implement our insomnia/EEG testing and treatment program at The Sleep Center of Nevada. Patient encounters, patient tests administered, and revenue generated from this program are all growing rapidly with plenty of upside opportunities remaining. Fourth, we have also expanded and opened our new state-of-the-art Henderson, Nevada, sleep testing and treatment facility, which has effectively more than doubled our production capacity there in Henderson to well over $10 million annually.

That expansion gives both The Sleep Center of Nevada and SAMC additional capacity and infrastructure as patient volumes grow. It's a practical but important piece of this strategy. If we are successful in generating more demand, we also have to be able to serve it. Henderson and its expanded facility gives us additional room to do just that and to support more services as the platform continues to develop. Any treatment decision, of course, remains with the independent clinicians that work at these facilities. When clinically appropriate, their evaluations may include consideration of Vivos treatment options consistent with its applicable indications. So there are two potential benefits. EEG can grow as a standalone service within each of these SAMC centers and The Sleep Center of Nevada, and it can create another clinically appropriate entry point into the broader Vivos CARE model as those patients begin to receive treatment.

Another initiative we've discussed publicly is our contemplated collaboration and partnership opportunities with large cardiology groups in both Arizona and Florida. We continue to actively pursue those options and expect to finalize our negotiations with both groups in the near future. We expect each of those affiliations to add significantly to our current revenue streams being worked in Colorado, Nevada, and Michigan. Moreover, we expect to extend essentially the same operating model across additional affiliation opportunities that we are pursuing across the country. Based on the operating plan we previously announced, an initial fully staffed sleep optimization team could serve roughly 250 patients per month, and under the assumptions underlying that plan, generate more than $6 million in annual revenue with contribution margins approaching 40%-50% once fully developed.

Number six, we have previously announced our successful launch of a pediatric OSA testing and treatment program across all current markets. Today, I'm pleased to announce significant progress in this program with hundreds of children now receiving treatment and experiencing life-changing effects therefrom. We believe this program is still in its early stages, and that there is significant and material upside to enroll and service many more children as we continue to expand this program and successfully execute. Keep in mind that there is an estimated 10 million children across the U.S. who suffer from sleep and breathing disorders, such as obstructive sleep apnea. Seventh, finally, we continue to refine and fully develop our current opportunities at The Sleep Center of Nevada. After considerable work with providers and staff, we are already experiencing a significant uptick in the total referral volume from SCN to SAMC.

Just since the end of the second quarter, we have been seeing three to four times as many patients being referred by SCN physicians and nurse practitioners over to SAMC for treatment. We expect to see production from these referrals begin to impact our financial results in the third quarter. Of course, the realization of these opportunities remains subject to definitive agreements, regulatory requirements, staffing, payer contracting, facility readiness, staff execution, and other operating prerequisites. However, our deep experience in operating multi-site professional practices across multiple states, as well as our deep experience in Nevada with SCN, gives us a clear competitive advantage as we move forward. Keep in mind that we are still early on in these initiatives, and these results are still evolving within our operating model. Actual performance will depend on successful implementation and execution. The opportunity is straightforward.

The combined effect of these clinical and operational initiatives could be, and is expected to be, material and significant in the weeks, months, and quarters ahead. As we step back and look broadly at these initiatives together and their cumulative effect on our business, I think the strategy for us to achieve positive cash flow and profitability becomes much clearer. More patients from physician referrals gives us more opportunities to provide enhanced and recurring services. More production capacity from our facilities expansion, our providers, and our new collaboration affiliations allow us to serve more patients at higher service levels. More patient and provider relationships can create, and we expect will create, additional clinically appropriate ways to introduce patients into the core Vivos business ecosystem. That is the model we are building.

Based on our current assumptions and subject to successful implementation and scaling, patient enrollment and conversion, reimbursement, vendor economics, available capacity, and operating execution, we see a clear path for Vivos' growth initiatives to become cash flow positive near the end of 2026 or in early 2027, and generate significant positive EBITDA for the company in fiscal 2027. That potential does not depend on just one program working perfectly. It reflects the combined opportunity we see across patient volume growth, remote patient monitoring, CPAP services, expanded capacities, EEG, and our collaborations with cardiology groups in both Florida and Arizona. Now, there is still a lot of work to do. We have to launch these programs well. We have to enroll the right patients. We have to manage reimbursement and capacities. We have to prove the economics as we go. That is what this team is focused on.

We intend to measure what works, invest behind programs that perform, and be disciplined about how we scale them. That brings me back to what I think is most important about our reports here today. The infrastructure that we are building here at Vivos is designed to reinforce the core business, not simply operate alongside of it. We expect to continue to see more patients with more capacity for generating revenue off of those patients, with more recurring touch points and recurring revenue streams, and more clinically appropriate pathways into treatment for those patients. As we execute, we believe we can create a substantially stronger foundation for future growth across Vivos. I would like to close by saying that we continue to see a bright future for this company. Irrespective of what has happened to our stock price in the market, we still believe that this company has a tremendous future.

We believe that our technology continues to lead the world in terms of its ability to resolve the conditions of obstructive sleep apnea in both children and adults. We continue to believe that opportunities to deploy this technology will continue to arise across various platforms. As we do that, this company will emerge as an industry leader, and we believe that it will continue to set the pace for the future of an entire industry of advanced sleep medicine. With that, I will close my remarks. Thank you for your time and attention today. Operator, we will take a few questions from those who are in attendance today.

Thank you. Ladies and gentlemen, we will now begin the question and answer session. To ask a question, you may press star followed by the number one on your telephone keypad. If you are using a speakerphone, please pick up your handset before pressing the keys. To withdraw your question, please press star followed by the number two. One moment please for your first question. Your first question comes from the line of Yi Chen with H.C. Wainwright. Please go ahead.

Hi, this is Katie on for Yi. Quick follow-up from the call. The release, you guys have described the cardiology partnerships in Florida and Arizona as approaching finalization. What kind of capital does each one require? If you can give us a target quarter that would be reasonable to expect revenue to begin.

We would expect that each of those will require CapEx of between $800,000 and $1 million. We would see them beginning to generate revenue in the first part of the first quarter to second quarter of 2027.

Great. If I have time, a quick follow-up on the insomnia and EEG program. They're cited as a growth driver for kind of the first time. Are you able to define its currently quarterly revenue? How is the reimbursement pathway working for those programs?

Let me address the reimbursement pathway. So far, so good with the reimbursements. We're seeing broad participation of insurance payers, in the Nevada market in particular, for the EEG testing services, with average reimbursements running around $800±. There's quite a broad range there of reimbursement levels. But we're seeing roughly $800 per patient on that score for just the testing. The actual treatments, we're just now beginning to refer the patients that have tested positive for insomnia via the EEG. We've began referring them in, and we don't really have a bead yet on the level of reimbursements, but there's multiple ways in which those multiple different treatment options, including some of our oral appliances, and in particular our VITA, what we call our Vivos VITA appliance. There are a number of ways that patients can be treated.

Traditional ways through CBTI, and other traditional methods, as well as some of the methods that we use with our oral appliances. I think it's a little early on the treatment reimbursement front, but it is definitely a big win on the reimbursement front. That's a pretty significant level of reimbursement for us as we think about the total volume of patients that could go in, and we expect to be going into this evaluation and testing treatment program for insomnia.

Great. Thank you, guys.

You bet.

I am showing no further questions at this time. I would like to hand it back to Kirk Huntsman for closing remarks.

Thank you, operator. In closing, I would just like to say that we believe here at Vivos that we continue to see great progress in patient volumes, in margin growth, in actual revenue growth. We see things happening here that are just now beginning to emerge and should be. We have always said that the third quarter of 2026 would probably be the time that we would start to see this show up in the financials. We are starting to see some good positive signs in Q2, but we see a lot greater opportunities for growth and development ahead in Q3 and as we round the corner going into 2027, which we expect to be a very, very good year for Vivos.

We recognize we have some headwinds with respect to sort of our Nasdaq standing and other things, but we are working closely with our investor groups and key constituents to ensure our viability and continuation as best we can on Nasdaq and to comply with all the regulatory requirements that we have before us. With that, I will close out today. We appreciate everyone's support of this company. We continue to feel like we are making a difference in the world doing this, and we appreciate each one of you for your support for Vivos. Thank you very much, and have a great day.

This concludes today's conference call. Thank you for your participation. You may now disconnect your lines.

Good day everyone, and welcome to the Vivos full year 2025 Earnings Conference Call. At this time, all participants are in a listen-only mode. A question and answer session will follow management's remarks. This conference call is being recorded and a replay of today's call will be available on the investor relations section of Vivos' website and will remain posted there for the next 30 days. I will now hand the call over to Brad Amman, Chief Financial Officer, for introductions and a reading of the safe harbor statement. Please go ahead.

Thank you, operator. Hello, everyone, and welcome to our 2025 conference call. A copy of our earnings press release is available on the investor relations section of our website at www.vivos.com. With me on the call today is Kirk Huntsman, Vivos Chairman and Chief Executive Officer. Today, we will review the financial results for the full year 2025, as well as more recent developments and Vivos' plans for 2026 and beyond. Following these formal remarks, we will be happy to take questions. I would also like to remind everyone that today's call will contain forward-looking statements from our management made within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, concerning future events.

Words such as aim, may, could, should, projects, expects, intends, plans, believes, anticipates, hopes, estimates, goal, and variations of such words and similar expressions are intended to identify forward-looking statements. These statements involve significant known and unknown risks and are based upon a number of assumptions and estimates, which are inherently subject to significant risks, uncertainties, contingencies, many of which are beyond the Company's control.

Actual results, including, without limitation, the results of Vivos' growth strategies, operational plans, including sales, marketing, distribution, medical sleep provider acquisition and integration, research and development, regulatory initiatives, cost savings plans, and plans to generate revenue, as well as future potential results of operations or operating metrics, such as the potential for Vivos to achieve future positive cash flows or profitability, and other matters to be addressed by Vivos management in this conference call, may differ materially and adversely from those expressed or implied by such forward-looking statements.

Factors that could cause actual results to differ materially include, but are not limited to, the risk factors described and other disclosures contained in Vivos' filings with the Securities and Exchange Commission, including the risk factors and other disclosures in our Form 10-K for the year ended December 31st, 2025, which was filed with the SEC today, our interim quarterly reports, and other filings with the SEC, all of which are or will be accessible on the investor relations section of the Vivos website, as well as the SEC's website. Except to the extent required by law, Vivos assumes no obligation to update statements as circumstances change. Finally, please be aware that the U.S. Food and Drug Administration has given certain specific Vivos appliances 510(k) clearance to treat mild to severe OSA.

With the FDA clearance of certain Vivos products for severe OSA in November 2023 and moderate to severe OSA in children ages six to 17 years of age in September of 2024, treatment of patients with severe OSA with these specific appliances is no longer needed to be performed off-label at the clinical discretion of the treating doctor and is now an integral part of the Vivos treatment protocol. Treatment of OSA of any severity or any other condition with any other of Vivos FDA-cleared devices remains at the clinical discretion of the treating doctor. For further information on our results for the years ended December 31st, 2025 and 2024, please see our earnings release, which was distributed earlier today, and our annual report filed on Form 10-K, which is available on the SEC filings portion of the investor relations section of our website.

With that, I'll turn to a discussion of our 2025 year-end results. In the fourth quarter of 2025, Vivos completed its second full quarter of activity following our June 10th, 2025 acquisition of the Sleep Center of Nevada, demonstrating that our pivot of our sales, marketing, and distribution model has taken hold. Overall, revenue was positively impacted by the sales strategy shift and focus towards sleep center affiliations. The full year 2025 revenue increase of $2.4 million or 16% was due primarily to an increase of approximately $4.8 million in sleep testing services and an increase of approximately $2.2 million of revenue generated from the treatment to patients launched at two of SCN's seven sleep center locations.

The increase in revenue during the year was partially offset by the decline in product revenue to our legacy VIP dentists of approximately $1.4 million in appliance and tooth positioner sales. Additionally, we had a decrease in service revenue of approximately $2 million in our VIP enrollment revenue and a decrease of $700,000 in sponsorship, conference, and training-related revenue. As we pivoted our business model to a medical provider-focused business strategy and reduced our dependence on enrolling and training VIP dentists to sell our products, we fully expected revenue from these legacy programs to decline. For the year ended December 31st, 2025, we sold 25,441 oral appliances and tooth positioners for a total of approximately $6.5 million, an 18% decrease in revenue from the year ended 2024, when we sold 16,182 oral appliances and tooth positioners for a total of $7.9 million.

The revenue decrease is directly attributable to an increase in discounts offered during the same period, with $1.6 million in discounts offered during the year ended December 31st, 2025, when compared to approximately $200,000 of discounts offered during the year ended 2024, coupled with an increase in tooth positioner sales, a lower price point product when compared to Vivos' more advanced appliances. We will discuss this more in a bit, but now that we've gotten through the initial integration phase of SCN, including the achievement of critical insurance coverage for our more advanced OSA appliances, we are expecting more revenue from higher price point products in 2026 and beyond. Cost of sales increased by approximately $900,000 or 15% to $6.9 million for the full year ended 2025, compared to $6 million for the year ended 2024.

This was primarily due to approximately $1.1 million in higher costs in diagnostic services related to new sleep center affiliations and an increase of a half a million dollars related to additional staff associated with the sleep center affiliations in both Nevada and our Detroit-affiliated center. Gross profit was $10.5 million for the full year ended December 31st, 2025, compared with $9 million for the full year ended December 31st, 2024, an increase of 17%. The 17% increase in gross profit during the full year 2025 compared to 2024 was attributable to an increase in revenue of approximately $2.4 million, offset by an increase in cost of sales of $900,000. Gross margin remained constant at 60% for the years ended December 31st, 2025, and 2024. Operating expenses for the full year ended December 31st, 2025, were $30.4 million, compared to $20.2 million for the full year ended 2024.

This increase resulted primarily from an increase in general and administrative expenses related to our new model. General and administrative expenses increased $9.8 million to $27.7 million for the year ended 12/31/2025 compared to approximately $17.9 million for 2024. This increase was primarily due to $6.7 million in costs associated with running SCN operations and related Vivos treatment centers. In addition, we incurred approximately $1.6 million related to professional fees, most of which were one-time expenses, and $800,000 associated with salaries and wages and Vivos personnel, as well as infrastructure costs of approximately $600,000 when compared to the year ended December 31st, 2024. Sales and marketing expenses decreased by $300,000 to $1.4 million for 2025, compared to $1.7 million for 2024. This decrease was primarily driven by a $200,000 decrease in commissions, as well as $100,000 decrease in convention and trade show expenses.

This is again attributable to our focus on bringing SCN online rather than our legacy business model. Depreciation and amortization expense was approximately $1.3 million for the year ended 2025, compared to $600,000 for the year ended 2024. Depreciation and amortization increased due to an increase in depreciable assets related to the SCN asset acquisition and additional depreciation on affiliations model assets. For the full year ended December 31st, 2025, our net loss increased to $21.2 million, reflecting higher costs of our strategic transition during the year. Approximately $1.4 million of expenses were one-time, out-of-pocket costs. In addition, resources were used in recruiting and training staff, rightsizing the team in anticipation of demand, and procuring space and equipment requirements. Regarding cash flow, net cash used in operating activities amounted to approximately $15.3 million and $12.7 million for the years ended December 31st, 2025 and 2024, respectively.

As of December 31st, 2025, we had total liabilities of approximately $26.7 million, compared with $7.3 million as of December 31st, 2024, reflecting the debt we incurred to acquire and fund SCN. As of December 31st, 2025, we had approximately $2 million in cash and cash equivalents. Subsequent to the end of fiscal year 2025, on January 16th, 2026, we announced that we raised $4.6 million in gross proceeds from a warrant inducement transaction. On April 7th, 2026, we announced the completion of a private placement with our existing private equity investor, New Seneca Partners, raising gross proceeds of $2.25 million. These financings bolstered our post-year-end stockholders' equity, which we need to continue to augment with additional equity financing in order to stay in compliance with Nasdaq's minimum stockholders' equity requirement.

In summary, we're seeing significant increases in revenue reflecting the acquisition of SCN and related treatment revenue from providing patients with OSA treatment options, which is extremely encouraging. We are also seeing increased costs from hiring SCN personnel on the diagnostic side, as well as additional hiring on the treatment side. We believe the strategic move to acquire SCN and other potential affiliate alliances and acquisitions set the stage for stronger performance in the coming quarters. For more detailed information, I refer you to our earnings release and our full Form 10-K filed today. With that, I'll now hand over the call to our chairman and CEO, Kirk Huntsman, to discuss the progress we have made to date on SCN, our Detroit affiliation, and our business generally. Kirk?

Thank you, Brad. Good afternoon, everyone, and thank you for joining us on today's conference call. After many years of actively searching for a business and distribution model capable of more fully realizing the monetary and profit potential of our advanced proprietary technology, we are pleased to announce today that we are beginning to see the emergence of the very kind of improved financial results we always believed were possible. As we moved to acquire The Sleep Center of Nevada in June of 2025, we said we believed that our new business and distribution model could deliver impressive financial returns for the company as many more patients would be exposed to and select Vivos treatment. Whereas the company would, at the same time, have far superior economics as compared to our legacy VIP model.

Today, we are pleased to report that our MSO/DSO provider support model, as implemented at SCN there in Las Vegas, has proven to be everything we expected it to be. As a result of our emerging momentum and success in Las Vegas at SCN, many other revenue and profit opportunities are also emerging, which we believe will further grow and expand our top-line revenue with strong margins and enhanced patient outcomes. Thus, 2025 was a pivotal year for Vivos. A year in which we proved our core thesis around patient demand and preference for our Vivos Method over other, more traditional treatment modalities such as CPAP or surgery. A year in which we experienced strong clinical support and endorsement from actual medical sleep specialists.

A year in which we took great strides forward with insurers towards providing more comprehensive coverage for our treatments, and a year in which our pathway forward came boldly and clearly into focus. As Brad mentioned, in 2025, we grew full-year revenue by 16%, something we regard as quite an achievement, considering that much of our financial gains from the SCN transaction were directly offset by revenue losses attributable to our strategic pivot away from our prior market selling through dentists. We also maintained gross margin despite significant ramp-up investments in our sleep testing and treatment services and the integration of the Sleep Center of Nevada.

While our 2025 operating loss includes material one-time upfront investments in this new model, we believe these actions, together with recently announced significant cost savings initiatives and strengthened capital structure, have now positioned Vivos to drive higher top-line growth, better contribution margins, and a clear path forward towards our goal of cash flow positive operations by the end of this year. Of course, in June 2025, we completed the acquisition of SCN and have been ramping up our operations there in Las Vegas. Generally speaking, what we've found there since closing the transaction in early June has been extremely encouraging.

We note that the enthusiastic endorsement of Vivos treatments by medical specialists at SCN, who have been patiently waiting many years for a viable alternative option to CPAP for their patients, has been critical to our ultimate success in that market. Thus far, we have seen many more OSA patients from SCN who are interested and willing to accept Vivos treatment as alternatives to CPAP than we had forecast. So much so that we have expanded the physical facilities and also our staffing and number of clinical providers to handle the patient demand. No doubt it has taken time, investment, and hard work to integrate SCN into our operations, and more work remains to be done. Put simply, these important efforts are starting to pay off.

Notably, we recently announced that SCN has received notices of in-network status with a number of commercial health insurance payers, along with participating status with Medicare. We believe this major development, along with the addition of several newly trained providers, will positively impact patient access to our patented and proprietary OSA treatments and modalities and the resulting top-line revenue and gross profitability from operations in that market. The insurance payers now covering our SCN operations collectively cover a substantial portion of the insured population in the greater Las Vegas metropolitan area, representing what we believe to be a significant addressable patient population for both OSA testing and treatment. Central to our efforts to build revenue and momentum across all markets has been our creation of what we call sleep optimization or SO teams.

Each SO team consists of approximately 16 medical, dental, and support staff who are all specially trained and equipped by Vivos. The primary focus of each SO team is to ensure that each and every patient is fully informed and educated about all treatment options and what might be best for their condition and situation, and then to assist them in getting into their treatment of choice, which most of the time involves treatment from Vivos products and services. Our operational growth plan is driven by our deployment of our SO teams, each consisting of one nurse practitioner or physician's assistant and two specially trained dentists employed by an independent medical or dental professional corporation, six dental assistants, six administrative support personnel, and one treatment navigator. These SO teams can be dedicated to high-demand locations or spread across multiple locations as circumstances dictate.

We currently have approximately one and a half SO teams deployed across two SCN locations and expect to have additional partial or whole SO teams deployed during 2026. We anticipate an initial ramp of up to 60 days for SO teams to become fully functional and up to six months or longer before net revenue collections match revenue-generating activities such as OSA diagnostic services or OSA treatments case starts. Based on the current volume of OSA patient demand, we believe the current addressable market served by SCN could support several additional SO teams, especially if certain planned growth initiatives and patient referrals meet expectations.

Such initiatives include, but are not limited to, the expansion of diagnostic and treatment services, the establishment and rollout of a pediatric OSA program, and the collaboration with certain specialty medical groups who treat patients with comorbid OSA but who lack the ability to test, evaluate, and treat such patients within their existing practice environments. Keep in mind that there are well over 240,000 OSA patients that have been tested and seen by SCN providers since 2019. Based on our experience to date, we believe our limiting constraints for near-term revenue growth at SCN have been, one, insufficient physical space to see an optimal number of patients. Two, inadequate number of providers and staff recruiting, training, and onboarding. Three, customary issues with third-party payer credentialing.

At the end of 2025, our operations at the two SCN locations we have onboarded were fully booked for appointments through April of 2026, and we were processing what we believe were less than 40% of patients attempting to get appointments for treatment. Our two greatest barriers to servicing more OSA patients at that time were a lack of Vivos-trained providers and delays in obtaining full access to most major insurance carriers. As I mentioned, we have made good progress in both areas since then, although further work remains. We are working to fully meet current demand by adding SO teams, further insurance participation access being granted, and additional facility space is made ready. We view this as significant upside potential for Vivos.

Our initial average case revenue and acceptance rate for Vivos treatment at SCN to date, based on a limited period of operations at two of SCN's seven locations, suggests that each SO team could potentially generate collections well in excess of $500,000 per month, net of adjustments with contribution margins well above 50%. In addition to current Vivos diagnostic and treatment options, we expect to be able to offer SCN patients additional diagnostic and treatment services that could generate and will generate, we expect, additional revenue. Our operational experience in Las Vegas at SCN is proving to be invaluable in terms of providing numerous additional revenue and profit growth opportunities, and also positioning us as the clear market leader with several competitive advantages.

No other sleep testing or treatment center in Nevada or elsewhere in the United States offers patients the full range of treatment options, including the ability to rehabilitate and restore their airway health like we do. Nor does any other testing or treatment center offer patients the kinds of adjunctive treatments and services that we offer, such as CO2 laser treatments, myofunctional therapy, in-home EEG testing, or alternative treatments for insomnia, excessive daytime drowsiness, chronic sinusitis, or other sleep disorder-related conditions. We believe our particular combination of such services represents a much-needed evolution over the traditional CPAP-only type treatments that are currently the norm across the United States today. Each of those services enhance patient care and clinical outcomes while adding significantly to our overall revenue and profit potential.

Perhaps most importantly, as news of our relationship with SCN has spread throughout the medical community, we have begun fielding inquiries from across the United States from rather large medical specialty groups such as cardiologists, neurologists, functional medicine doctors, primary care groups, hospitals, and others. While each group may have their own individual reasons for reaching out, they all tend to share one thing in common. A large majority of their patients have obstructive sleep apnea, and their OSA is rendering whatever other health conditions they may have, such as diabetes, cardiovascular disease, hypertension, Alzheimer's, depression, et cetera, much, much worse. One prominent cardiologist recently said to me, quote, "Kirk, obstructive sleep apnea is cardiovascular disease. We now know that, and it is wrecking our cardio interventions and killing our patients prematurely if they don't get the help they need to identify and treat it." Close quote.

These groups all say basically the same thing, that they are not sleep specialists and thus are ill-prepared to treat their patients' sleep and breathing disorders. They need someone else to handle it for them, and Vivos is very well positioned to do just that. We are currently exploring partnering and affiliation opportunities with several medical specialty groups in various parts of the United States. Each of these groups report treating between 20,000 and 40,000 patients per month within their specialty and tell us that they believe 85%-90% of those patients also have obstructive sleep apnea, with most of them undiagnosed and untreated. Creating these affiliations and optimizing them will come with financing and other challenges, such as we've dealt with at SCN, but the prospect of replicating our new model around the country has us excited.

One significant benefit of our affiliation model, as opposed to our acquisition model, is that it is much more capital efficient than a pure acquisition model. Typical capital outlays for an affiliation are under $1 million apiece, while similar-sized acquisitions may require 10-15 times as much capital. Moreover, affiliations typically preserve about 75%-80% of the economics for the company. Typically, in each affiliation, we will seek to collaborate with local medical groups to enhance the diagnosis and treatment of their patients with OSA through a regulatorily compliant services and support model suited to each circumstance, but largely patterned after our Sleep and Airway Medicine Center, what we call SAMC, model in Nevada with SCN. We believe this SAMC model not only meets the clinical and medical requirements of both patients and providers, but also presents significant revenue-generating opportunities for Vivos.

For reference, our current revenue per case in Nevada averages just under $5,000 with contribution margins above 50%. We expect those figures to improve further as we continue to roll out additional diagnostic and treatment modalities, some of which are already underway. I would also like to take the opportunity to point out some significant progress being made by our research and development team led by Dr. Bahar Esmaili at our Highlands Ranch clinic in Colorado. Her team's efforts there are showing what we believe are unprecedented and consistently positive clinical outcomes for patients with sleep and breathing disorders, many of whom are seriously ill and desperate for help, and who have typically flown in from all around the world to receive treatment there in Colorado.

We firmly believe that through the efforts of Dr. Esmaili's team in Colorado, significant diagnostic and clinical breakthroughs are being made, such that later this year and throughout 2027, we expect to begin publishing key case studies and clinical results. In December, we announced the grand opening of our latest SAMC center near Detroit in Auburn Hills, Michigan. Our opening in Auburn Hills signals the continuation of Vivos' national expansion strategy to leverage commercial affiliations with high-volume sleep clinics and physician-owned sleep and other medical practices to bring Vivos' proprietary line of FDA-cleared diagnostic and therapeutic products and services to tens of millions suffering from OSA and related health conditions, as I just referenced.

We believe our new affiliation model will be very attractive to both medical specialty groups and more than 2,600 accredited sleep center operators and owners around the country who may not want to be acquired but may instead be looking to grow their business and referral networks by offering a highly differentiated treatment package to OSA patients. We have several growth initiatives planned for 2026 and beyond, which have the potential to further increase our growth in our current and new markets. Such initiatives include the expansion of diagnostic and treatment services, the establishment and rollout of a pediatric OSA program, and the collaboration with certain specialty medical groups who treat patients with comorbid OSA but who lack the ability to test, evaluate, and treat such patients within their existing practice environments.

Importantly, we have designed our model to be readily expanded and adapted to other locations throughout the United States. Our M&A team continues to field calls and inquiries from both acquisition and affiliation prospects around the country. As previously mentioned, we are currently in negotiation with several potential affiliation candidates in various key markets. Given our experience with SCN, we believe these opportunities should be similarly accretive. In summary, we believe our initial results with SCN are a strong indication of the potential upside for Vivos. As we roll forward, we expect to continue to modify and refine our model to make it even more efficient, with the potential for even higher revenue and better gross margins. Furthermore, we fully expect that this model, including the potential for both acquisitions and affiliations, is highly replicable and scalable across multiple markets.

As it expands, we expect it will continue to be highly accretive to top-line revenue growth, as well as create the potential for cash flow positive operations and bottom-line profitability. We believe that this methodical effort, patiently executed over time, has put Vivos in a much better position to realize the full potential of our technological advantage in industry-leading products and services. Most importantly, perhaps, we believe this new model will now begin to help improve the lives and health of many more patients who have, up until now, not had access to the kind of life-changing treatment that we provide. For all of us here at Vivos, that mission of improving lives and providing fresh hope to the tens of millions of Americans who suffer from breathing and sleep disorders is what drives us each and every day.

Now that we've found a business model to match the superiority of our technology, those aspirations are becoming a reality, and it feels great. That concludes our prepared remarks. Now we'll be happy to take questions. Operator?

Thank you, ladies and gentlemen. We will now begin the question and answer session. Should you have a question, please press the star followed by the one on your touchtone phone. Should you wish to cancel your request, please press the star followed by the two. If you are using a speakerphone, please lift the handset before pressing any keys. Once again, that is star one should you wish to ask a question. Your first question is from Scott Henry from Alliance Global Partners. Your line is now open.

Thank you, and good afternoon. A lot of moving parts with the new business model. Just an observation followed by questions. Obviously, you did about $6.8 million in Q3, which dropped to $3.8 million in Q4, if I back out the three quarters, assuming that's accurate. Two questions. One, what happened in Q4 to make it lower than Q3? And two, we're already in April. What are your thoughts on Q1? Do you expect it to look more like the third quarter or the fourth quarter? Thank you.

Okay. Great question, Scott. Listen, our new model is highly dependent upon total doctor days. We have to have providers who show up and are available to treat patients. When providers are absent or we have insufficient numbers of providers, then our production necessarily declines. That's exactly what we experienced in Q4. We had some challenges with some of our existing provider groups. Most specifically, our dentists. We had some dentists have family problems, some of them had health issues, some of them had travel constraints, and we just had an unexpected and unforeseeable set of circumstances whereby we lost a few providers that we didn't expect to lose. We set about immediately trying to recruit and train, but that doesn't happen overnight. Throughout the fourth quarter, we struggled with that issue. We remedied it.

We recruited an excess number of what we believe is an excess number of providers, so we have some redundancy now. As we move into Q1, and especially as we go further into Q2 here, we feel very, very good. Some of those providers to replace the ones that we lost, they came on throughout the quarter in Q1. The full impact of having replaced these doctors and replaced the doctor days will start to be seen towards the end of Q1 and then into Q2. That's a great question, and I think it highlights some new dynamics of our model, which are, we have to have sufficient dentists in network with payers and having them producing every single day. When a dentist doesn't show up for a day, it can be $15,000, $20,000, $30,000 or more of lost productivity.

If you have just a few days a week of doctors who you've lost doctor days with, it can make a significant impact on your monthly revenues pretty quick, and that's what happened in Q4.

Okay. It sounds like we should see some improvement in Q1, but the bulk of it probably in Q2.

Yes. There's a couple of reasons for that. It's doctor days, as I mentioned, and it's also, as we got towards the end of Q1, Scott, you'll see that in February, or I'm sorry, in March, we announced that we had in-network access. We've been granted in-network access with a number of payers. Well, that in-network access just started to fold into the revenue productivity stream in the latter part of Q1. Yes. For all of those reasons, you'll see it start to fold into Q1, but most of the impact is going to be in Q2 forward. It's a significant change. Both of those things combined are significant.

Okay. You mentioned possibly being cash flow positive exiting 2026. What kind of quarterly revenue run rate would you need to achieve that goal? Approximately.

Brad, do you want to take that?

Yeah. This analysis involves a revenue increase as well as reducing, as you heard in our last press release, we trimmed some legacy VIP costs. It's not just revenue, but there's costs associated as well. We were at $17 million for 2025. Roughly, on a run rate basis, we need to be close to double that by 2027 to hit that number going forward on a net income positive basis.

Okay. All right. Great. Thank you, Brad. Just final question. On the balance sheet, I see that $8.3 million in current portion of long-term debt. Do you have to deal with that in the next 12 months, or what's the status of that situation now that it's classified as short-term or current?

Yeah. Throughout the year when we were reporting that in our quarterly filings, that was long-term. The maturity date on that is in 2026. We've reclassified all of that as short-term debt on our balance sheet.

Okay. I guess you would anticipate rolling that over at some point.

Rolling it over or paying it off. Far, we have been compliant with the debt covenants on those pieces of debt. We'd either raise capital to pay it off or roll it over into additional debt and extend those terms.

Okay. Great. Thank you for taking the questions.

You bet, Scott. Thank you.

Thank you once again. That is star one should you wish to ask a question. Your next question is from Robert Sassoon from Water Tower Research. Your line is now open.

Thank you. I've got a few questions, actually. One is, if we look at the revenue performance, can you speak to the year-on-year growth you saw in diagnostic and treatment revenue generated under the new model?

I'm not sure exactly what the question is. Can you just clarify that?

On the growth in sleep testing services and treatment centers. Robert, is that kind of what?

Yeah, that's correct.

Yeah. We had about $4.8 million in sleep testing service revenue over 2024. We had about $6 million sleep testing service revenue in 2025. That increase of $4.8 million is entirely due to SCN on the diagnostic side. On the treatment center side In 2025, those diagnostics, people testing positive for OSA, are what allowed us to recognize $2.2 million in treatment revenue. In total, between those two buckets, the diagnostic of $6 million and the $2.2 million of treatment revenue is an increase of over $8 million of revenue. That revenue is really where we think the growth's going to be. If you look at the full year, the total revenue is a $2.4 million increase. That $2.4 million increase was offset by some VIP revenue decrease by $2 million, and some of the other legacy items decreased accordingly. The fact that we had an increase of $7-$8 million in new model revenue, that was offset by VIP revenue, which we totally expected.

Going forward, that VIP revenue starts to roll off, so we won't see those big decreases in legacy revenue as we move into 2020, throughout 2026 and beyond.

Okay, got it. You mentioned your strategies to expand your alliance model. What key lessons have you learned from the integration of SCN and how will that shape that particular expansion model in alliance?

That's a great question. I would say, we've learned how to work with medical doctors in a collaborative manner. We've learned how to coordinate treatment and care of patients across the various specialties. We've learned how to navigate the insurance payer community and how to also set up the entities that we need to be regulatorily compliant. We have to navigate a number of different fronts to make these things come about. Once we get the structure in place for each situation, and once we staff them with sufficient providers and then put those providers under contract in-network with these payers, we have a significant, I think a significant advantage over anybody else coming into the market.

Because this is a, as I think somebody else said, there are a lot of moving parts and there's a lot of structure that has to go into place, and it's not for somebody that doesn't understand it. Yeah. We have it down. We have it figured out. Also, we're in the process of contracting with a national firm that has insurance contracts across the country.

Right

In each state, and all of those things accelerate. By contracting with them, we will accelerate our in-network participation and the time to revenue generation is cut dramatically down. Those are lessons that I would say we've learned, and we're applying them as we go.

Yeah. I have a couple of other questions. One is, you recently announced a joint partnership with Sound Health. Are you seeing any traction from that yet, or is it still early days?

Yeah, it's still fairly early, but in Las Vegas, we're having trouble keeping their units in stock. I think patient demand for that is good. I don't think that even if that continues on, that will be a material aspect of our earnings or profits or whatnot. But the patient demand there has exceeded expectations, and patients are loving the treatment, and we're seeking to expand that relationship.

Right. Okay. Final question for me. Can you discuss your long-term growth prospects and explain why you're particularly excited about the opportunities ahead?

Well, look, we spent seems like a long time wandering in the desert of trying to figure out what kind of business model we could deploy that would do justice to our breakthrough technology. We really came to the conclusion back a couple years ago that furthering our efforts down the path of the dental community was just not going to ever get it done. As we pivoted, we basically told the world that, well, we've got a different way to do this, and we think this is going to work. We put forward that prospect. We went out on a limb. We sort of bet the farm here on what our experience was going to be out there at SCN. I mean, to our great pleasure, what's happened out there at SCN so far has been really, really good.

Again, I know that it doesn't show up fully in the numbers. The core underlying thesis that we had going into that acquisition in June of last year, our core underlying thesis that we could in fact generate great patient demand by intercepting the patients at the time that they are being diagnosed and deciding upon their treatment modality, that at that juncture in the patient journey, that was the ideal juncture in which to introduce Vivos as an alternative to CPAP. We bet that patients would rather fix their OSA in 9-12 months and prefer that option over going into a CPAP, where they have to wear that thing for the rest of their life every night. We made that bet. That bet is paying off.

We see further, as I mentioned in my remarks, the amount and number of clinical contacts that we've had with specialty groups around the country, hospitals, cardiology groups, neurologists, all these groups coming to us saying, "We need what you guys are doing. We hear that you have something different than CPAP. Our patients don't like CPAP. They don't want CPAP. When can you come see us?" That kind of demand is something we're excited about. The cost to affiliate and set up SO teams in various markets is a fraction of what it costs for us to acquire these companies like we did with SCN. Because of all those things, we are really, really excited about what the future holds. We used to talk about whether patients were getting better, whether we were having clinical success. We're so far beyond that right now.

We know beyond any shadow of doubt that we have the best technology there is on the market today to treat and resolve obstructive sleep apnea. There's no question about it. Now the issue is how can we get that in front of as many people as possible?

Right. Do you think you're going to get over those sort of barriers that you mentioned earlier in terms of recruiting the right people and expanding the SO teams to be able to implement that?

Yes, I do. In fact, we've demonstrated that here in the first quarter. We've constituted the full measure of a team and a half out there in Las Vegas. We have additional doctors and providers, nurse practitioners, and others ready to go for other opportunities that we're exploring right now. I don't think that's going to be a limiting constraint in the future. I readily admit that it took us a little bit by surprise in Q4. We just didn't expect some of the attrition that we had in our provider pool. Now we know to have redundancy and to have the kind of team that is perhaps a little more robust than what we had planned for. At the same time, the redundancy will pay dividends when we have providers who leave unexpectedly or have personal issues or whatever.

We're learning as we go, but I think we're in great shape to do that. We have no challenges recruiting doctors or recruiting nurse practitioners or recruiting staff members. Yeah. That's always what we're going to be doing, and it's going to be an ongoing effort as we roll forward. There is no shortage of dentists or nurse practitioners or staff members available to work in our model. We just had to be out in front of that, and we got caught a little by surprise in Q4.

Well, anyway, it sounds like it's a pretty encouraging picture looking ahead. Anyway, thanks for taking my questions, and the best of luck for this year.

All right. Thank you so much. Operator?

Thank you. Our next question is from Yi Chen from H.C. Wainwright. Your line is now open.

Are you there, Yi?

Yi Chen, your line is now open.

All right. Operator, let's go ahead and close it off. I don't think he's there. Operator?

All right. Thank you. There are no further questions at this time. Please proceed with the closing remarks.

On behalf of Vivos, I would just like to express our gratitude and thanks to all of the investors and analysts and investment bankers and whatnot that have supported us over the course of time. I think it's been a little bit of a longer journey than any of us had hoped for, but we, as I think is pretty clear from this report, we are more optimistic about the prospects for this company today than we probably have ever been. The cooperation of providers of the medical sleep community, of specialists, of payers, of all the different constituencies which make this all possible, is just so gratifying, and we're very pleased about all that. I just want to express on behalf of all of us here at Vivos, our profound gratitude for everyone who's hung in there with us all these years.

Just know that brighter days are ahead, and we're excited about this. We think the future here at Vivos is very bright. Thank you very much, everyone, and have a great night, and appreciate your participation today. Thank you.

Thank you, ladies and gentlemen. The conference has now ended. Thank you all for joining. You may now disconnect your lines.