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Nano-X Imaging Ltd. (NNOX)

Q1 2025 Earnings Call· Thu, May 22, 2025

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Transcript

Operator

Operator

Good day, and thank you for standing by. Welcome to the Nano-X Imaging Ltd. Q1 2025 Earnings Conference Call. At this time, all participants are in a listen-only mode. After the speakers' presentation, there will be a question and answer session. To ask a question during the session, you will need to press star one one on your telephone. You will then hear an automated message advising that your hand is raised. To withdraw your question, please press star one one again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Mike Cavanaugh, of Investor Relations. Please go ahead.

Mike Cavanaugh

Management

Good morning, and thank you for joining us today. Earlier today, Nano-X Imaging Ltd. released financial results for the quarter ended March 31, 2025. The release is currently available on the Investors section of the company's website. With me today are Erez Meltzer, Chief Executive Officer and Acting Chairman, and Ran Daniel, Chief Financial Officer. Before we get started, I would like to remind everyone that management will be making statements during this call that include forward-looking statements regarding the company's financial results, research and development, manufacturing commercialization activities, regulatory process and clinical activities, and other matters. These statements are subject to risks, uncertainties, and assumptions that are based on management's current expectations as of today and may not be updated in the future. Therefore, these statements should not be relied upon as representing the company's views as of any subsequent date. Factors that may cause such a difference include, but are not limited to, those described in the company's filings with the Securities and Exchange Commission. We will also refer to certain non-GAAP financial measures to provide additional information to investors. A reconciliation of the non-GAAP to GAAP measures is provided with our press release with the primary differences being non-GAAP net loss attributable to ordinary shares, non-GAAP cost of revenue, non-GAAP gross profit, non-GAAP gross profit margin, non-GAAP research and development expenses, non-GAAP sales and marketing expenses, non-GAAP general administrative expenses, and non-GAAP gross loss per share. With that, I'd now like to turn the call over to Erez Meltzer.

Erez Meltzer

Management

Good morning, everyone. Thank you for taking the time to review Nano-X Imaging Ltd.'s Q1 2025 financial results with us today. I'm pleased to report that we have made progress in our mission to improve medical imaging and enhance patient outcomes. At Nano-X Imaging Ltd., we pride ourselves on our comprehensive end-to-end solution that supports preventive health care and expands access to imaging services. With that goal in mind, we made two strategic acquisitions in 2021: USARad, our teleradiology business, and Zebra Medical Vision, which is now Nano-X AI, to build out our end-to-end solution around the core Nano-X ARC technology. Integrating AI-powered imaging analysis and a global teleradiology solution with our groundbreaking Nano-X ARC technology takes us one step closer to creating a global connected medical imaging solution with the potential to meaningfully expand the delivery of health care. These acquisitions have proven to be good strategic decisions. Since the acquisitions less than four years ago, we have doubled the revenues generated by USARad, and at the same time, Nano-X AI has progressed from a pre-revenue business to one that is now generating growing revenue. To highlight another benefit of our end-to-end solution, most of our Nano-X customers also use our teleradiology services, and this not only provides more effective imaging and diagnosis for providers and patients but also increases revenues per customer and creates value for our shareholders. Nano-X AI continues to be a key part of our strategy, driving forward our commitment to integrating artificial intelligence into medical imaging. By leveraging advanced AI capabilities, we aim to streamline workflows, support clinical decision-making, and improve efficiency across the imaging ecosystem. Our innovative technologies, including Nano-X ARC and our AI solutions, are gaining traction in the market, and we are excited about the future of our company. Let's review…

Ran Daniel

Management

Thank you, Erez. We reported a GAAP net loss for the first quarter of 2025 of $13.2 million for the reported period, compared with a net loss of $12.2 million in the first quarter of 2024, which is the comparable period. The increase of $1.0 million was largely due to an increase of $1.1 million in our gross loss. Revenue for the reported period was $2.8 million, and gross loss was $3.0 million on a GAAP basis. Revenue for the comparable period was $2.6 million, and gross loss was $2.1 million on a GAAP basis. Non-GAAP gross loss for the reported period was $0.4 million, as compared to a gross profit of $0.6 million in the comparable period, which represents a gross margin of approximately 15% on a non-GAAP basis for the reported period, as compared to a gross profit margin of 22% on a non-GAAP basis in the comparable period. Revenue from the teleradiology services for the reported period was $2.6 million, with a gross profit of $0.4 million on a GAAP basis, as compared to revenue of $2.4 million with a gross profit of $0.3 million on a GAAP basis in the comparable period, which represents a gross profit margin of approximately 17% on a GAAP basis for the reported period, as compared to 14% on a GAAP basis in the comparable period. Non-GAAP gross profit of the company's teleradiology services for the reported period was $1.0 million, as compared to $0.9 million in the comparable period, which represents a gross profit margin of approximately 39% on a non-GAAP basis for the period, as compared to 37% on a non-GAAP basis in the comparable period. The increase in the company's revenue and gross profit margin from the teleradiology services was mainly attributable to customer retention, increased rate, and…

Erez Meltzer

Management

Thank you, Ran. To close our call, I would like to extend our appreciation for your continuous support of Nano-X Imaging Ltd. We understand that our investors are key to the journey that Nano-X Imaging Ltd. is undertaking to transform medical imaging. Like many companies over the past several years, we have experienced challenges. But our belief in the Nano-X Imaging Ltd. vision, as well as the support of our investors, encourages us to keep pushing ahead. We are making steady progress commercializing the Nano-X ARC and Nano-X AI utilizing multiple different initiatives. Our telemedicine business continues to provide a revenue base to help fund our continued growth. We are also doing much work behind the scenes to support our commercialization through clinical data generation, securing more regulatory clearances, and marketing campaigns designed to raise awareness of the Nano-X Imaging Ltd. end-to-end solution. We are advancing our clinical trials with promising initial results. We continue to increase the number of our commercial collaborations, and we are working with our growing customer base to help them integrate the Nano-X ARC into their practices. In closing, we remain committed to making medical imaging more accessible and improving patient outcomes through innovative technologies and strategic collaborations. We thank you for joining us today and look forward to providing additional updates on our next call. Operator, please open the call for questions.

Operator

Operator

And our first question will be coming from Jeffrey Cohen of Ladenburg Thalmann and Company. Your line is open.

Jeffrey Cohen

Analyst

Good morning, Erez. So, Ran, thanks for taking our questions. I wondered if you could talk about the fleet by the end of the year where you're speaking of a hundred units. Could you give us a sense or flavor for geographies at which point you anticipate placements to occur during this year or already placed? Thank you.

Erez Meltzer

Management

Okay. Still the majority of the units will be in the US. Based on the progress of the regulation approvals in the countries that we are planning to place ARCs in Europe, it seems that, I would say, maybe fifteen or twenty percent will be in Europe. And I would say Israel and other probably ten percent will be in other places like Israel, like Africa, like Latin America. It all depends on the progress of the ability to speed up the regulation approvals and the import license in the various countries that we operate. So that's and, of course, the other thing which is very important is how fast are we going to be able to install the system that we currently have in orders agreements that were signed, the projects that we mentioned. In a nutshell, I would say that this is a very important element of what I was trying to deliver in this earnings, that the ceiling of the building blocks of our and the future of short-term future in terms of the ability to generate the ARCs that are going to be installed from this sales team, from the campaign that we are leading. One of them, each one of these campaigns generates about one thousand leads, and we're starting the process to implement them. The workers' comp portion, the business partners that we work with, and, of course, the Europe and the rest of the world that we do these installations. But in a nutshell, it's worth I gave you.

Jeffrey Cohen

Analyst

Got it. And then as a follow-up, can you talk a little more about the USARad Second Opinion services? Is there a particular list price for that service, and is it being reimbursed by the payers out there? Any further color would be appreciated. Thank you.

Erez Meltzer

Management

Okay. With USARad, we are lately, we have, I would say, some peaks or high numbers in terms of the weekly revenues which are being generated or scans that they are reading. In addition, it seems that what we were trying to do, and we have been amazingly successful in implementing the end-to-end solution where USARad is doing a lot of the readings of the places that we are installing the ARCs. So we are generating from the same unit and the same scan more revenues to the company. In addition, the workers' comp is going to be based initially or to begin with at least based on USARad that are going to read. And last but not least is what you have asked is the Second Opinion. Second Opinion is about $300. It's mostly private. It's a growing business. And yeah. So that's it's a retail model. It's more of a retail model. By the way, in addition, if you know, by the same token, I would say, that it's interesting to see that part of the increase in revenues or business that we're doing is what we call the B2B2C. So we are serving someone who is serving the consumer or the retail, and this is what we do with Ezra. In Ezra, for example, every reading is about $75 right now. And if we do more applications of AI other than the CCS, it's going to increase above the $100 per scan. As you remember, the workers' comp, I mentioned around one. And so basically, it's growing this part of the business.

Jeffrey Cohen

Analyst

Perfect. Thanks for taking our questions. Good quarter.

Erez Meltzer

Management

Thank you.

Operator

Operator

And one moment for our next question. Our next question comes from Ross Osborn of Cantor Fitzgerald. Your line is open, Ross.

Ross Osborn

Analyst

Hey, guys. Thanks for taking our questions. So starting off, you mentioned sixty units in various stages of the How many of these were placed, approved, and operating in the US? And why have we not seen the associated influx revenue based upon these units being used.

Erez Meltzer

Management

So I'll start with the first number. Right now, to your reference of the question, it's more than twenty. As some of them are being installed as we speak. Some of them are installed but waiting for approval from regulation or the building or the city or the state, I think we passed most of the approvals. So this is with respect to the numbers. Ran, would you like to address the revenues?

Ran Daniel

Management

Yes. You have to bear in mind that since from the time that as Erez mentioned, from the time that we deploy the machine until we generate revenue, there's a few phases that need to go through with the machine. First of all, it's the registration with the state and all kinds of other permits. Sometimes there's a setup to be made, and more importantly, it's all the process with getting the approved EOB for the procedure itself. Once we get the EOB that we see in certain places, then the number of scans increases, and then the revenue generation is following up.

Erez Meltzer

Management

The interesting part there, Ross, is that we have indeed mentioned the average of the seven scans per an operating day, which was the base of the model. But definitely, I would say that we can see that in the segment of the market that we are putting the systems in a multi-specialty medical centers, we can see days with eleven scans per day, even days with seventeen scans per day. The workers' comp probably will generate more than seven scans per day. So the ramp-up takes time, and the reimbursement, although there is a CPT code and all of this, the reimbursement and the EOB sometimes take time, and the increase in revenue follows after.

Ross Osborn

Analyst

Yes. But once we get the EOB, we do see a mining inflection point where the operator increases significantly the number of the scan.

Ross Osborn

Analyst

Okay. Understood. I appreciate the color there.

Operator

Operator

And then moving down the P&L to gross margin, how should we be thinking about you guys getting to a breakeven point or turning positive between your three business lines.

Ran Daniel

Management

Okay. So if you look at the twentieth, so you can see that our delivery, all and I'm talking about on a non-GAAP basis because you have to if you look at the base of the P&L, so you look at the measurement you look at the numbers on a GAAP basis, and there's all kinds of amortization, of intangible and share-based compensation and all kinds of items that we actually add back when we talk about the amount of bases. But even when we talk about non-GAAP basis, you can see that our teleradiology division is already profitable. And the gross profit margins start with between thirty-six, thirty-seven percent to forty-one, forty-two percent. The AI business should be with the higher gross profit margin. And the ARC division will be somewhere between. Of course, once we'll transition from to the ARCX where we have the glass field rather the ceramic tip, then we should expect our gross profit margins to increase over there. Since as we know, the cost of the machine of the ARCX is much lower.

Ross Osborn

Analyst

Thanks for taking our question.

Operator

Operator

Thank you. And our next question will be coming from Scott Henry of AGP. Scott, your line is open.

Scott Henry

Analyst

Thank you. Good morning or afternoon to depending where one is. It seems to me in the quarter that there's a lot of really strong technological progress. And people that have the machines are using it. But the quarterly placement level of you know, ten to fifteen per quarter, it's gonna take a while. To get to breakeven. How should we think about when there may be an inflection point to get to higher placements per quarter? Thank you.

Erez Meltzer

Management

I would like to answer your question and by the same token to also to refer to the tail of Ross to Ross question. Okay? So under all the the fact that, you know, the safe harbor and the and the uncertainties in the market and all the results that what is happening right now in the market, etcetera. We are indicating expectations that USARad is making money right now. The AI is going to break even. Our AI business is going to be breakeven next year, 2026. And the ARC business is going to breakeven in 2027. So that's actually right now the plan, and these are the indications that we expect. We work hard in order to be there. In terms of the you like the word inflection point. I would say that inflection point will be probably the second half of 2025. Where we are going to see a lot of the results. You are right that there is a lot of progress in the technology in this quarter. But if you notice, we made progress in the ARC. We made progress with the AI customers and revenues. We made progress with the Second Opinion. We made progress with the teleradiology. Made progress with the clinical efforts and the clinical education and brand awareness. We have made progress with regulatory. We've made progress with cooperation, with new market segments. With the OEM business, with the implementation of the end-to-end solution, and also with what we call the cost of the product. So I think that what this quarter actually shows first of all, that we are delivering what we promised. But second, we are making progress all the time. Yet, we are saying getting a medical a new medical equipment to the market is not an easy one. And getting something which is as you all write, disruptive changing the standard of care is not an easy one. It requires a lot of education, a lot of efforts, in terms of the clinical support, but that's what we are doing. And that's the reason why we have indicated that, in the RSNA this year, we're going to present the new product that we're going to be to install the ARC AI the solution of the AI to the ARC that is going to be built in in the system. The fact that the ARC is going to do to the X-ray as well. Built in in the system, and a lot of other goodies which are part of the ARCX.

Scott Henry

Analyst

Oh, okay. Great. Thank you. A lot in that answer. I appreciate that. If I could just double click on one thing you mentioned. You said ARC business potentially profitable or cash flow breakeven in 2027, should we be thinking about at a quarterly run rate exiting 2027 as breakeven? And, you know, I don't know if you want to answer this question or not, but could you get a bit a sense of you know, what kind of revenue run rate it would take to breakeven? We could do the math ourselves, but I thought I would ask. Thank you.

Ran Daniel

Management

So it would depend. It really depends on the mixture of the revenue. And this is not really a formal guidance, but we previously know, we have spoken. We gave some unit numbers of 1,500 to 2,000 units being deployed in order to get to a breakeven point. And, of course, if we get more attraction from the teleradiology business rather than AI and ARC. So it's a bit it comes with low-cost margin, but we will get more from the hardware and the AI. And we'll see more growth over there than the breakeven point will be even faster. Just because it comes with the higher gross profit margin.

Erez Meltzer

Management

It really depends on the mix between the CapEx sales, hybrid sales, and the EMSAS sales. Which right now I don't think that we are in a position to indicate the mix between these three elements. But the more we get into getting more experience in the market and starting to penetrate to the European market, as well as the Latin America market. I think that we will be able to shed some more light and give some more guidance with respect to what will be the mix of these types of sales. But it definitely depends on the mix.

Scott Henry

Analyst

Okay. Great. Thank you for taking the questions.

Operator

Operator

Thank you. And I'm showing no further questions. This will conclude today's conference call. Thank you for participating. You may now disconnect.