iRhythm Holdings, Inc.

Previous wording

Each Zio System combines an FDA-cleared and CE-marked, wire-free, patch-based, 14-day wearable biosensor that continuously records ECG data with a proprietary, FDA-cleared, CE-marked cloud-based data analytic software to help physicians monitor patients and diagnose arrhythmias. Since receiving FDA clearance, we have provided the Zio Services to over six million patients and have collected over 1.8 billion hours of curated heartbeat data.

Current wording

Each Zio System combines an FDA-cleared, CE-marked and Japan PMDA-approved wire-free, patch-based, 14-day wearable biosensor that continuously records ECG data with a proprietary, FDA-cleared, CE-marked, and Japan PMDA-approved cloud-based data analytic software to help physicians monitor patients and diagnose arrhythmias. Since receiving FDA clearance, we have provided the Zio Services to over eight million patients and have collected over 2 billion hours of curated heartbeat data.

Previous wording

We define Adjusted EBITDA for a particular period as net loss before income tax provision, depreciation and amortization, interest expense, interest income and as further adjusted for stock-based compensation expense, changes in fair value of strategic investments, impairment and restructuring charges, business transformation costs, and loss on extinguishment of debt. Business transformation costs include costs associated with professional services, employee termination and relocation, third-party merger and acquisition, integration, and other costs to augment and restructure the organization, inclusive of both outsourced and offshore resources.

Current wording

We define Adjusted EBITDA for a particular period as net loss before income tax provision, depreciation and amortization, interest expense, interest income and as further adjusted for stock-based compensation expense, changes in fair value of strategic investments, impairment and restructuring charges, business transformation costs, certain intellectual property litigation expenses and settlements, and loss on extinguishment of debt. Business transformation costs include costs associated with professional services, employee termination and relocation, third-party merger and acquisition, integration, and other costs to augment and restructure the organization, inclusive of both outsourced and offshore resources. Beginning in the first quarter of 2025, we have excluded third-party attorneys' fees and expenses associated with patent litigation brought against the Company by Welch Allyn, Inc. and Bardy Diagnostics, Inc., subsidiaries of Baxter International, Inc. Factors we considered in arriving at this determination to exclude these patent litigation costs from our Adjusted EBITDA include frequency and complexity of the patent litigation, the counterparty involved, and the expected magnitude of patent litigation costs for this matter.

Previous wording

1 Net loss for the three and nine months ended September 30, 2024 includes $32.1 million of acquired in-process research and development expense.

Current wording

1 Net loss for the three months ended March 31, 2025, includes $0.3 million of acquired in-process research and development expense.

Previous wording

Our future results of operations and liquidity could be materially adversely affected by macroeconomic factors contributing to delays in payments of outstanding receivables, supply chain disruptions, including shortages and inflationary pressure, uncertain or reduced demand, and the impact of any initiatives or programs that we may undertake to address financial and operational challenges faced by our customers.

Current wording

Our future results of operations and liquidity could be materially adversely affected by macroeconomic factors contributing to delays in payments of outstanding receivables, supply chain disruptions, including shortages, tariffs on imports, and inflationary pressure, uncertain or reduced demand, and the impact of any initiatives or programs that we may undertake to address financial and operational challenges faced by our customers.

Previous wording

The current macroeconomic environment is impacting our customers, both financially and operationally. Hospitals are experiencing staffing shortages and supply chain issues that could affect their ability to provide patient care. Additionally, hospitals are facing significant financial pressure as supply chain constraints and inflation drive up operating costs, rising interest rates make access to credit more expensive, unrealized losses decrease available cash reserves, and fiscal stimulus programs enacted during the COVID-19 pandemic continue to wind down. As a consequence of the financial pressures and decreased profitability, some hospitals have indicated that they are lowering their capital investment plans and tightening their operational budgets. Climate-related events, including the increasing frequency of extreme weather events, natural disasters, or other catastrophic events may cause damage or disruption to our domestic or global customers or our operations, which could have an adverse effect on our business, operating results, and financial condition.

Current wording

The current macroeconomic environment is impacting our customers, both financially and operationally. Hospitals are experiencing staffing shortages and supply chain issues that could affect their ability to provide patient care. Additionally, hospitals are facing significant financial pressure as supply chain constraints and inflation drive up operating costs, interest rate volatility make access to credit more expensive, and unrealized losses decrease available cash reserves. As a consequence of the financial pressures and decreased profitability, some hospitals have indicated that they are lowering their capital investment plans and tightening their operational budgets. Private and government payers around the world are increasingly challenging the utilization and overall cost charged for medical products and services. The containment of healthcare costs has become a priority of governments on a global basis. Private and government payors may decline to cover and reimburse for claims or portions of claims.Climate-related events, including the increasing frequency of extreme weather events, natural disasters, or other catastrophic events may cause damage or disruption to our domestic or global customers or our operations, which could have an adverse effect on our business, operating results, and financial condition.

Previous wording

Our hybrid work arrangements and decision to pursue a sublease for our leased San Francisco headquarters resulted in an impairment of its ROU asset and related leasehold improvements and furniture and fixtures during the years ended December 31, 2023 and 2022. As we continue to evaluate our global real estate footprint, we may incur additional impairment charges related to real property lease agreements.

Current wording

Our hybrid work arrangements and decision to pursue a sublease have previously resulted in an impairment of our right-of-use asset and related leasehold improvements and furniture and fixtures. As we continue to evaluate our global real estate footprint, we may incur additional impairment charges related to real property lease agreements.

Previous wording

We typically experience reduced revenue during the third quarter, as well as during the year-end holiday season. We believe this is the result of physicians and patients taking vacations and patients electing to delay our monitoring services during the summer months or holidays. Revenue may be impacted by the outcome of adjudications with contracted and non-contracted payors, as well as changes in CMS reimbursement rates like we experienced with final, lower rates being established for our Zio Services as of January 1, 2024. Clinical capacity limitations may also restrict our ability to complete the performance obligations to achieve revenue recognition.

Current wording

We typically experience reduced revenue during the third quarter, as well as during the year-end holiday season. We believe this is the result of physicians and patients taking vacations and patients electing to delay our monitoring services during the summer months or holidays. Revenue may be impacted by the outcome of adjudications with contracted and non-contracted payors, as well as changes in CMS reimbursement rates that are updated annually.

Previous wording

Cost of revenue includes direct labor, material costs, equipment and infrastructure expenses, amortization of internal-use software, allocated overhead, royalties, and shipping and handling. Direct labor includes payroll-related costs including stock-based compensation involved in manufacturing, clinical data curation, and customer service. Material costs include both the disposable materials costs of the Zio patches and amortization of the re-usable printed circuit board assemblies ("PCBAs"). Each Zio XT patch and Zio Monitor patch includes a PCBA, and each Zio AT patch includes a PCBA and gateway board, the cost of which is amortized over the expected useful life of the board. We expect cost of revenue to increase in absolute dollars as our revenue increases due to increased direct labor, direct materials, and variable spending, as well as amortization of internal-use software, partially offset by economies of scale in relation to fixed costs such as overhead and facilities costs.

Current wording

Cost of revenue includes direct labor, material costs, equipment and infrastructure expenses, amortization of internal-use software, allocated overhead, royalties, and shipping and handling. Direct labor includes payroll-related costs including stock-based compensation involved in manufacturing, clinical data curation, and customer service. Material costs include both the disposable materials costs of the Zio patches and amortization of the PCBAs. Each Zio XT patch and Zio Monitor patch includes a PCBA, and each Zio AT patch includes a PCBA and gateway board, the cost of which is amortized over the expected useful life of the board. We expect cost of revenue to increase in absolute dollars as our revenue increases due to increased direct labor, direct materials, and variable spending, as well as amortization of internal-use software, partially offset by economies of scale in relation to fixed costs such as overhead and facilities costs.

Previous wording

Our gross margin has been and will continue to be affected by a variety of factors, including increased contracting with third-party payors and institutional providers. We have in the past been able to increase our pricing as third-party payors become more familiar with the benefits of the Zio Services and move to contracted pricing arrangements. We expect increases to the cost of revenues due to increases to materials and electronics components pricing, labor rates, shipping rates, amortization of capitalized internal-use software, and increases in the general level of inflation, partially offset by reduced costs from obtaining volume purchase discounts for our material costs, implementing scan-time algorithms and process improvements, automating manufacturing assembly and packaging, and through software-driven and other workflow enhancements to reduce labor costs.

Current wording

Our gross margin has been and will continue to be affected by a variety of factors, including increased contracting with third-party payors and institutional providers. We have in the past been able to increase our pricing as third-party payors become more familiar with the benefits of the Zio Services and move to contracted pricing arrangements. We expect increases to the cost of revenues due to increases to materials and electronics components pricing, labor rates, shipping rates, amortization of capitalized internal-use software, along with increases in the general level of inflation and potential tariffs on imports (which may complicate and increase costs associated with our supply chain). We expect to partially offset these increases by reduced costs from obtaining volume purchase discounts for our material costs, implementing scan-time algorithms and process improvements, automating manufacturing assembly and packaging, and through software-driven and other workflow enhancements to reduce labor costs. We experienced an improvement in our gross margin from 2023 to 2024, and continue to focus on improving annual gross margins in the future, while navigating through the macroeconomic and supply chain headwinds discussed above that we expect to face.

Previous wording

We expense research and development costs as they are incurred. Research and development expenses include payroll-related costs, including stock-based compensation, consulting services, clinical studies, laboratory supplies and allocated facility overhead costs. In addition, we expense milestone payments, when probable, for the Development Agreement with Verily. We expect our research and development costs to increase in absolute dollars as we hire additional personnel to develop new product and service offerings, product enhancements, and clinical evidence.

Current wording

We expense research and development costs as they are incurred. Research and development expenses include payroll-related costs, including stock-based compensation, consulting services, clinical studies, laboratory supplies, milestone payments and allocated facility overhead costs. We expect our research and development costs to increase in absolute dollars as we hire additional personnel to develop new product and service offerings, product enhancements, and clinical evidence.

Previous wording

Our in-process research and development acquired in an asset acquisition for use in research and development activities with no alternative future use is expensed in the condensed consolidated statements of operations on the acquisition date.

Current wording

Our in-process research and development acquired in an asset acquisition for use in research and development activities with no alternative future use is expensed in the unaudited condensed consolidated statements of operations.

Previous wording

Interest income consists of interest income received on our cash and cash equivalents, marketable securities, and other investments.

Current wording

Interest income consists of interest income received on our cash and cash equivalents and marketable securities.

Previous wording

Comparison of the Three and Nine Months Ended September 30, 2024 and 2023

Current wording

Comparison of the Three Months Ended March 31, 2025, and 2024

Previous wording

Cost of revenue increased by $3.9 million, or 9%, to $46.1 million during the three months ended September 30, 2024, as compared to $42.1 million during the three months ended September 30, 2023. Cost of revenue increased by $19.3 million, or 17%, to $135.1 million during the nine months ended September 30, 2024, as compared to $115.8 million during the nine months ended September 30, 2023. The increase in cost of revenue was due primarily to increases in headcount-related costs associated with the increase in volume of Zio Services. For the three and nine months ended September 30, 2024, additional impacts to cost of revenue include an increase of approximately $1.3 million and $3.9 million, respectively, in amortization charges for Zio XT and Zio Monitor PCBAs in conjunction with the ongoing commercial launch of Zio Monitor, as well as an increase of approximately $0.5 million and $2.4 million, respectively, in amortization charges for internal-use software which support delivery of our services.

Current wording

Cost of revenue increased by $5.0 million, or 11%, to $49.5 million during the three months ended March 31, 2025, as compared to $44.4 million during the three months ended March 31, 2024. The increase in cost of revenue was due to increases in material component costs and headcount-related costs associated with the increase in volume of Zio Services. Additional impacts to cost of revenue include $0.7 million in amortization costs primarily for Zio Monitor PCBAs in conjunction with the ongoing commercial launch of the Zio Monitor System.

Previous wording

Research and development expenses decreased by $0.6 million, or 4%, to $15.7 million during three months ended September 30, 2024, as compared to $16.3 million during the three months ended September 30, 2023. Research and development expenses increased by $7.6 million, or 17%, to $52.4 million during the nine months ended September 30, 2024, as compared to $44.8 million during the nine months ended September 30, 2023. The decrease in research and development expenses during the three months ended September 30, 2024 was primarily related to lower headcount-related costs (including stock-based compensation). The increase in research and development expenses during the nine months ended September 30, 2024 was primarily due to higher headcount-related costs (including stock-based compensation), consulting costs to support regulatory and legal matters, and further development, enhancement and functionality of our current and future product offerings.

Current wording

Research and development expenses increased by $4.5 million, or 27%, to $21.5 million during three months ended March 31, 2025, as compared to $17.0 million during the three months ended March 31, 2024. The increase in research and development expenses was primarily due to higher employee-related costs (including stock based compensation) supporting ongoing FDA remediation and sustaining activities, product development consulting costs, and further development, enhancement, and functionality of our current and future product offerings.

Previous wording

Acquired IPR&D expense was $32.1 million during the three and nine months ended September 30, 2024. The expense was related to the Technology License Agreement (the “License Agreement”) we entered into with BioIntelliSense, Inc. (“BioIS”) during the third quarter of 2024. See Note 7, Commitments and Contingencies, in the notes to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q for further details.

Current wording

Acquired IPR&D expense was $0.3 million during the three months ended March 31, 2025. The expense was related to the Technology License Agreement (the “License Agreement”) we entered into with BioIntelliSense, Inc. (“BioIS”) during the third quarter of 2024. See Note 7, Commitments and Contingencies, in the notes to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q for further details.

Previous wording

Interest income increased by $4.7 million to $6.5 million during the three months ended September 30, 2024, as compared to $1.7 million during the three months ended September 30, 2023. Interest income increased by $11.6 million to $16.2 million during the nine months ended September 30, 2024, as compared to $4.6 million during the nine months ended September 30, 2023. The increase was attributable to higher market interest rates earned from our cash and cash equivalents and marketable securities, an increase in the average invested balances during the three and nine months ended September 30, 2024, as compared to the same periods in 2023, primarily as a result of the borrowing under the 2029 Notes in March 2024.

Current wording

Interest income increased by $1.9 million to $4.9 million during the three months ended March 31, 2025, as compared to $3.1 million during the three months ended March 31, 2024. The increase was attributable to higher average invested balances during the three months ended March 31, 2025, as compared to the same period in 2024, primarily as a result of the borrowing under the 2029 Notes in March 2024.

Previous wording

Interest expense increased by $2.4 million to $3.3 million during the three months ended September 30, 2024, as compared to $0.9 million during the three months ended September 30, 2023. Interest expense increased by $6.8 million to $9.5 million during the nine months ended September 30, 2024, as compared to $2.7 million during the nine months ended September 30, 2023. The increase in interest expense was primarily attributable to the $75.0 million Braidwell Term Loan Facility borrowed and repaid during the first quarter of 2024, as well as the $661.3 million 2029 Notes borrowed in March 2024.

Current wording

Interest expense increased by $0.4 million to $3.3 million during the three months ended March 31, 2025, as compared to $2.9 million during the three months ended March 31, 2024. The increase in interest expense was primarily attributable to the $661.3 million 2029 Notes borrowed in March 2024.

Previous wording

Other income (expense), net increased by $1.3 million to $1.2 million during the three months ended September 30, 2024, as compared to other income (expense), net of ($0.1 million) during the three months ended September 30, 2023. Other income (expense), net increased by $0.9 million to $0.8 million during the nine months ended September 30, 2024, as compared to other income (expense), net of ($0.1 million) during the nine months ended September 30, 2023. The increases were primarily attributable to the changes in the fair value of our strategic debt and equity investments recognized during the three months ended September 30, 2024.

Current wording

Other income (expense), net increased by $1.0 million to $0.9 million during the three months ended March 31, 2025, as compared to other income (expense), net of $(0.1) million during the three months ended March 31, 2024. The increase was primarily attributable to the changes in the fair value of our strategic equity investments recognized during the three months ended March 31, 2025.

Previous wording

Loss on extinguishment of debt was nil and $7.6 million for the three and nine months ended September 30, 2024, respectively. The loss was related to the early extinguishment of both the SVB Loan Agreement and the Braidwell Term Loan Facility during the first quarter of 2024. See Note 8, Debt, in the notes to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q for details of our financing activities.

Current wording

Loss on extinguishment of debt was $7.6 million for the three months ended March 31, 2024. The loss was related to the early extinguishment of both the SVB Loan Agreement and the Braidwell Term Loan Facility during the first quarter of 2024. See Note 8, Debt, in the notes to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q for details of our financing activities.

Previous wording

As of September 30, 2024, we had cash and cash equivalents of $519.5 million, marketable securities of $2.5 million, and accounts receivable of $77.4 million, with a significant portion of our cash and cash equivalents balance deposited within our interest-bearing bank concentration accounts. We continuously review our liquidity and anticipated capital requirements in light of the significant uncertainty created by the current macroeconomic environment, including inflation, interest rate volatility, and potential instability in the global banking system. We intend to continue to make investments to support our business, which may require us to engage in equity or debt financings to secure additional funds. During the first quarter of 2024, we experienced a temporary delay in the billing of our contracted and non-contracted payer customers, performed by our third-party claims processing vendor. The delay was due to a cybersecurity incident experienced by Change Healthcare, a division of UnitedHealth Group, which our third-party vendor engages for services relating to billing and collections. While we substantially cleared the billing backlog as of the end of the first quarter of 2024, the delay in billing resulted in a temporary delay in our cash collections. During the second and third quarters of 2024, we received a significant portion of our cash collections from the delayed billings. We believe that our current cash, cash equivalents, and marketable securities balances, together with income to be derived from the sales of our Zio Services, will be sufficient to meet our liquidity requirements for at least the next 12 months.

Current wording

As of March 31, 2025, we had cash and cash equivalents of $375.3 million, marketable securities of $145.3 million, and accounts receivable, net of $80.6 million.We continuously review our liquidity and anticipated capital requirements in light of the significant uncertainty created by the current macroeconomic environment, including inflation, interest rate volatility, and potential instability in the global banking system. We intend to continue to make investments to support our business, which may require us to engage in equity or debt financings to secure additional funds. During the first quarter of 2024, we experienced a temporary delay in the billing of our contracted and non-contracted payer customers, performed by our third-party claims processing vendor. The delay was due to a cybersecurity incident experienced by Change Healthcare, a division of UnitedHealth Group, in which our third-party vendor did engage for services relating to billing and collections. While we substantially cleared the billing backlog as of the end of the first quarter of 2024, the delay in billing resulted in a temporary delay in our cash collections. We have received the majority of our cash collections from the delayed billings. During the first quarter of 2025, we experienced higher levels of contractual adjustments associated with our gross accounts receivable. Additionally, through our revenue cycle management transformation we have focused our efforts in part to resolve payor claims denials and unpaid portions of patient-responsible balances in a more timely basis.

Previous wording

During the nine months ended September 30, 2024, cash used in operating activities was $15.8 million, a decrease of $18.3 million, as compared to cash used in operating activities of $34.1 million during the nine months ended September 30, 2023. The reduction in cash used in operating activities was primarily attributable to favorable impacts from decreases in prepaid and other current assets, and a reduction in other long-term assets primarily from lower levels of purchases of PCBAs. Additionally, timing of collections associated with our accounts receivable, offset with the timing of payments associated with our accounts payable and accrued liabilities, is further contributing to our net usage levels of cash in operations.

Current wording

During the three months ended March 31, 2025, cash used in operating activities was $7.9 million, a decrease of $44.1 million, as compared to cash used in operating activities of $52.0 million during the three months ended March 31, 2024. The reduction in cash used in operating activities was primarily attributable to reductions in our net loss driven by our revenue growth, timing of collections associated with our accounts receivable, as well as the timing of payments associated with our accounts payable and accrued liabilities. These reductions in cash used in operating activities were offset by an increase to prepaid expenses and other current assets.

Previous wording

During the nine months ended September 30, 2024, cash used in investing activities was $0.8 million, an decrease of $1.8 million, as compared to cash used by investing activities of $2.6 million during the nine months ended September 30, 2023. The decrease was primarily attributable to a net increase in the change in marketable securities of $69.0 million. This was offset by an increase of $52.0 million in cash used for the purchases of strategic investments, as well as $15.0 million of acquired in-process research and development from BioIS, during the nine months ended September 30, 2024.

Current wording

During the three months ended March 31, 2025, cash used in investing activities was $38.1 million, an increase of $78.1 million, as compared to cash provided by investing activities of $40.0 million during the three months ended March 31, 2024. The increase in cash used in investing activities was primarily attributable to a net increase in the change in marketable securities of $78.5 million, offset by decrease in purchases of property and equipment of $0.4 million.

Previous wording

During the nine months ended September 30, 2024, cash provided by financing activities was $508.4 million, an increase of $503.0 million as compared to $5.4 million during the nine months ended September 30, 2023. The increase was primarily attributed to $661.3 million in proceeds from the issuance of our 2029 Notes. The increase was offset by $37.8 million associated with the payment of the SVB Loan Agreement and related termination costs, payment of $5.6 million associated with the Braidwell Term Loan Facility debt issuance and termination costs, payment of $17.4 million associated with debt issuance costs for our 2029 Notes, payment of $72.4 million for the purchase of the 2029 Capped Calls, and payment of $25.0 million for the repurchase of shares of our common stock.

Current wording

During the three months ended March 31, 2025, cash provided by financing activities was $1.7 million, a decrease of $502.9 million as compared to $504.6 million during the three months ended March 31, 2024. The decrease was primarily attributed to $661.3 million in proceeds from the issuance of our 2029 Notes during the three months ended March 31, 2024. The decrease was offset by $37.8 million associated with the payment of the SVB Loan Agreement and related termination costs, payment of $5.5 million associated with the Braidwell Term Loan Facility debt issuance and termination costs, payment of $16.6 million associated with debt issuance costs for our 2029 Notes, payment of $72.4 million for the purchase of the 2029 Capped Calls, and payment of $25.0 million for the repurchase of shares of our common stock.

Previous wording

Our contractual obligations as of December 31, 2023, are presented in our Annual Report on Form 10-K filed with the SEC on February 22, 2024. There were no significant changes to our lease obligations during the nine months ended September 30, 2024. As of September 30, 2024, we had approximately $43.4 million of open purchase orders and contractual obligations in the ordinary course of business, the majority of which are due within one year. See Note 8, Debt, in the notes to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q for changes in our debt obligations during the nine months ended September 30, 2024.

Current wording

Our contractual obligations as of December 31, 2024, are presented in our Annual Report on Form 10-K filed with the SEC on February 20, 2025. There were no significant changes to our lease obligations during the three months ended March 31, 2025. As of March 31, 2025, we had approximately $67.7 million of open purchase orders and contractual obligations in the ordinary course of business, the majority of which are due within one year. See Note 8, Debt, in the notes to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q for changes in our debt obligations during the three months ended March 31, 2025.

Previous wording

Our significant accounting policies are described in Note 2, Summary of Significant Accounting Policies, to the consolidated financial statements included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2023. Updates to our significant accounting policies are described in Note 2, Summary of Significant Accounting Policies, in the notes to our unaudited condensed consolidated financial statements in Part 1, Item 1 of this Quarterly Report on Form 10-Q. The critical accounting estimates that are most critical to a full understanding and evaluation of our reported financial results are described in Management’s Discussion and Analysis of Financial Condition and Results of Operations in Part II, Item 7 of our Annual Report on Form 10-K for the fiscal year ended December 31, 2023. There were no material changes to our critical accounting estimates during the nine months ended September 30, 2024.

Current wording

Our significant accounting policies are described in Note 2, Summary of Significant Accounting Policies, to the consolidated financial statements included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2024. Updates to our significant accounting policies are described in Note 2, Summary of Significant Accounting Policies, in the notes to our unaudited condensed consolidated financial statements in Part 1, Item 1 of this Quarterly Report on Form 10-Q. The critical accounting estimates that are most critical to a full understanding and evaluation of our reported financial results are described in Management’s Discussion and Analysis of Financial Condition and Results of Operations in Part II, Item 7 of our Annual Report on Form 10-K for the fiscal year ended December 31, 2024. There were no material changes to our critical accounting estimates during the three months ended March 31, 2025.