Ladies and gentlemen in attendance and to our webinar guests around the world, welcome back to the 2025 MicroCap Rodeo. Next up, it is the CFO of Paysign Inc. I give you Mr. Jeff Baker. Jeff, come on up here.
Thank you very much. Jeff, as I said, my name is Jeff Baker, CFO of Paysign. I've been with the company just over four years. Happy to present, the company is listed on the NASDAQ under the symbol PAYS. Some forward-looking statements. I'm not gonna read this, but you should read this, as part of the housekeeping details, as well as, management uses non-GAAP financial measures. Most of the companies that follow us look at adjusted EBITDA, which is EBITDA plus stockholders' comp. So what does Paysign do? We effectively, what this slide says, is that we are a program manager, processor. We do everything soup to nuts. One throat to choke, so to speak. We do charge our own chargebacks. We do our own customer service, 24/7, 365 bilingual customer service. We're not relying on third parties.
When we need to make a change to our software, we do it ourselves. We do not have to wait in line three, six, nine months for processors to do what we need to do to be successful. The company was incorporated in 1995. We are headquartered in Southern Nevada. Actually, we are just a suburb of Las Vegas. We have been around for more than 20 years, mostly providing payment services to the healthcare industry. We also do other prepaid areas, where, you know, we are replacing checks and cash just like other prepaid companies. Like I said, the predominant piece of our business is in healthcare payments and two vertical markets. I will talk about those in a moment. Some quick milestones here. In 2007, we actually entered the pharmaceutical prepaid space where we were providing electronic payments for other customers like hub service providers in the industry.
One that everybody is pretty familiar with is called McKesson. I'm sure most people have heard of that company. They have a division called Cover My Meds, where we were doing prepaid payments. In 2011, we moved into the plasma industry, where people, when they go give plasma, used to, they used to pay them with cash and check, and now they put it on an open-loop debit card, Visa branded card. We entered that space. The company went public through a reverse merger in 2018. In 2019, we rebranded Paysign, again, symbol PAYS. At the end of the fourth quarter, some metrics here, we had 480 plasma centers that we did payments for. There's about a little over 1,200 in the U.S. The U.S., ironically, provides over 75% of the world's plasma.
Plasma is used, that's the clear liquid that comes out of the blood. You can get plasma twice a week, eight times a month. I think you can get blood like every six weeks. You sit in a machine and they separate the plasma from the red blood cells and put the red blood cells back in your body. Anyway, we have about 40% market share today in that business. We exited the year also with 76 patient affordability programs. That's the other side of our business. Patient affordability is also known as copay. What happens is, you get a script from your doctor, you go to the pharmacist, you're trying to get that script filled. 80% is gonna be paid by your health insurance, usually with most health plans.
The other 20%, they're gonna say, "Jeff, I need, you know, 20, 20% from you." A lot of these, especially pharma drugs, there's over 800 in the country, in the market today. Like I said, with the end of the year, we had 76, but they're very expensive drugs, and most people can't afford a $200 copay. What will happen at that point is that the pharmaceutical company will be willing to pay that because the abandonment rate for drugs for them filling a prescription at the pharmacy is like 60%-over 65%. The pharmaceutical company would rather have 80% of something rather than 0% of nothing.
They also realize that eventually you're gonna reach a point where you're gonna reach your maximum out-of-pocket expenditure, and then the health insurance company's gonna pay 100%. This happens every year. At January 1st every year, your benefits reset, as you know. Some investment highlights. On our financials, we have strong cash flow. It's been continuing to improve. We had heavy investments in the patient affordability business over the past three years, 2022, 2023, and 2024, and we're starting to show that that investment's paying off and you're starting to see margin expansion, and, you know, good cash flow. Like I said, we have zero debt. Both businesses, the plasma business in a normal world grows about 5% a year. It's a good cash cow. Last year did about $43 million-$44 million in revenue.
And then the pharma patient affordability business, it's our real growth driver. And I've already given guidance this year that it'll grow at least 135% over last year. Last year it did $12.7 million, and that's kind of putting it in at $28 million-$30 million camp this year. We have great technology in the cloud. The platform continues to be developed and improved. We have superior products and services and really good, you know, sales and delivery and service. That's one thing. I mean, the plasma and patient affordability or pharmaceutical customers, they have zero appetite for systems to go down. That's the best way I can say it. Uptime, service, and delivery is extremely important. We can move very fast when things change or when our customers need to change.
From a leadership perspective, if you look at our senior leadership, it's people either out of the banking industry, the payments industry like myself, or out of the patient affordability industry. So a lot of great domain expertise. That's one thing our CEO's done a really good job over the last, I'd say, five to six years is bring in good quality, senior leadership. Paysign at a glance. The stock closed just over $4.40 on, I think this is Monday. Market cap, just over $240 million. Fully diluted shares outstanding 55 million. Our 2024 revenue was $58 million. Trailing 12-month revenue was $64 million. You'll see that here on the, in the bottom slide with the green representing the first quarter. Fully diluted EPS was $0.07.
Yes, we are profitable, both from an earnings perspective, from a net income perspective as well as an adjusted EBITDA perspective. My gross margins at the end of the first quarter was 62.9%. That's up from 53% the same period last year. You know, like I said, I have no debt and I've got $111 million of cash, of which $7 million roughly is unrestricted. The rest is restricted cash, about half of that is the dollars that are sitting in a bank account waiting to be spent. These are people that have paid, gone and given plasma, and they've gotten paid $60-$70 per instance as they use those funds by going to buy groceries, gas, getting money off ATM. I make money, and that's, you know, that's our card-based revenue.
This is just a quick screenshot of our, you know, 12-month chart. You'll see it was in a downtrend, for whatever reason. I have no idea. It rallied after we reported first quarter earnings 'cause I think the street is starting to recognize the leverage that we now have that we're showing with that patient affordability business, that investment that was made. I think there was a lot of doubt from investors whether or not we could actually turn that into a leverageable business. We started to demonstrate that in the first quarter. By the numbers, I mentioned 2024 revenue $58.4 million. The trailing 12-month revenue $64 million. We've got trailing 12-month adjusted EBITDA of $13 million and total assets of $105 million. On the left here, you'll see revenue by segment, and the light blue is the plasma business.
The darker blue is the patient affordability business. The green is kind of the other. We have other prepaid programs that we use. We've got a payroll business. We've got a metal recycling business. We've got AAA where I do gift cards for them. It's a very small piece of our business. The chart on the right shows you our annual revenue growth from 2022, 2021, 2021, through 2024, and then trailing 12 months. I mentioned down here earlier the revenue drivers we have, the cardholder fees, which I already explained. I also get interchange when those cards are used. I also get interchange from my patient affordability business because we'll pay some of those claims with a virtual debit card. I get interchange there. I get monthly management fees in the patient affordability business.
and then I get other fees like call center fees, etc. Very interesting point is that we've got to the point where we basically run our call center at breakeven. In other words, I'm able to bill out as much as it costs me to pay for the call center employees. That that's a very unique business, from us. And then the other thing I mentioned, I didn't mention claim fees. So in the patient affordability, it's also transactional. I get paid based on the number of claims that I settle. And it doesn't matter if the claim is for $1,000 or $100. I get paid the same amount. and, the, the first quarter, the first half of the year is always the strongest from a claims perspective because people haven't reached their maximum out-of-pocket yet.
Like I said, in the second half of the year, claims go down, because your insurance company usually picks up that 100%. The patient affordability business, I mentioned it a little bit. There are kind of two areas. One of them is pharmacy benefit copay, just like what it says. You go to a pharmacy, Walgreens, Rite Aid, you know, independent pharmacy, you get your prescription filled, and we're gonna pay that claim. The other one is the medical benefit copay solutions, which is the same thing. It's if it's, you know, intravenous drugs delivered at hospitals or urgent care facilities, etc. Again, you know, the pharmaceutical companies pay these on your behalf because they want you on the drug.
One of the things that we have in this business that has really helped our success is this thing called Dynamic Business Rules. Dynamic Business Rules, it's a proprietary technology that we're able to see in the transaction flow where we can identify on first fill whether or not a claim is being paid by or should be paid by from a copay program or whether it's gonna be paid by, into these maximizers that are out there. I don't wanna lose people through the weeds here, but these maximizers are like SaveOn, PrudentRx. We can identify a transaction and stop that transaction. In 2024, we saved our customers over $100 million in claims that they would have made if they weren't using this technology. This year, it'll be at least double that. It is real money, real dollars.
We've had, you know, we've had customers who are, you know, marquee customers for us who have agreed to be referenced. And they've said, "Paysign, is no longer a call center for us. They're a revenue-generating center for us." That is very powerful, especially as we are able to add more customers. The numbers speak for themselves. I mean, this is the patient affordability business. The green again is the first quarter of this year versus last year. It's somewhat kind of the growth is masked a little bit. Like I said earlier, you know, in a normal world, the revenues would kind of fall off at the end of the second half of the year. We've been adding so many programs. Exited 2024, like I said, with 76 programs. I exited the first quarter with 90 programs.
There's more coming, that we'll add throughout the year and stage it for when the clock switches on January 1 and everything resets. Now, all those programs and all those claims will then, you know, hit in the first quarter of next year. The other part of our business, the plasma donor solutions, you know, pretty self-explanatory. You know, 40% market share. Told you how we make money on that. This business is, you know, grows about 5% a year, in a normal world. Come out of COVID, inventory levels were so depressed because the biggest risk of this business are people that sit at home and get free money from the government. People get plasma because they're using it to supplement their income, not because they like sitting in a chair for two hours to give, you know, have a needle in their arm.
Coming out of COVID, the inventory levels were low. You know, plasma companies were trying to build those inventory levels back up. Like anything else, they overcorrected. In about the fourth quarter of last year, we started to see plasma companies starting to cut their hours. They do not shut the centers because you have to get, it is a six-month process to get a center certified by the FDA to be selling plasma. What they did is, you know, if they were open seven days a week, now they are open five days a week. They have cut the weekend staff out. This business, you know, we have told the street that we expect it to be down 8%-10% this year. It is a good variable business. My revenues go down, my costs go down.
You know, still a nice margin, nice cash cow business. This will all abate. You know, plasma has a limited shelf life of it, but this will all abate over the next, you know, by the end of this year, first half of next year. This is, plasma by the numbers. Plasma, usually the first quarter is the weakest quarter because what happens? Tax refunds, right? People getting free money from the government. It usually builds throughout the rest of the year. It is, there's some seasonality with it when you're looking at the business and trying to compare year- over- year. We recently bought a company named Gamma Innovation. I'm really excited about this. We paid $60 million in cash and stock, structured it over four years, both the cash component and the stock vesting component of it.
We bought three software applications that were really built for the plasma industry. The TAM in the plasma market is about $100 million just on the payment side. We have 40% market share. It's, you know, that's kind of somewhat limited. The TAM on the patient affordability side, just on the payment side, is like over $500 million, and we're early days on that. This acquisition, by bringing in three more software applications, expands the TAM, our opportunity in plasma in general. The plasma industry is dominated from a software and hardware perspective by one company out of Canada named Haemonetics, and there really hasn't been a lot of development from them. There hasn't been a lot of, you know, disruption in the plasma space.
But with these applications now, there are international hardware companies that are in the process of getting FDA approval for their machines to come to the U.S. They would like nothing more than to have an integrated software application that they could help sell into other plasma companies. We were in Poland two weeks ago. I wasn't, but my CEO and other individuals from the company were there. The receptivity on these products was extremely positive. We'll see how that develops going forward. Even without that, if I don't sell one, I'm already happy with this acquisition because it came with a guy who has a great development shop. He was formerly with Google, Citibank, and he came in and immediately recognized over $4 million-$5 million in cash savings from just improving our development activities or our development.
We told the street exiting the second quarter we will be on that $4 million-$5 million annual run rate in cash savings. Now, it will not all drop to the bottom line because I was capitalizing on a lot of those costs, but it will improve my cash flow. These are some of the other, I mentioned, you know, the payroll. I mentioned, you know, AAA for their gift card business and others. We have kind of these small other prepaid areas that we go after that are still paying people in cash or checks. Our main focus is in the healthcare payments. Every prepaid company has this probably same slide. This is a huge market opportunity.
And on the far right, you see all of the products that we have that we could sell if we wanted to go after some of these. I mean, I'll be very honest. I came from one of the largest retail prepaid companies in the world. We're not going into retail. It's a pay-to-play game. It's dominated by two companies, Blackhawk and InComm. You know, if you're small like us, then you find these little niches where you can make a difference, you can provide great service, and you can beat the competition based on innovation. Like I said, most of our stuff comes from the corporate-funded incentive and rebates, is what that area is called, with the healthcare. Some financial highlights.
As I mentioned, if you look here on the second line, net income, we are profitable. You have to look at really, same period this year versus same period last year. So Q1 versus Q1, Q2 versus Q2, etc. And we do have, you know, benefit from a really nice, sponsorship deal, where we get, you know, interest income on the balances that we keep at the bank. You know, our depreciation amortization has been climbing, due to the investment, like I mentioned, in the patient affordability business, that capitalized software development. But if you, you know, go all the way down to the bottom, you'll see our adjusted EBITDA is growing. You'll see our adjusted EBITDA margins growing. You see our net income is growing and our net income margin is growing.
I think it's a testament to the vision that Mark had, you know, five years ago when he started back into the patient affordability business, built out a team, invested the company's capital knowing that it wasn't gonna happen overnight. We're finally reaching a point where we're starting to see that operating leverage. We're covered by five companies. They all have buy or buy equivalent ratings on us. Their target price is anywhere from $6-$8. You know, there's some good analyst coverage here, some resources. If you go to our website, our investor relations website, you can download this presentation. It's very important because I put this in here. If you wanna know whatever you wanna know about the plasma industry, you can click on the top row here, those three areas.
It'll tell you how many plasma centers there are. It'll tell you what plasma therapies are used, you know, what therapies use plasma, etc. The bottom section here, due to the complexity in the patient affordability business and copay, it's not as easy as I just told you. If you're interested, go do the research. You'll find out why PBMs are not good. You'll find out why maximizers are not good. You'll find out, you know, how complex and how inefficient our entire drug system is. People ask me, "Is this, you know, can you expand this outside the U.S.?" I'm like, "No, it doesn't exist outside the U.S. It's socialist medicine, and the government pays for most of everything. In the U.S., the government doesn't." By the way, and I did mention this, copay is only applicable to non-government health plans.
If you're on Medicare or Medicaid, you can't, you're not even associated. You can't even be a part of a copay program. This is the 170 million, roughly, individuals who aren't on government programs, which is unfortunate because I have parents who I would love to be able to subsidize their drug costs, but, you know, they're on Medicare. Unfortunately, they don't, they don't qualify. The leadership team I mentioned here are, you can look at these wonderful mug shots at your own leisure. Trust me when I say 90% of the people on this page either came out of the three areas: banking, payments, or healthcare, patient affordability. We have a really good group of independent directors. Dan Henry is an icon in the payments industry. He used to be the president of Euronet Worldwide, a public company.
He then went on to be the CEO of Netspend, which is another prepaid company, and then went on to be the CEO of Green Dot. Great payment domain expertise. Dennis Triplett, he was at UMB Health, he was the CEO of the healthcare side of UMB Bank. He comes out of banking. Jeff Newman used to work with Dan at Euronet. He was the general counsel there for many years. Bruce Mina, our audit chair, has his own CPA firm. With that, I will turn it over for questions.
We're now sort of working, like something changed internally?
Yeah. The question is, what happened in the pharma prepaid space is what we used to call it back in the early 2000s. The prepaid space is just that. We were the electronic or prepaid, the prepaid provider for hubs, like McKesson I mentioned. Before Paysign stepped into this market, the industry repaid claims using checks. That's all it is. Check, check, check, check. They would send a flat file to a check processor. They mail out checks. In steps Paysign. We knew that we were only getting a fraction of the opportunity for that business. In 2022, September 2022, the contract that we had with the big hub provider, we exited out of that contract and ended up actually going to other hub providers that did not have payment capabilities, saying, "Let's partner up. You do your hub stuff.
We'll do the payment stuff." And then, you know, here, here now we sit, with that. The other thing we did is we went direct to pharma. Before that, we didn't have any way to go direct to pharma. Now we've gone direct to pharma to do, you know, the bigger companies, payments for them. That's what happened.
Correct.
Yep. That was a big change when we moved from just doing the electronic payments for one customer and little bitty pieces of the business to going, boom, now we can do payments for everybody. We can do payments for hubs, and they act as kind of like our indirect salespeople. They bring us their customers, and then we can go direct to pharma, which we could not do before. We do all their payments. I do check, I do ACH, I do virtual debit card. That is how I pay. Most of my payments are electronic, ACH and virtual debit card. I hate checks. I wish they would go away, but they are not. You have to take the good to get the bad, so. Yeah.
The other important thing is we open booked the pharmaceutical companies. In the past, it was a big black box. They did all these services. Payments was one of them. We went in and said, "Listen, here's how much you're gonna pay per claim." Boom. You can figure out if you're getting an ROI by paying those monies to cover that copay. Totally different mentality. I'm getting the yank. Thank you very much for your time. I appreciate it. Please let me know if you have any questions.
Thank you very much. Yeah, appreciate it.
Folks, once again, the CFO of Paysign, Jeff Baker. On deck, everybody, it's ZenaTech coming up in just a couple of minutes. That will be followed by Sally's Apizza. ZenaTech is next.