Billiontoone, Inc. · NASDAQ:BLLN
Billiontoone — Q4 2025 Earnings Presentation
27 slides from Billiontoone's earnings presentation, Mar 4, 2026
Slide 1: Q4 2025 & FY 2025 Business Update
Q4 2025 & FY 2025 Business Update March 4, 2026
Slide 2: Disclaimer & Forward Looking Statement
Disclaimer & Forward Looking Statement This presentation contains certain “forward-looking statementsˮ within the meaning of applicable Though we have attempted to identify important factors that could cause actual results to differ materially securities laws. These statements relate to future event
Slide 3: Full Year 2025 Milestones and Key Metrics
FULL YEAR 2025 Milestones Key Metrics Northstar Select received $ Medicare coverage 305M 100% 13% Positive Full-year revenue YoY revenue Adjusted GAAP operating profit Northstar Response vs $153M in 2024 growth* EBITDA margin & cashflow achieved 0.01% LOD 14-gene sgNIPT launched YoY Performance* ahe
Slide 4: Our Pillars of Differentiation
4 Our 4 Pillars of Differentiation CONFIDENTIAL & PROPRIETARY Revolutionary smNGS Scalable Superior Gross GAAP Platform & Products Rapid Growth Margin Profile Profitability Patented QCT™ technology Zero to $384M ARR* 70% gross margin Culture of fiscal discipline enabling single-molecule in 5 years
Slide 5: Summary of Q4 Achievements
5 Summary of Q4 Achievements CONFIDENTIAL & PROPRIETARY Revolutionary smNGS Scalable Superior Gross GAAP Platform & Products Rapid Growth Margin Profile Profitability • Prenatal: UNITY FNAIT & • Rapid test growth to • Robust ASP growth to • Achieved 11% GAAP Fetal Antigen expansion 170,000 at 47% Y
Slide 6: Revolutionary smNGS Platform & Products
Revolutionary smNGS Platform & Products
Slide 7: Strong Practice Guideline Support for Fetal Antigen NIPT
7 Pillar 1 — Platform & Product Prenatal CONFIDENTIAL & PROPRIETARY LATEST DEVELOPMENT Strong Practice Guideline Support for Fetal Antigen NIPT NEW Clinical Guidance We recommend the use of If cffDNA testing reveals an cell-free fetal DNA (cffDNA) antigen negative fetus, no A Clinical Practice to ac
Slide 8: FNAIT & Expanded Fetal Antigen
8 Pillar 1 — Platform & Product Prenatal CONFIDENTIAL & PROPRIETARY LAUNCHED FNAIT & Expanded Fetal Antigen After changing guidelines for fetal Closing gaps in RBC alloimmunization Creating a new path for patients at risk of FNAIT antigen testing for alloimmunized RBC Fetal Antigen NIPT Platelet Fet
Slide 9: Northstar Select Upgrades
9 Pillar 1 — Platform & Product Oncology CONFIDENTIAL & PROPRIETARY LAUNCHED Northstar Select Upgrades Pharmacogenomics Clonal Hematopoiesis Northstar PGx ensures we Northstar PGx™ Northstar Select CH™ remain aligned with evolving oncology guidelines. Convenient add on for recommended New and improv
Slide 10: Scalable Rapid Growth
Scalable Rapid Growth
Slide 11: Our total test volume is rapidly increasing with 47% YoY growth
11 Pillar 2 — Scalable Rapid Growth Our total test Test Volume Delivered Quarterly volume is rapidly 170K increasing with 47% 47% YoY* growth. • Continued strong QoQ growth across both prenatal & oncology, despite seasonally slower Q4 with fewer * accessioning days • Record number of new active ord
Slide 12: Exponential revenue growth: zero to $384M ARR in ~5 years
12 Pillar 2 — Scalable Rapid Growth Exponential Total GAAP Revenue Quarterly revenue growth: $96.1M zero to $384M* 113% ARR in ~5 years. Driven by rapid YoY** increases both in tests delivered 47%) and ASP 47% across both product lines. * Q4 2025 revenue of $96.1M annualized as of Dec 31, 2025.
Slide 13: Prenatal and Oncology GAAP Revenue Quarterly
13 Pillar 2 — Scalable Rapid Growth Prenatal GAAP Revenue Quarterly Oncology GAAP Revenue Quarterly $86.9M* $9.1M 98% 736% * Includes revenue associated with clinical trial services Percentage growth rates represent growth from Q4 2024 to Q4 2025
Slide 14: Superior Gross Margin Profile
Superior Gross Margin Profile
Slide 15: Our overall ASP is rapidly growing
15 Pillar 3 — Superior Gross Margin Profile Our overall ASP is Overall ASP* rapidly growing. $561 • Overall ASP increased another 12% QoQ from $501 to $561, a significant $60 per test increase. This represents a 47% YoY increase. • For the FY 2025, our overall ASP increased to $495 in FY 2025 from $
Slide 16: Overall COGS per test was $161 in Q4
16 Pillar 3 — Superior Gross Margin Profile Overall COGS Overall COGS Per Test Quarterly per test was $161 in Q4. The overall COGS-per-test was lower by 3.6% $161 3.6% YoY* and slightly higher QoQ $127 • Oncology test volume grew by 20% QoQ, leading to a higher proportion of tests in oncology, wh
Slide 17: 71.4% gross margin with continuing expansion
17 Pillar 3 — Superior Gross Margin Profile 71.4% gross Gross Margin Quarterly margin* with continuing Overall $561 ASP $501 expansion. $384 $444 $455 71.4% Gross 70% Margin $348 • GM continued to increase, 65% 64% despite increasing volume from oncology, which has lower 57% 53% margins at its curre
Slide 18: GAAP Profitability
GAAP Profitability
Slide 19: GAAP profitability achieved in Q4 2025 and FY 2025
19 Pillar #4 — GAAP Profitability CONFIDENTIAL & PROPRIETARY GAAP profitability Net Margin achieved in Q4 2025 and FY 2025 Attained 29% YoY* improvement in net income margin and 36% YoY improvement in operating margin, achieving positive GAAP profitability for both Q4 2025 and FY 2025. Net Income $
Slide 20: Q4 2025 Earnings Summary
20 2025 Q4 Earnings Summary CONFIDENTIAL & PROPRIETARY Our Q4 2025 performance continued our strong growth. Actual Actual Actual YoY QoQ Q4 2024 Q3 2025 Q4 2025 Growth Growth Commentary Total Tests Delivered 115,959 165,047 169,902 47% 3% Overall ASP Per Test $382 $501 $561 47% 12% 98% YoY prenatal
Slide 21: FY 2025 Earnings Summary
21 FY 2025 Earnings Summary CONFIDENTIAL & PROPRIETARY FY 2025: 100% YoY growth rate & 13% adjusted EBITDA margin Actual Actual YoY FY 2024 FY 2025 Growth Commentary Total Tests Delivered 405,019 610,431 51% Overall ASP Per Test $368 $495 35% 87% YoY prenatal revenue growth Revenue - Total Prenatal
Slide 22: Raising our 2026 guidance by another $15M
22 Guidance CONFIDENTIAL & PROPRIETARY We are achieving profitability while growing exponentially, and we are raising our 2026 guidance by another $15M. Projections vs Actuals Historical Projection Previous vs Current $430M $445M 83% CAGR $415M - $430M Previous Projection: JPM 2026 $305M Previous
Slide 23: Catalysts for 2026
23 2026 Growth CONFIDENTIAL & PROPRIETARY Catalysts for 2026 Prenatal Oncology Sales Team Growth Epic Aura Integration Sales Team Growth MolDx Approval From 150 to 185 reps Driving further health From 45 to 65 reps For Northstar Response system adoption (immunotherapy) Product Launches Product L
Slide 24: BillionToOne will be in-network with UnitedHealthcare
24 Important News CONFIDENTIAL & PROPRIETARY BillionToOne will be In-Network Effective Apr 1, 2026 in-network with United Healthcare, the UnitedHealthcare largest health insurer in the country.
Slide 25: Summary
25 Summary We are transforming healthcare: one molecule at a time, one patient at a time. MolDx submission for Strong GM profile LONG-TERM GOAL Northstar Response in Q4 above 70% with ASPs & multiple product increasing another 12% launches by mid-Q1 QoQ To build a category-defining Highest number of
Slide 26: EBITDA Reconciliation
26 Appendix CONFIDENTIAL & PROPRIETARY EBITDA Reconciliation Q4 2024 Q4 2025 FY 2024 FY 2025 Net Income Loss $11.5M $6.0M $41.6M $7.4M Provision for Income Taxes $0.0M $0.3M $0.0M $0.3M Interest Income $1.7M $3.3M $5.8M $7.8M Interest Expense $0.1M $0.0M $2.4M $0.1M Depreciation and
Slide 27: Adjusted EBITDA Reconciliation
27 Appendix CONFIDENTIAL & PROPRIETARY Adjusted EBITDA Reconciliation Q4 2024 Q4 2025 FY 2024 FY 2025 Net Income Loss $11.5 $6.0M $41.6M $7.4M Provision for Income Taxes $0.0M $0.3M $0.0M $0.3M Interest Income $1.7M $3.3M $5.8M $7.8M Interest Expense $0.1M $0.0M $2.4M $0.1M Depreciat