0001193125-26-348902 | 10-Q | XBRL Viewer | Lumexa Imaging Holdings INC

The Company’s condensed consolidated balance sheets include assets of consolidated variable interest entities (“VIEs”), that can only be used to settle obligations and liabilities of the VIE and for which creditors do not have recourse to the primary beneficiary (Lumexa Imaging Holdings, Inc.). As of June 30, 2026 and December 31, 2025, total assets of consolidated VIEs consisted of accounts receivable of $60,623 and $49,560, respectively; accounts receivable, related party of $3,094 and $5,811, respectively; prepaid expenses of $1,111 and $1,502, respectively; other receivables of $5,482 and $4,463, respectively; property and equipment, net of accumulated depreciation of $18,173 and $17,669, respectively; operating lease right-of-use assets of $10,457 and $9,541, respectively; goodwill of $101,802 and $101,802, respectively; investments in unconsolidated affiliates of $54,020 and $54,087, respectively; and other assets of $23,356 and $21,554, respectively. As of June 30, 2026 and December 31, 2025, total liabilities of consolidated VIEs consisted of accounts payable of $349 and $373, respectively; accrued expenses and other current liabilities of $18,662 and $18,150, respectively; current portion of operating leases of $1,721 and $1,647, respectively; other liabilities of $28,296 and $25,724, respectively; and long-term operating lease liabilities, less current maturities of $9,302 and $8,492, respectively. See Note 10 “Variable Interest Entities” for further discussion.

- Definition

Amount of asset recognized for present right to economic benefit.

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Amount of liability recognized for present obligation requiring transfer or otherwise providing economic benefit to others.

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+ Details

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Organization and Nature of Business	6 Months Ended
Jun. 30, 2026
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Nature of Business	1. Organization and Nature of Business Lumexa Imaging Holdings, Inc., a Delaware corporation, (the “Company”) was incorporated on November 14, 2025. On December 10, 2025, Lumexa Imaging Equity Holdco, LLC (formerly US Radiology Specialists Holdings LLC) (“Holdings LLC”) contributed 100% of its equity in its wholly owned consolidated operating entities to the Company in exchange for 68,856,706 shares of the Company’s common stock, par value $0.001 per share (“Common Stock”) at the time of the pricing of the Company’s initial public offering (“IPO”), and the Company agreed to issue certain additional shares of Common Stock in the future in respect of certain incentive units of Holdings LLC (“Incentive Units”) that remained outstanding after the IPO (such contribution, the “Equity Reorganization”). The number of shares received by Holdings LLC in the Equity Reorganization was calculated based on a distribution ratio of 1 share of Common Stock per 9 units of Holdings LLC. The Equity Reorganization was accounted for as a common control transaction as it did not result in a change of control over the Company's operating entities. The consolidated historical financial statements prior to the IPO are those of Holdings LLC and its consolidated subsidiaries after giving effect to the Equity Reorganization. On December 12, 2025, the Company completed the IPO of 25,000,000 shares of Common Stock at a price to the public of $18.50 per share. The gross proceeds of the IPO were $462.5 million, before underwriting discounts of $27.8 million and offering costs of $7.8 million. $406.4 million of the net proceeds were used to pay down a portion of the Company's outstanding borrowings. The Company, together with its subsidiaries, is a network of diagnostic outpatient imaging centers in the United States, many of which are operated directly or indirectly through investments in unconsolidated affiliates with hospital partners. The investments in unconsolidated affiliates are accounted for using the equity method of accounting. The Company also has relationships with physician-owned radiology practices, which provide professional services to the Company and third-party hospitals. The Company has operations in 14 states. The Company operates its business through two wholly owned subsidiaries: Lumexa Imaging, Inc. (formerly US Radiology Specialists, Inc., (“LII”)) and Lumexa Imaging Outpatient, Inc. (formerly US Outpatient Imaging Specialists, Inc. (“LIOI”)). The consolidated financial statements include the accounts of Lumexa Imaging Holdings, Inc., its wholly owned subsidiaries and entities in which the Company has a controlling financial interest, also known as a variable interest entity (“VIE”). Generally accepted accounting principles in the United States of America (“US GAAP”) require variable interest entities to be consolidated if an entity’s interest in the VIE is a controlling financial interest. See further discussion of VIEs in Note 2 “Summary of Significant Accounting Policies.”

Organization and Nature of Business

6 Months Ended

Jun. 30, 2026

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Organization and Nature of Business

1. Organization and Nature of Business

Lumexa Imaging Holdings, Inc., a Delaware corporation, (the “Company”) was incorporated on November 14, 2025. On December 10, 2025, Lumexa Imaging Equity Holdco, LLC (formerly US Radiology Specialists Holdings LLC) (“Holdings LLC”) contributed 100% of its equity in its wholly owned consolidated operating entities to the Company in exchange for 68,856,706 shares of the Company’s common stock, par value $0.001 per share (“Common Stock”) at the time of the pricing of the Company’s initial public offering (“IPO”), and the Company agreed to issue certain additional shares of Common Stock in the future in respect of certain incentive units of Holdings LLC (“Incentive Units”) that remained outstanding after the IPO (such contribution, the “Equity Reorganization”). The number of shares received by Holdings LLC in the Equity Reorganization was calculated based on a distribution ratio of 1 share of Common Stock per 9 units of Holdings LLC. The Equity Reorganization was accounted for as a common control transaction as it did not result in a change of control over the Company's operating entities. The consolidated historical financial statements prior to the IPO are those of Holdings LLC and its consolidated subsidiaries after giving effect to the Equity Reorganization.

On December 12, 2025, the Company completed the IPO of 25,000,000 shares of Common Stock at a price to the public of $18.50 per share. The gross proceeds of the IPO were $462.5 million, before underwriting discounts of $27.8 million and offering costs of $7.8 million. $406.4 million of the net proceeds were used to pay down a portion of the Company's outstanding borrowings.

The Company, together with its subsidiaries, is a network of diagnostic outpatient imaging centers in the United States, many of which are operated directly or indirectly through investments in unconsolidated affiliates with hospital partners. The investments in unconsolidated affiliates are accounted for using the equity method of accounting. The Company also has relationships with physician-owned radiology practices, which provide professional services to the Company and third-party hospitals. The Company has operations in 14 states.

The Company operates its business through two wholly owned subsidiaries: Lumexa Imaging, Inc. (formerly US Radiology Specialists, Inc., (“LII”)) and Lumexa Imaging Outpatient, Inc. (formerly US Outpatient Imaging Specialists, Inc. (“LIOI”)). The consolidated financial statements include the accounts of Lumexa Imaging Holdings, Inc., its wholly owned subsidiaries and entities in which the Company has a controlling financial interest, also known as a variable interest entity (“VIE”). Generally accepted accounting principles in the United States of America (“US GAAP”) require variable interest entities to be consolidated if an entity’s interest in the VIE is a controlling financial interest. See further discussion of VIEs in Note 2 “Summary of Significant Accounting Policies.”

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Jun. 30, 2026
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Investments in Unconsolidated Affiliates - Additional Information (Details)	6 Months Ended
	Jun. 30, 2026 ImagingCenter
Schedule of Equity Method Investments [Line Items]
Number of imaging centers operates	88
Interest owned by subsidiary	49.00%
Touchstone Imaging Of Mesquite LLC [Member]
Schedule of Equity Method Investments [Line Items]
Interest owned by subsidiary	49.00%
Baylor University Medical Center [Member]
Schedule of Equity Method Investments [Line Items]
Interest owned by subsidiary	51.00%
All Others [Member] \| Maximum
Schedule of Equity Method Investments [Line Items]
Interest owned by subsidiary	50.00%
All Others [Member] \| Minimum
Schedule of Equity Method Investments [Line Items]
Interest owned by subsidiary	30.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Long-Term Debt

6 Months Ended

Jun. 30, 2026

Debt Disclosure [Abstract]

Long-Term Debt

6. Long-Term Debt

The following is a summary of the Company’s long-term debt (in thousands):


	JUNE 30,			DECEMBER 31,
	2026			2025
Senior secured term loan	$	822,938		$	825,000
Promissory notes		20,645			17,441
Accounts receivable pledging arrangement		1,267			1,599
Total debt obligations		844,850			844,040
Less debt issuance costs and discount		(9,500	)		(10,300	)
Long-term debt, net of debt issuance costs		835,350			833,740
Less accounts receivable pledging arrangement		(1,267	)		(1,599	)
Less current maturities of long-term debt		(14,330	)		(13,112	)
Long-term debt, less current maturities	$	819,753		$	819,029

Scheduled maturities of long-term debt as of June 30, 2026, excluding the Accounts Receivable Pledging Arrangement, were as follows (in thousands):


Years Ending December 31,
2026 (remaining six months)	$	7,069
2027		14,505
2028		13,598
2029		11,395
2030		10,440
Thereafter		786,576
Total	$	843,583

Senior Secured Credit Facility

On December 15, 2020, the Company entered into a senior secured credit agreement (“Original Credit Agreement”) consisting of a secured term loan facility of $790 million (“Original Term Loan”) and a secured revolving credit facility of $165 million (“Original Revolving Credit Facility”). On December 31, 2021, the Company entered into Incremental Amendment No. 1 (“First Amendment”) to its Original Credit Agreement. The First Amendment consisted of an additional $450 million incremental term loan. All other terms of the Original Credit Agreement remained unchanged. On March 21, 2023, the Company entered into Amendment No. 2 (“Second Amendment”) to its Original Credit Agreement. The Second Amendment transitioned the term loan benchmark interest rate from Eurodollar to Secured Overnight Financing Rate (“SOFR”) interest pricing. On July 16, 2024, the Company entered into Amendment No. 3 (“Third Amendment”) to its Original Credit Agreement. The Third Amendment reduced the Original Term Loan’s interest rate to

SOFR, plus 4.75% per annum (where the applicable SOFR rate had a 0.5% floor). On November 22, 2024, the Company entered into Amendment No. 4 (“Fourth Amendment”) to its Original Credit Agreement. The Fourth Amendment extended the maturity to the Original Revolving Credit Facility to September 2027.

On December 17, 2025, the Company entered into Amendment No. 5 to the Original Credit Agreement (Original Credit Agreement, as so amended, the “Amended Credit Agreement”). The Amended Credit Agreement provides for (i) a secured term loan facility of $825.0 million (“Refinancing Term Loan”) and (ii) a secured revolving line of credit of $250.0 million (“Amended Revolving Credit Facility”). The Refinancing Term Loan bears interest at SOFR plus 3.0%, or the Prime Rate plus 2.0%, and matures in December 2032. The Amended Revolving Credit Facility bears interest at SOFR plus 3.0%, or the Prime Rate plus 2.0%, and matures in December 2030. Proceeds from the Refinancing Term Loan of $825.0 million, along with $406.4 million of the Company’s IPO proceeds, were utilized to repay the term loans in full that were outstanding under the Original Credit Agreement. The Refinancing Term Loan requires quarterly principal payments of $2.1 million. On June 30, 2026, the Company entered into Amendment No. 7 to the Original Credit Agreement (the “7th Amendment”). The 7th Amendment reduced the Refinancing Term Loan’s and Amended Revolving Credit Facility’s interest rates from SOFR plus 3.0% to SOFR plus 2.5%.

The Amended Credit Agreement and 7th Amendment were evaluated under ASC 470-50, Debt-Modifications and Extinguishments. The borrowings under the Original Credit Agreement and the Amended Credit Agreement represented a loan syndication. As such, the accounting for the Amended Credit Agreement was evaluated on a lender by lender basis and resulted in new borrowings, extinguishments and modifications depending on each lender’s participation or lack thereof in the Amended Credit Agreement and the Original Credit Agreement. The Company incurred a total of $19.3 million in third party and lender costs as part of the Amended Credit Agreement. The Company capitalized $5.4 million and $5.9 million of costs associated with the Refinancing Term Loan and Amended Revolving Credit Facility, respectively. Such amounts are reported in Long-term debt, less current maturities and Other assets, respectively, on the condensed consolidated balance sheet as of December 31, 2025. The remaining $8.0 million of costs were expensed within Loss on extinguishment and modification of debt in the consolidated statement of operations for the year ended December 31, 2025. Additionally, as part of the Amended Credit Agreement, $5.4 million of previously capitalized debt issuance costs were expensed within Loss on extinguishment and modification of debt in the consolidated statement of operations for the year ended December 31, 2025. As part of the 7th Amendment, the Company incurred $1.2 million of third party costs related to the repricing, which were expensed within Loss on extinguishment and modification of debt in the consolidated statement of operations for the six months ended June 30, 2026.

As of June 30, 2026 and December 31, 2025, the interest rate on the Refinancing Term Loan was 6.2% and 6.7%, respectively. No amounts were outstanding under the Amended Revolving Credit Facility as of June 30, 2026 or December 31, 2025. Additionally, a commitment fee accrues per annum on the unused revolver commitments. The fee varies based on the Company’s leverage ratio. As of June 30, 2026 and December 31, 2025, the unused commitment fee was 0.50%. The fair value of the Refinancing Term Loan, which is classified within Long Term Debt on its condensed consolidated balance sheets, was $825.0 million and $829.0 million as of June 30, 2026 and December 31, 2025, respectively. The fair value estimates for the Company’s Refinancing Term Loan are based on bid quotes for comparable liabilities in inactive markets, a Level 2 input.

Covenants

The Amended Credit Agreement contains various restrictive covenants, including financial covenants that limit the Company’s ability and the ability of its subsidiaries to incur additional debt, pay dividends and other distributions, and engage in certain other transactions as specified therein. Failure to comply with these covenants could constitute an event of default notwithstanding the Company’s ability to meet its debt service obligations. The Company’s financial covenant is triggered if outstanding revolving credit exposure exceeds 40% of the aggregate principal amount of the Amended Revolving Credit Facility on the last day of the quarterly reporting period. If the covenant is triggered, the Company’s consolidated net leverage ratio on the last day of the test period shall not exceed 7.5 to 1. As of June 30, 2026, the Company’s outstanding revolving credit exposure did not exceed 40% of the aggregate principal amount of the Amended Revolving Credit Facility and, therefore, did not trigger the covenant. The Amended Credit Agreement includes various customary remedies for the lenders following an event of default. The Company was in compliance with all applicable covenants in the Amended Credit Agreement as of June 30, 2026.

The Company’s borrowings under the Amended Credit Agreement are guaranteed by LII and LIOI and each other wholly owned subsidiary of the Company, subject to certain exceptions. Substantially all of the assets of the Company are pledged as collateral in connection with the Amended Credit Agreement.

Promissory Notes

The Company has financed the acquisition of certain medical equipment and leasehold improvements under promissory notes. The promissory notes bear interest at rates ranging from 4.57% to 12.35% per annum and mature at various times through 2031. The promissory notes are collateralized by property and equipment of the Company and given the nature of the promissory notes, it was determined that the fair value approximates carrying value.

Accounts Receivable Pledging Arrangement

In August 2025, the Company entered into an accounts receivable pledging arrangement (the “AR Pledging Arrangement”) with a third-party financing company (the “Financer”). The final payment of the pledged accounts receivable will be settled through the judicial system (i.e., litigation between third parties), rather than by the associated patient or insurance company (the “Legal AR”). Under the AR Pledging Arrangement, the Company pledges certain of its Legal AR to the Financer in exchange for an advance cash payment in an amount equal to a predefined percentage multiplied by the amount due under such Legal AR. The AR Pledging Arrangement does not qualify for sale accounting, and the amounts received are reported as collateralized borrowings. Accordingly, the related assets remain on the Company’s condensed consolidated balance sheet and continue to be accounted for as if the transfer had not occurred. As of June 30, 2026, $1.3 million was outstanding under the AR Pledging Arrangement, which is secured by $2.6 million of accounts receivable. As of December 31, 2025, $1.6 million was outstanding under the AR Pledging Arrangement, which is secured by $3.3 million of accounts receivable. The amounts borrowed are reported as a current liability on the condensed consolidated balance sheets.

The Financer also acts as a servicer of the Legal AR over its remaining life and, upon settlement and collection on the Legal AR, the Company owes the Financer a servicing fee that is equal to a predefined percentage multiplied by the amount of cash collected. Until settlement and collection, the Legal AR under this arrangement is recognized by the Company and used to secure the borrowing from Financer. The Company has elected to account for the secured borrowing by utilizing the fair value option. There have been no material changes in the fair value of the secured borrowing as of June 30, 2026. Therefore, no mark to market adjustment has been recognized for the six months ended June 30, 2026.

Supplemental Cash Flow Information (Tables)

6 Months Ended

Jun. 30, 2026

Supplemental Cash Flow Elements [Abstract]

Schedule of Supplemental Cash Flow Information

SIX MONTHS ENDED
JUNE 30,

(in thousands)

2026

2025

SUPPLEMENTAL DISCLOSURE OF CASH
FLOW INFORMATION

Cash paid for interest

31,116

57,075

Cash paid for income taxes, net

1,748

—

SUPPLEMENTAL DISCLOSURE OF NONCASH
INVESTING AND FINANCING ACTIVITIES:

Equipment acquired under finance leases

17,992

4,414

Right of use assets acquired under operating leases

9,334

4,451

Purchase of property and equipment in accounts
payable and accrued expenses

4,823

3,962

Investments in Unconsolidated Affiliates (Tables)

6 Months Ended

Jun. 30, 2026

Equity Method Investments and Joint Ventures [Abstract]

Schedule of Investments in Unconsolidated Affiliates On Aggregated Basis

The following is a summary of the statements of income for the investments in unconsolidated affiliates on an aggregated basis for the periods indicated (in thousands):


	THREE MONTHS ENDED JUNE 30,
	2026									2025
	BTDI			ALL OTHERS			TOTAL			BTDI			ALL OTHERS		TOTAL
Income statement:
Revenues	$	109,533		$	42,905		$	152,438		$	100,890		$	39,282	$	140,172
Expenses		78,142			34,476			112,618			72,416			31,971		104,387
Net income	$	31,391		$	8,429		$	39,820		$	28,474		$	7,311	$	35,785
Company’s share of net income	$	14,966		$	4,226		$	19,192		$	13,616		$	3,411	$	17,027
Amortization of basis difference		(500	)		(73	)		(573	)		(500	)		—		(500	)
Equity in earnings of unconsolidated affiliates	$	14,466		$	4,153		$	18,619		$	13,116		$	3,411	$	16,527


	SIX MONTHS ENDED JUNE 30,
	2026									2025
	BTDI			ALL OTHERS			TOTAL			BTDI			ALL OTHERS		TOTAL
Income statement:
Revenues	$	208,505		$	83,616		$	292,121		$	193,945		$	77,989	$	271,934
Expenses		151,437			67,855			219,292			141,684			61,522		203,206
Net income	$	57,068		$	15,761		$	72,829		$	52,261		$	16,467	$	68,728
Company’s share of net income	$	27,211		$	7,537		$	34,748		$	25,014		$	7,831	$	32,845
Amortization of basis difference		(1,000	)		(105	)		(1,105	)		(1,000	)		—		(1,000	)
Equity in earnings of unconsolidated affiliates	$	26,211		$	7,432		$	33,643		$	24,014		$	7,831	$	31,845

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Income Tax Disclosure [Abstract]
Income tax expense	$ 3,020	$ 4,809	$ 4,384	$ 8,188
Effective tax rate	52.40%	(199.00%)	49.60%	(121.80%)

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

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+ Details

Summary of Significant Accounting Policies - Additional Information (Details)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2026 USD ($)	Jun. 30, 2025 USD ($)	Jun. 30, 2026 USD ($) Segment	Jun. 30, 2025 USD ($)	Dec. 31, 2025 USD ($)
Disaggregation of Revenue [Line Items]
FDIC insured limit	$ 250,000		$ 250,000
Percentage of investment in unconsolidated affiliate			49.00%
Percentage of management fees and other revenue	72.00%	72.00%	72.00%	72.00%
Percentage of accounts receivable			61.00%		60.00%
Amortization expense for capitalized cloud computing	$ 600,000	$ 100,000	$ 800,000	$ 200,000
Number of reportable segments \| Segment			2
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]			srt:ChiefExecutiveOfficerMember
Maximum
Disaggregation of Revenue [Line Items]
Capitalized software implementation cost amortization period	10 years		10 years
Minimum
Disaggregation of Revenue [Line Items]
Capitalized software implementation cost amortization period	1 year		1 year
Administrative Services Agreements [Member] \| Maximum
Disaggregation of Revenue [Line Items]
Agreement term duration	30 years		30 years
Administrative Services Agreements [Member] \| Minimum
Disaggregation of Revenue [Line Items]
Agreement term duration	20 years		20 years
Franchise Agreements [Member]
Disaggregation of Revenue [Line Items]
Agreement term duration	20 years		20 years
Prepaid expenses [Member]
Disaggregation of Revenue [Line Items]
Cloud computing software implementation costs	$ 2,500,000		$ 2,500,000		$ 1,300,000
Other assets [Member]
Disaggregation of Revenue [Line Items]
Cloud computing software implementation costs	$ 5,100,000		$ 5,100,000		$ 4,600,000
Revenue Benchmark [Member] \| Customer Concentration Risk [Member] \| Service [Member]
Disaggregation of Revenue [Line Items]
Percentage of revenues	10.00%	10.00%	10.00%	10.00%

Long-Term Debt - Summary of Long-Term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Debt Instrument [Line Items]
Total debt obligations	$ 844,850	$ 844,040
Less debt issuance costs and discount	(9,500)	(10,300)
Long-term debt, net of debt issuance costs	835,350	833,740
Less accounts receivable pledging arrangement	(1,267)	(1,599)
Less current maturities of long-term debt	(14,330)	(13,112)
Long-term debt, less current maturities	819,753	819,029
Senior Secured Term Loan
Debt Instrument [Line Items]
Total debt obligations	822,938	825,000
Promissory Notes
Debt Instrument [Line Items]
Total debt obligations	20,645	17,441
Accounts Receivable Pledging Arrangement
Debt Instrument [Line Items]
Total debt obligations	$ 1,267	$ 1,599

Net Income (Loss) Per Common Share (Additional Information) (Details) - shares shares in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Stock Option [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock excluded from computation of diluted net loss per share as their impact would have been anti-dilutive (in shares)	4.6		4.6
RSU [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock excluded from computation of diluted net loss per share as their impact would have been anti-dilutive (in shares)	4.6		4.6
Common shares [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock excluded from computation of diluted net loss per share as their impact would have been anti-dilutive (in shares)	4.6		4.6
Incentive Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock excluded from computation of diluted net loss per share as their impact would have been anti-dilutive (in shares)		12.3		12.3

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Net Income (Loss) Per Common Share - Schedule of Computation of Basic and Diluted Net Loss Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2026	Mar. 31, 2026	Jun. 30, 2025	Mar. 31, 2025	Jun. 30, 2026	Jun. 30, 2025
Numerator:
Net Income (Loss)	$ 2,745	$ 1,717	$ (7,226)	$ (7,687)	$ 4,462	$ (14,913)
Denominator:
Weighted average common shares outstanding - Basic	95,983,246		69,526,574		95,983,240	69,524,980
Shares issuable upon exercise or vesting of dilutive stock options, RSAs or RSUs	56,180		0		28,095	0
Weighted Average Number of Shares Outstanding, Diluted, Total	96,039,426		69,526,574		96,011,335	69,524,980
Net loss per share attributable to common stockholders:
Basic	$ 0.03		$ (0.1)		$ 0.05	$ (0.21)
Diluted	$ 0.03		$ (0.1)		$ 0.05	$ (0.21)

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The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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+ Details

Summary of Significant Accounting Policies

6 Months Ended

Jun. 30, 2026

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Principles of Consolidation and Basis of Financial Statement Presentation

The condensed consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries and controlled affiliates that are considered to be VIEs for which the Company is the primary beneficiary. See “Variable Interest Entities” below for further discussion of the Company’s VIEs. Investments in companies in which the Company has the ability to exercise significant influence, but not control, are accounted for under the equity method of accounting.

All intercompany accounts and transactions with consolidated entities have been eliminated in consolidation. The Company does not have any components of other comprehensive income within its condensed consolidated financial statements, and, therefore, does not separately present a statement of comprehensive income (loss) in its condensed consolidated financial statements. The accompanying condensed consolidated financial statements have been prepared in conformity with US GAAP.

The Company presents equity in earnings from investments in unconsolidated affiliates as a component of operating income since the activities of the investees are closely aligned with the operations of the Company.

The Company has prepared the accompanying condensed consolidated financial statements in accordance with US GAAP for interim financial information, and the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”) applicable to interim financial reporting. Accordingly, these condensed consolidated financial statements do not include all of the information and footnotes required for complete annual financial statements and should be read in conjunction with the audited consolidated financial statements and accompanying notes as of and for the year ended December 31, 2025.

In the opinion of the Company, the accompanying condensed consolidated financial statements contain all adjustments, consisting of only normal recurring adjustments, necessary for a fair statement of its financial position as of June 30, 2026, its results of operations for the three and six months ended June 30, 2026 and 2025 and cash flows for the six months ended June 30, 2026 and 2025. The condensed consolidated balance sheet as of December 31, 2025, was derived from audited annual consolidated financial statements but does not contain all of the footnote disclosures from the audited consolidated financial statements.

The Company’s significant accounting policies are disclosed in the audited consolidated financial statements as of and for the year ended December 31, 2025 contained in the Company’s Annual Report on Form 10-K filed with the SEC on March 30, 2026. There have been no material changes in the Company’s significant accounting policies during the six months ended June 30, 2026.

Use of Estimates

The preparation of the condensed consolidated financial statements in conformity with US GAAP requires the use of estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the condensed consolidated financial statements and the reported amounts of revenue and expenses during the reporting period. The most significant assumptions and estimates underlying these condensed consolidated financial statements and accompanying notes involve calculation of the Company’s provision for price concessions reducing revenue, allowances on accounts receivable, the fair value of assets and liabilities acquired in business combinations, the fair value of equity issued in business combinations, useful lives of property and equipment, long-lived asset and goodwill impairment analyses, valuation allowance on deferred tax assets and the fair value of equity awards. These estimates involve judgments with respect to numerous factors that are difficult to predict and are beyond management’s control. Although the Company believes its assumptions are reasonable, actual results could differ from those estimates.

Variable Interest Entities

US GAAP requires an entity to consolidate a VIE if the entity is determined to be the primary beneficiary of the VIE. Under the VIE model, the primary beneficiary is the party that meets both the following criteria: it has (i) the power to direct the activities of the VIE that most significantly impact the VIE’s economic performance and (ii) the obligation to absorb the losses, or the right to receive benefits, from the VIE that could potentially be significant to the VIE. The Company determines whether the Company is the primary beneficiary of a VIE through a qualitative analysis. As the primary beneficiary, the VIE’s assets, liabilities and results of operations are included in the Company’s consolidated financial statements (see Note 10 “Variable Interest Entities”). The creditors of the VIEs do not have recourse to the Company’s general credit, however, the Company may need to provide financial support to cover any operating expenses in excess of operating revenues in the VIEs. The Company performs ongoing reassessments of whether changes in the facts and circumstances regarding the Company’s involvement with a VIE will cause the consolidation conclusion to change. Changes in consolidation status, if any, are applied prospectively.

The condensed consolidated financial statements include VIEs in which the Company is the primary beneficiary. Those VIEs include Charlotte Radiology, P.A. (“CRAD”), Connexia, LLC (“Connexia”), South Jersey Radiology Associates, P.A. (“South Jersey”), Radiology Associates of Burlington County, P.A. (“RABC”), Larchmont Imaging Associates, L.L.C. (“LIA”), Upstate Carolina Radiology, P.A. (“UCR”), and Windsong Radiology Group, P.C. (“Windsong”) (collectively, the “VIE Physician Practices”). Additionally, one of the Company’s wholly owned subsidiaries, American Health Imaging, Inc. (“AHI”), provides management and administrative services to five unaffiliated physician-owned imaging centers which use the AHI name (“Franchise Centers”). The Franchise Centers are also considered VIEs that the Company consolidates. Transactions with VIEs are eliminated in consolidation.

Revenues

Net Patient Service Revenues

The Company’s revenues are generated by providing diagnostic imaging services (i.e. scans) and physician interpretation services (i.e. reads) to patients within outpatient imaging centers. The Company also earns professional services revenue where revenue is earned by providing physician interpretation services to patients at hospitals or other sites of care. The contractual relationships with patients (i.e., the customers), in most cases, also involve a third-party payor. Third-party payors include entities such as Medicare, Medicaid, managed care health plans and commercial insurance companies. The fees for the services provided are dependent upon the terms provided by Medicare and Medicaid, or negotiated with managed care health plans and commercial insurance companies.

The payment arrangements with third-party payors for the services the Company provides to the related patients typically specify payments at amounts less than the Company’s standard charges and generally provide for payments based upon predetermined rates per diagnostic imaging service and physician interpretation service. The payment terms indicate that payment is due upon receipt and there is no significant financing component associated with the services provided. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. As such, revenue is recognized based on the Company’s estimate of the implicit price concessions (i.e. expected cash collections from patients and third-party payors) for each service offering rendered. The Company determines its estimate of implicit price concessions based on historical collection experience with classes of patients using a portfolio approach as a practical expedient. Performance obligations for net patient services revenue are recognized at the read date. This point in time is considered to be representative of the timing in which the respective performance obligations are satisfied. The Company has no obligation to provide further patient service, and because the Company primarily performs outpatient procedures, performance obligations are generally satisfied same day and revenue is recognized on the date of service.

The Company evaluates amounts collected in relation to billed charges and records estimated price concessions to account for the anticipated differences between billed amounts and amounts ultimately collected. Estimates of price concessions are reported in the period during which the services are provided even though the actual amounts may become known at a later date.

Accordingly, net patient service revenue is presented net of an estimated provision for price concessions. The Company estimates the allowance for price concessions based upon historical collections experience in relation to the amounts billed, changes in contractual rates, past adjustments, current contract and reimbursement terms, changes in payor mix, an aging of accounts receivable, and other relevant information.

The following table disaggregates net patient service revenue by major third-party payor source for the periods presented:


	THREE MONTHS ENDED JUNE 30,
	2026			2025
Commercial insurance		59	%		59	%
Government—Medicare		25			24
Government—Medicaid		4			5
Attorney liens		3			5
Self-pay		4			3
Other third-party payors		5			4
		100	%		100	%

	SIX MONTHS ENDED JUNE 30,
	2026			2025
Commercial insurance		58	%		58	%
Government—Medicare		24			24
Government—Medicaid		4			5
Attorney liens		3			5
Self-pay		4			3
Other third-party payors		7			5
		100	%		100	%

Management Fee and Other Revenue, Related Party

The Company has contracts with certain unconsolidated affiliates and other related parties to provide management and administrative services on a monthly basis. These management and administrative services include, but are not limited to, contract negotiation, claims processing, utilization review, operations management, information technology, human resources, risk management, legal, compliance, budgeting and finance, accounting, staffing, and marketing services.

Additionally, the Company provides management and administrative services to its consolidated VIEs, including CRAD, South Jersey, RABC, LIA, UCR, Windsong and Connexia, directly or through various wholly owned management service organization (“MSO”) subsidiaries. The MSOs provide management and administrative services including, but not limited to, contract negotiation, claims processing, utilization review, operations management, information technology, human resources, risk management, legal,

compliance, budgeting and finance, accounting, and marketing services. These services are provided through administrative services agreements (“ASAs”), which have term lengths that are between 20 and 30 years long.

Pursuant to the ASAs, the Company receives fees from the VIEs, unconsolidated affiliates, and other related parties for the services performed. The Company has exclusive responsibility for the provision of all nonmedical services required for the day-to-day operation and management of the physician practices and outpatient imaging centers, which are subject to these ASAs. These fees charged to consolidated physician practices and outpatient imaging centers are eliminated in consolidation.

AHI provides management and administrative services to the Franchise Centers pursuant to the associated franchise agreements. The franchise agreements have a term length of 20 years. The services include, but are not limited to, contract negotiation, claims processing, utilization review, operations management, information technology, human resources, risk management, legal, compliance, budgeting and finance, accounting, and marketing services. The Company, via AHI, receives royalty, billing, and management fees from the Franchise Centers for the use of the AHI name and the services performed. The Company has exclusive responsibility for the provision of all nonmedical services required for the day-to-day operation and management of the Franchise Centers. The fees received from the Franchise Centers are eliminated in consolidation.

These management agreements also provide for the recovery of clinical and management support costs that these entities incur based on their utilization of the Company’s clinical staff in their operations and actual costs incurred by the Company in delivering the management services (collectively referred to as “pass-through costs”).

The Company charges for the management and administrative services rendered based on a defined formula outlined in the contracts based on the net revenues of the related party. The amount recognized for the recovery of pass-through costs is based on the actual costs of leased employees providing the services. Both the charges for management and administrative services and the amounts recognized for the recovery of pass-through costs are considered variable consideration. There is no fixed consideration with respect to these arrangements. This revenue is reported within management fee and other revenue, related party.

The Company recognizes management fee revenue on a monthly basis as the performance obligations are satisfied over time (i.e., monthly revenues are recorded for the month to which the services relate), and any unpaid amounts are reflected in accounts receivable, related party in the consolidated balance sheets. The performance obligation with respect to management fee revenue is treated as a series of distinct services provided over the related contracts’ terms, because each month of services performed is substantially the same and has the same pattern of transfer to the customer. The remaining variable consideration at the end of each reporting period is allocated entirely to that single performance obligation. See Note 12 “Related Party Transactions” for further information regarding the Company’s related party transactions.

Management Fee and Other Revenue

Management fee and other revenue primarily consists of management and administrative services performed for third-party hospitals. This revenue is recognized as the performance obligations are satisfied over time and any unpaid amounts are reflected in accounts receivable in the condensed consolidated balance sheets.

Accounts Receivable

Accounts receivable represent charges to patients, third-party insurance payors, government-sponsored payors, and other payors for which payment has not been received. The Company continuously monitors collections from payors based upon specific payor collection issues that it has identified and historical experience. While changes in estimated reimbursement from third-party payors remain a possibility, the Company expects that any such changes would be minimal and, therefore, would not have a material effect on its financial condition or results of operations.

The Company’s collection policies and procedures are based on the type of payor, size of claim, and estimated collection percentage for each modality. The Company analyzes accounts receivable at each of its operating entities to ensure the proper collection and aged category. Collection efforts include direct contact with third-party payors or patients, written correspondence, and the use of legal or collection agency assistance, as required.

The Company’s percentage of accounts receivable by payor class was as follows:


	JUNE 30,			DECEMBER 31,
	2026			2025
Commercial insurance		41	%		42	%
Attorney liens		33			36
Government—Medicare		13			12
Government—Medicaid		4			3
Self-pay		1			1
Other third-party payors		8			6
		100	%		100	%

Attorney liens represent patient accounts receivable related to ongoing litigation between third parties, in which the Company has been contracted to provide imaging services. The Company is not directly involved in the ongoing litigation. Payment is not made until litigation is completed, which can exceed 36 months. Other third-party payors include government plans (excluding Medicare and Medicaid), workers’ compensation, and contract plans.

Concentration of Credit Risk and Significant Customers

No single customer exceeded 10% of net patient service revenue during the three or six months ended June 30, 2026 and 2025.

Financial instruments that potentially subject the Company to concentrations of credit risk consist principally of cash, cash equivalents, and accounts receivable. The Company maintains its cash balances principally in major financial institutions. The cash is subject to credit risk to the extent that the balances exceed the FDIC insured limit of $250,000.

Management regularly considers its ability to collect outstanding receivable balances. The Company receives payments for services rendered from federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies, employers, attorneys and patients.

The Company recognizes that revenues and receivables from commercial payors and government agencies are significant to its operations but does not believe there are significant credit risks associated with these counterparties.

The Company owns 49% of an investment in an unconsolidated affiliate, BTDI JV, LLP (“BTDI”), which made up 72% of management fees and other revenue, related party during both the three and six months ended June 30, 2026, and 72% during both the three and six months ended June 30, 2025. BTDI made up 61% and 60% of accounts receivable, related party, as of June 30, 2026 and December 31, 2025, respectively. Refer to Note 12 “Related Party Transactions” for further discussion on related party relationships.

Holdings LLC Common Units

Prior to the IPO, Holdings LLC had historically issued common units of Holdings LLC (“Common Units”) in exchange for cash. Additionally, affiliates of the Company (the “Holding Companies”), whose only assets were Common Units, had issued their own equity in conjunction with the acquisition of certain physician practices. Shares of the Holding Companies generally vest on a cliff basis after five years of service or upon a sale of Holdings LLC.

Unless subject to documented exceptions for retirees, Holdings LLC equity that is issued to owners who do not perform the requisite five years of service is forfeited, and if owned indirectly via a Holding Company, the forfeited interest is reallocated to the remaining owners of the Holding Company. Given that the Holding Companies’ primary purpose is to own common equity of Holdings LLC, it was concluded that the Holding Company shares are substantially similar to Holdings LLC’s common equity. As a result, the Holding Company equity is accounted for in accordance with ASC 718, Compensation—Stock Compensation (“ASC 718”).

Net Income (Loss) Per Share

The Company follows the two-class method when computing net income (loss) per common share when shares are issued that meet the definition of participating securities. The two-class method determines net income (loss) per common share for each class of common share and participating securities according to dividends declared or accumulated and participation rights in undistributed

earnings. The two-class method requires income available to common stockholders for the period to be allocated between common shares and participating securities based upon their respective rights to receive dividends as if all income for the period had been distributed.

Basic net income (loss) per common share is computed by dividing the net income (loss) by the weighted-average number of common shares outstanding during the period, less shares subject to repurchase. The diluted net income (loss) per common share is computed by giving effect to all potentially dilutive securities outstanding for the period. Equity awards with only a service condition are included in diluted net income per common share under the treasury stock method. Equity awards containing a market condition are excluded under the treasury stock method unless the condition has been met at the end of the applicable reporting period. For periods in which the Company reports net losses, diluted net loss per common share is the same as basic net loss per common share, because potentially dilutive common shares are not assumed to have been issued if their effect is antidilutive. Holdings LLC Incentive Units are considered participating securities prior to the Company’s Equity Reorganization that occurred (See Note 1) in connection with the IPO because they contractually entitled the holders of such units to participate in dividends. However, the Incentive Units do not contractually require such holders to participate in Holdings LLC’s losses, and therefore during periods of loss, Incentive Units are excluded from the number of weighted average common shares outstanding for calculating basic loss per common share.

For the purposes of determining the basic and diluted weighted-average number of common shares outstanding during the periods presented that are prior to the IPO, the Company retrospectively reflected the Equity Reorganization. As such, the basic and diluted weighted-average number of common shares outstanding for those periods reflect the contribution by the Company of shares of Common Stock to Holdings LLC on a 1 share of Common Stock to 9 units of Holdings LLC ratio, assuming that all such shares of Common Stock were issued and outstanding as of the beginning of the earliest period presented. In periods following the Equity Reorganization, only shares of the Company’s Common Stock represent participating securities.

Holdings LLC Incentive Unit Plan

Prior to the IPO, Holdings LLC granted incentive units to key employees, directors and physicians achieving partner status under its 2018 Equity Incentive Plan. Compensation expense is recognized for all incentive unit awards based on estimated fair value on the grant date. Unit-based compensation is expensed over the requisite service period using the straight-line method for awards with time-based vesting criteria, and forfeitures are accounted for as they occur. Upon a qualifying liquidity event of Holdings LLC, which is defined as the date when all or substantially all of the Holdings LLC’s securities have been sold, all time-based incentive units outstanding will vest. Certain incentive unit awards have performance-based vesting criteria based on the achievement of a qualifying liquidity event. Awards with performance criteria will vest, and the related compensation expense will be recognized, when the probability of a qualifying liquidity event is probable. The fair value of awards is computed using the Monte Carlo simulation which is affected by Holdings LLC’s unit price and related volatility, expected dividend yield, term of the award, exercise price and risk-free interest rate. As part of the IPO, outstanding Holdings LLC Incentive Units either remained outstanding, were converted to shares of the Common Stock or converted to new equity awards in the Company under the Lumexa Imaging Holdings, Inc. 2025 Equity and Incentive Plan (“2025 Equity Plan”). See Note 8 “Stock-Based Compensation” for further discussion.

Stock-based Compensation

The Company has issued stock-based awards to key employees and directors under the 2025 Equity Plan in the form of restricted stock units (“RSUs”), restricted stock awards (“RSAs”) and stock options. The Company accounts for these stock-based awards based on their grant date fair values. Determining the grant date fair values of stock-based awards requires management to make assumptions and judgments. The fair value of awards with market conditions is computed using the Monte Carlo simulation which is affected by the Company’s stock price and related volatility, expected dividend yield, term of the award, exercise price and risk-free interest rate. The fair value of service-based RSUs and RSAs is determined using the Company’s stock price as of the date of grant. These assumptions reflect the Company’s best estimates, but they involve inherent uncertainties based on market conditions. Stock-based compensation expense is recognized on a straight-line basis for awards with service vesting conditions, whereas awards with market conditions are recognized using the accelerated attribution method. Forfeitures are accounted for as they occur. The Company’s Employee Stock Purchase Plan (“ESPP”) commenced during the second quarter of 2026, with an initial six-month offering period, at the end of which, eligible employees’ accumulated payroll deductions will be used to purchase shares of the Company’s common stock. See Note 8 “Stock-based Compensation” for further discussion.

Cloud Computing Software Implementation Costs

The Company capitalizes certain costs related to cloud computing software implementations. These costs are capitalized once certain criteria are met and are primarily comprised of contracted labor, direct labor and related expenses. Costs related to overhead, general and administrative and training costs are expensed as incurred. The eligible costs are capitalized once the project is defined, funding is committed, and it is confirmed the software will be used for its intended use. Capitalization of these costs concludes once the project is substantially complete and ready for its intended purpose. Post-configuration training and maintenance costs are expensed as incurred.

The capitalized cloud computing software implementation costs are reported as a component of prepaid expenses and other assets on the condensed consolidated balance sheets. As of June 30, 2026, the Company had $2.5 million (within prepaid expenses) and $5.1 million (within other assets) of such costs on the condensed consolidated balance sheet. As of December 31, 2025, the Company had $1.3 million (within prepaid expenses) and $4.6 million (within other assets) of such costs on the condensed consolidated balance sheets.

These costs are amortized using the straight line method over their respective contract service periods, including periods covered by an option to extend, ranging from one to 10 years. Amortization expense for capitalized cloud computing implementation costs for the three and six months ended June 30, 2026 and 2025 was $0.6 million, $0.8 million, $0.1 million and $0.2 million, respectively, and is included in cost of operations, excluding depreciation and amortization in the condensed consolidated statements of operations and comprehensive income (loss).

Investments in Unconsolidated Affiliates

Investments in unconsolidated affiliates in which the Company has the ability to exert significant influence but less than a controlling interest are accounted for using the equity method of accounting. Investments in unconsolidated affiliates are initially recorded at cost, unless there is a deconsolidation where the investments are a result of the Company no longer having control of a previously controlled entity but still retaining a non-controlling interest. Under the equity method of accounting, the Company’s proportionate share of an investee’s net assets is reflected on the Company’s consolidated balance sheets and the Company’s proportionate share of earnings and losses are reflected on the Company’s condensed consolidated statements of operations and comprehensive income (loss). The Company assesses the carrying value of its investments in unconsolidated affiliates annually or more frequently if events arise that may indicate that the value of the investment is not recoverable. The Company examines potential impairments by considering factors such as current economic and market conditions and the operating performance of the investees. Should such examination indicate that an impairment is more than short-term in nature, a charge to earnings and the carrying value of the investment would be recorded. As of December 31, 2025, the Company performed its annual assessment of investments in unconsolidated affiliates and determined that these investments were not impaired.

The Company’s investments in unconsolidated affiliates distribute cash and allocate income to the Company in accordance with the terms of their respective agreements. The Company has made an accounting policy election to classify distributions received from such unconsolidated affiliates using the “nature of distribution” approach which classifies distributions received from unconsolidated affiliates as either cash inflows from operating activities or cash inflows from investing activities in the statement of cash flows based on the nature of the activities of the unconsolidated affiliate that generated the distribution.

Segment Reporting

The Company prepares its segment reporting in accordance with ASC 280, Segment Reporting, which establishes standards for entities reporting information about the operating segments and geographic areas in which they operate. The Company’s products and operations are managed and reported in two operating segments: Outpatient Imaging Centers (“Outpatient”) and Professional Services (“Professional”). The Company’s Chief Executive Officer, who is its Chief Operating Decision Maker (“CODM”), reviews the segments’ performance for the purpose of making operating decisions, assessing financial performance, and deciding how to allocate resources.

As of June 30, 2026 and December 31, 2025, all of the Company’s long-lived assets were located in the United States, and for the three and six months ended June 30, 2026 and 2025, all revenue was earned in the United States.

Recent Accounting Pronouncements

In September 2025, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2025-06, Accounting for and Disclosure of Software Costs. The new standard modernizes the guidance to reflect the software development approaches currently being used by removing all references to “development stages” from ASC 350-40, Intangibles--Good and Other - Internal Use Software. Under ASU 2025-06, only the following criteria in ASC 350-40-25-12(b) and (c) must be met for entities to begin capitalizing software costs: (i) management, with the relevant authority, implicitly or explicitly authorizes and commits to funding a computer software project and (ii) it is probable that the project will be completed and the software will be used to perform the function intended (referred to as the “probable-to-complete recognition threshold”). ASU 2025-06 is effective for all entities for annual reporting periods beginning after December 15, 2027, and interim reporting periods within those annual reporting periods, with early adoption permitted. Entities may apply the guidance prospectively, retrospectively, or via a modified prospective transition method. The Company is evaluating this new standard, but does not expect it to have a significant impact on its consolidated financial statement presentation or results.

In July 2025, the FASB issued ASU 2025-05, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses for Accounts Receivable and Contract Assets, which provides a practical expedient permitting an entity to assume that conditions at the balance sheet date remain unchanged over the life of the asset when estimating expected credit losses for current accounts receivable and current contract assets. ASU 2025-05 is effective for annual reporting periods beginning after December 15, 2025, and for interim periods within those annual reporting periods, with early adoption permitted. The Company adopted ASU 2025-05 on January 1, 2026 on a prospective basis. There was no impact on the Company’s condensed consolidated financial statements.

In November 2024, the FASB issued ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses, which requires the disclosure of information about certain costs and expenses that are included in relevant expense captions on the face of the income statement. The amendments require disclosure of specific expense categories in the notes to the financial statements for both interim and annual reporting periods. The amendment also requires disaggregated information about certain prescribed expense categories underlying any relevant income statement expense caption. ASU No. 2024-03 is effective for annual periods beginning after December 15, 2026 and interim periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the impact the adoption of this guidance will have on its consolidated financial statement disclosures.

In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, which expands income tax disclosure requirements to include additional information related to the rate reconciliation of effective tax to statutory rates, as well as additional disaggregation of taxes paid in both U.S. and foreign jurisdictions. The amendments in the ASU also remove disclosures related to certain unrecognized tax benefits and deferred taxes. The Company has elected to take advantage of the extended transition period pursuant to Section 107 of the Jump Start Our Business Startups Act (“JOBS Act”). Section 107 of the JOBS Act provides that an emerging growth company can use the extended transition period provided in Section 7(a)(2)(B) of the Securities Act of 1933, as amended, for complying with new or revised accounting standards. This permits an emerging growth company, like the Company, to delay the adoption of certain accounting standards until those standards would otherwise apply to private companies. As a result, ASU No. 2023-09 is effective for the Company’s annual consolidated financial statements for the fiscal year ending December 31, 2026. The Company is currently evaluating the impact the adoption of this guidance will have on its consolidated financial statement disclosures.

Organization and Nature of Business - Additional Information (Details) $ / shares in Units, $ in Millions				6 Months Ended
	Dec. 17, 2025 USD ($)	Dec. 12, 2025 USD ($) $ / shares shares	Dec. 10, 2025 $ / shares shares	Jun. 30, 2026 State $ / shares	Dec. 31, 2025 $ / shares
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Date of Incorporation				Nov. 14, 2025
Percentage of equity method investee's stock owned by parent			100.00%
Number of shares issued by the subsidiary or equity method investee \| shares			68,856,706
Number of states in which entity operates \| State				14
Common stock, par value \| $ / shares			$ 0.001	$ 0.001	$ 0.001
Description of distribution ratio				The number of shares received by Holdings LLC in the Equity Reorganization was calculated based on a distribution ratio of 1 share of Common Stock per 9 units of Holdings LLC.
Proceeds from issuance of initial public offering		$ 462.5
Amount of IPO proceeds utilized to pay down debt	$ 406.4
IPO [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Number of shares issued in transaction \| shares		25,000,000
Sale of stock price per share \| $ / shares		$ 18.5
Amount of IPO proceeds utilized to pay down debt		$ 406.4
Underwriting discounts		27.8
Offering cost expense		$ 7.8

Long-Term Debt - Schedule of Maturities of Long-Term Debt Excluding Accounts Receivable Pledging Arrangement (Details) $ in Thousands	Jun. 30, 2026 USD ($)
Debt Disclosure [Abstract]
2026 (remaining six months)	$ 7,069
2027	14,505
2028	13,598
2029	11,395
2030	10,440
Thereafter	786,576
Long-term debt, Total	$ 843,583

Variable Interest Entities - Schedule of Assets and Liabilities of VIE Physician Practices (Details) - USD ($)
$ in Thousands

Jun. 30, 2026

Dec. 31, 2025

ASSETS

Current assets

$ 256,416

$ 227,260

Total assets

^[1]

1,808,772

1,764,557

Liabilities

Current liabilities

178,355

179,194

Total liabilities

^[1]

1,193,711

1,178,434

Variable Interest Entity, Primary Beneficiary [Member] | VIE Physician Practices [Member]

ASSETS

Current assets

62,194

56,239

Non-current assets

205,787

202,549

Total assets

267,981

258,788

Liabilities

Current liabilities

15,748

17,038

Non-current liabilities

35,875

32,334

Total liabilities

51,623

49,372

Total net assets

$ 216,358

$ 209,416

[1]

Variable Interest Entities (Tables)

6 Months Ended

Jun. 30, 2026

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Assets and Liabilities of VIE Physician Practices

The table below illustrates the assets and liabilities of the VIE Physician Practices (in thousands):


	JUNE 30,		DECEMBER 31,
	2026		2025
Assets
Current assets	$	62,194	$	56,239
Non-current assets		205,787		202,549
Total assets of consolidated VIEs		267,981		258,788
Liabilities
Current liabilities		15,748		17,038
Non-current liabilities		35,875		32,334
Total liabilities of consolidated VIEs		51,623		49,372
Total net assets of consolidated VIEs	$	216,358	$	209,416

- Definition

Tabular disclosure of the significant judgments and assumptions made in determining whether a variable interest (as defined) held by the entity requires the variable interest entity (VIE) (as defined) to be consolidated and (or) disclose information about its involvement with the VIE, individually or in aggregate (as applicable); the nature of restrictions, if any, on the consolidated VIE's assets and on the settlement of its liabilities reported by an entity in its statement of financial position, including the carrying amounts of such assets and liabilities; the nature of, and changes in, the risks associated with involvement in the VIE; how involvement with the VIE affects the entity's financial position, financial performance, and cash flows; the lack of recourse if creditors (or beneficial interest holders) of the consolidated VIE have no recourse to the general credit of the primary beneficiary (if applicable); the terms of arrangements, giving consideration to both explicit arrangements and implicit variable interests, if any, that could require the entity to provide financial support to the VIE, including events or circumstances that could expose the entity to a loss; the methodology used by the entity for determining whether or not it is the primary beneficiary of the variable interest entity; the significant factors considered and judgments made in determining that the power to direct the activities of a VIE that most significantly impact the VIE's economic performance are shared (as defined); the carrying amounts and classification of assets and liabilities of the VIE included in the statement of financial position; the entity's maximum exposure to loss, if any, as a result of its involvement with the VIE, including how the maximum exposure is determined and significant sources of the entity's exposure to the VIE; a comparison of the carrying amounts of the assets and liabilities and the entity's maximum exposure to loss; information about any liquidity arrangements, guarantees, and (or) other commitments by third parties that may affect the fair value or risk of the entity's variable interest in the VIE; whether or not the entity has provided financial support or other support (explicitly or implicitly) to the VIE that it was not previously contractually required to provide or whether the entity intends to provide that support, including the type and amount of the support and the primary reasons for providing the support; and supplemental information the entity determines necessary to provide.

+ References + Details

Net Income (Loss) Per Common Share (Tables)

6 Months Ended

Jun. 30, 2026

Earnings Per Share [Abstract]

Schedule of Computation of Basic and Diluted Net Loss Per Common Share

The following table sets forth the computation of basic and diluted net income (loss) per common share for the periods indicated (in thousands, except for common share and per common share data):


	THREE MONTHS ENDED JUNE 30,					SIX MONTHS ENDED JUNE 30,
	2026		2025			2026		2025
Numerator:
Net income (loss)	$	2,745	$	(7,226	)	$	4,462	$	(14,913	)
Denominator:
Weighted-average common shares outstanding, basic		95,983,246		69,526,574			95,983,240		69,524,980
Shares issuable upon exercise or vesting of dilutive stock options, RSAs or RSUs		56,180		—			28,095		—
Weighted-average common shares outstanding, diluted		96,039,426		69,526,574			96,011,335		69,524,980
Net income (loss) per share attributable to common stockholders:
Basic	$	0.03	$	(0.10	)	$	0.05	$	(0.21	)
Diluted	$	0.03	$	(0.10	)	$	0.05	$	(0.21	)

Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Accrued Liabilities, Current [Abstract]
Accrued compensation and benefits	$ 42,896	$ 39,625
Contract labor	7,006	7,753
Medical claims payable	2,318	3,912
Profit sharing plan	7,550	14,870
Medical malpractice accrual	7,094	6,395
Taxes payable	4,229	421
Accrued professional fees	11,519	8,671
Accrued severance	30	1,978
Other accrued expenses	26,525	11,936
Total	$ 109,167	$ 95,561

Related Party Transactions - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025	Dec. 31, 2025
Related Party Transaction [Line Items]
Revenues	$ 264,162	$ 251,402	$ 516,699	$ 496,403
Net Patient Service Revenue [Member]
Related Party Transaction [Line Items]
Revenues	194,902	189,347	383,894	373,564
JV Centers [Member] \| Net Patient Service Revenue [Member]
Related Party Transaction [Line Items]
Revenues	8,800	8,800	17,200	16,900
Accounts receivable	3,000		3,000		$ 2,800
JV Centers [Member] \| Management Fee and Other Revenue [Member]
Related Party Transaction [Line Items]
Revenues	37,400	34,900	72,900	68,900
Accounts receivable	7,100		7,100		6,400
Management fees	14,300	12,900	28,400	25,800
Atrium [Member] \| Management Fee and Other Revenue [Member]
Related Party Transaction [Line Items]
Revenues		$ 600		$ 1,100
Accounts receivable					600
BTDI [Member] \| Management Fee and Other Revenue [Member]
Related Party Transaction [Line Items]
Accounts receivable	$ 9,900		$ 9,900		$ 9,100

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-5

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 30
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-30

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-40

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-4

+ Details

Commitments and Contingencies

6 Months Ended

Jun. 30, 2026

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

9. Commitments and Contingencies

Regulatory Oversight

The Company expects that audits, inquiries, and investigations from government authorities and agencies will occur in the ordinary course of business.

Such audits, inquiries, and investigations and their ultimate resolutions, individually or in the aggregate, could have a material adverse effect on the Company’s business, financial conditions, results of the operations, and cash flows. The Company has not recorded a reserve for these matters as of June 30, 2026 and December 31, 2025, as the variables affecting any potential eventual liability depend on the current unknown facts and circumstances that arise out of, and are specific to, any particular future audit, inquiry, and investigation and cannot be reasonably estimated at this time. Management believes that the resolution of all current regulatory matters will not result in a material impact to the Company’s financial condition, results of operation, or cash flows.

Legal Proceedings

The Company is subject to various legal proceedings, medical malpractice claims and regulatory tax inquiries and investigations that arise in the ordinary course of its business. With respect to these matters, the Company evaluates the developments on a regular basis and accrues a liability when we believe a loss is probable and the amount can be reasonably estimated. Based on current information, the Company does not believe that reasonably possible or probable losses associated with pending legal proceedings would, either individually or in the aggregate, have a material adverse effect on business and consolidated financial statements. However, the outcome of these matters is inherently uncertain.

Stock-Based Compensation - Additional Information (Details) - 2025 Equity Plan [Member] - USD ($) $ in Millions	3 Months Ended	6 Months Ended
	Jun. 30, 2026	Jun. 30, 2026
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of shares issued		0
Time Vesting RSU [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of options, Granted	297,700	912,800
Aggregate grant-date fair value	$ 3.7	$ 13.8
Remaining service period		3 years
Market Vesting RSU [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of options, Granted	144,900	223,700
Aggregate grant-date fair value	$ 3.7	$ 13.8

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Segment Reporting - Schedule of Segment Reporting Information, by Segment (Details) - USD ($)
$ in Thousands

3 Months Ended

6 Months Ended

Jun. 30, 2026

Mar. 31, 2026

Jun. 30, 2025

Mar. 31, 2025

Jun. 30, 2026

Jun. 30, 2025

Revenues [Abstract]

Revenues

$ 264,162

$ 251,402

$ 516,699

$ 496,403

Depreciation and amortization

(10,083)

(9,279)

(20,005)

(18,330)

Income tax provision

(3,020)

(4,809)

(4,384)

(8,188)

Interest expense

(16,222)

(30,097)

(32,553)

(59,946)

Loss on extinguishment and modification of debt

(1,053)

Gain (Loss) on disposal of property and equipment

(113)

146

Stock-based compensation

(25,011)

(14,720)

Net income

2,745

$ 1,717

(7,226)

$ (7,687)

4,462

(14,913)

Patient Service Revenue

Revenues [Abstract]

Revenues

194,902

189,347

383,894

373,564

Operating Segments

Revenues [Abstract]

Revenues

264,162

251,402

516,699

496,403

Other segment items

^[1]

207,717

195,128

409,055

389,129

Adjusted EBITDA

56,445

56,274

107,644

107,274

Depreciation and amortization

(10,083)

(9,279)

(20,005)

(18,330)

Income tax provision

(3,020)

(4,809)

(4,384)

(8,188)

Amortization of basis difference

(573)

(500)

(1,105)

(1,000)

Interest expense

(16,222)

(30,097)

(32,553)

(59,946)

Loss on extinguishment and modification of debt

(1,053)

Gain (Loss) on disposal of property and equipment

(16)

(113)

146

Stock-based compensation

(12,737)

(8,346)

(25,011)

(14,720)

Severance and executive recruiting

^[2]

(686)

(803)

(1,631)

(2,173)

Strategic initiatives and implementation

^[3]

(2,659)

(1,018)

(3,484)

(1,886)

Transaction costs

^[4]

(707)

(3,875)

(3,289)

(7,464)

Litigation and settlements

^[5]

(1,173)

(1,202)

128

Other

^[6]

(87)

(142)

(82)

(158)

Adjustments for equity in earnings of unconsolidated affiliates

^[7]

(4,724)

(4,615)

(9,270)

(8,596)

Net income

2,745

(7,226)

4,462

(14,913)

Operating Segments | Patient Service Revenue

Revenues [Abstract]

Revenues

203,735

198,185

401,053

390,483

Operating Segments | Management Fee and Other Revenue [Member]

Revenues [Abstract]

Revenues

60,427

53,217

115,646

105,920

Operating Segments | Outpatient

Revenues [Abstract]

Revenues

196,209

187,198

384,108

367,999

Other segment items

^[1]

149,844

140,216

299,370

279,196

Adjusted EBITDA

46,365

46,982

84,738

88,803

Operating Segments | Outpatient | Patient Service Revenue

Revenues [Abstract]

Revenues

143,747

138,909

281,839

272,339

Operating Segments | Outpatient | Management Fee and Other Revenue [Member]

Revenues [Abstract]

Revenues

52,462

48,289

102,269

95,660

Operating Segments | Professional

Revenues [Abstract]

Revenues

72,245

66,328

140,403

132,214

Other segment items

^[1]

62,165

57,036

117,497

113,743

Adjusted EBITDA

10,080

9,292

22,906

18,471

Operating Segments | Professional | Patient Service Revenue

Revenues [Abstract]

Revenues

64,280

61,400

127,026

121,954

Operating Segments | Professional | Management Fee and Other Revenue [Member]

Revenues [Abstract]

Revenues

7,965

4,928

13,377

10,260

Operating Segments | Intersegment Eliminations

Revenues [Abstract]

Revenues

(4,292)

(2,124)

(7,812)

(3,810)

Other segment items

^[1]

(4,292)

(2,124)

(7,812)

(3,810)

Adjusted EBITDA

Operating Segments | Intersegment Eliminations | Patient Service Revenue

Revenues [Abstract]

Revenues

$ (4,292)

$ (2,124)

$ (7,812)

$ (3,810)

[1]	Other segment items for both segments include certain operating expenses that are not regularly provided to the CODM on a segment basis and that are identifiable with that segment, including general and administrative expenses.
[2]	Includes severance and recruiting expenses for executive leadership departures as part of strategic organizational changes.
[3]	Includes third-party consulting, implementation and integration expenses incurred as part of the Company’s strategic transformation and optimization initiatives, specifically related to the deployment of a new technology system and labor model, as well as the development, customization and integration of a new enterprise resource planning system.
[4]	Includes costs for third-party non-recurring IPO costs, buy-side and sell-side due diligence activities to evaluate and execute potential mergers and acquisitions, integrate acquired businesses and one-time employee retention bonuses related to potential mergers and acquisitions.
[5]	Consists of litigation and settlement costs for matters not related to core operations.
[6]	Consists of other costs related to debt financing, certain de novo start-up costs related to outpatient imaging centers and certain exit costs related to closed outpatient imaging centers.
[7]	Adjusts for the Company’s proportional share of depreciation and amortization, interest expense and losses/gains on asset disposals related to unconsolidated affiliates, which are included in equity in earnings from unconsolidated affiliates on the accompanying condensed consolidated statements of operations and comprehensive income (loss).

Stock-Based Compensation

6 Months Ended

Jun. 30, 2026

Share-Based Payment Arrangement [Abstract]

Stock-Based Compensation

8. Stock-Based Compensation

The Company’s stock-based compensation expense includes Holdings LLC Common Units and Incentive Units as well as stock options, RSUs and RSAs issued under the 2025 Equity Plan and expense associated with the Company’s ESPP (together, the “Employee Awards”).

Stock-based compensation associated with Holdings LLC Common Units is recorded within Cost of operations, excluding depreciation and amortization and stock-based compensation related to the remaining equity awards is presented within General and administrative expense in the Company’s condensed consolidated statements of operations and comprehensive income (loss). The following table presents the components of stock-based compensation expense for the Employee Awards for the periods indicated (in thousands):


	THREE MONTHS ENDED JUNE 30,				SIX MONTHS ENDED JUNE 30,
	2026		2025		2026		2025
Holdings LLC Common Units	$	6,094	$	7,532	$	12,197	$	13,664
Incentive Units		163		814		418		1,056
Stock Options		3,448		—		7,087		—
RSAs and RSUs		2,942		—		5,219		—
ESPP		90		—		90		—
Total	$	12,737	$	8,346	$	25,011	$	14,720

During the three months ended June 30, 2026, the Company granted 297,700 time vesting RSUs and 144,900 market vesting RSUs under the 2025 Equity Plan. During the six months ended June 30, 2026, the Company granted 912,800 time vesting RSUs and 223,700 market vesting RSUs under the 2025 Equity Plan. The time vesting RSUs vest over three years of continuous service, while the market based RSUs vest upon achievement of specified price targets over a defined trading period. The aggregate grant-date fair value of these awards was $3.7 million for three months ended June 30, 2026 and $13.8 million for the six months ended June 30, 2026. No shares were issued under the ESPP as of June 30, 2026.

Document and Entity Information - shares	6 Months Ended
Document and Entity Information - shares	Jun. 30, 2026	Aug. 12, 2026
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2026
Document Fiscal Year Focus	2026
Document Fiscal Period Focus	Q2
Trading Symbol	LMRI
Entity Registrant Name	Lumexa Imaging Holdings, Inc.
Entity Central Index Key	0002071288
Entity Current Reporting Status	Yes
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity File Number	001-43010
Entity Tax Identification Number	41-2605845
Entity Address, Address Line One	4200 Six Forks Road
Entity Address, Address Line Two	Suite 1000
Entity Address, City or Town	Raleigh
Entity Address, State or Province	NC
Entity Address, Postal Zip Code	27609
City Area Code	919
Local Phone Number	763-1100
Entity Common Stock, Shares Outstanding		96,074,976
Entity Incorporation, State or Country Code	DE
Document Quarterly Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, $0.001 par value per share
Security Exchange Name	NASDAQ

Investments in Unconsolidated Affiliates - Schedule of Investments in Unconsolidated Affiliates On Aggregated Basis (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2026	Mar. 31, 2026	Jun. 30, 2025	Mar. 31, 2025	Jun. 30, 2026	Jun. 30, 2025
Schedule of Equity Method Investments [Line Items]
Revenues	$ 264,162		$ 251,402		$ 516,699	$ 496,403
Expenses	259,741		240,249		507,890	475,027
Net income (loss)	2,745	$ 1,717	(7,226)	$ (7,687)	4,462	(14,913)
Equity in earnings of unconsolidated affiliates	18,619		16,527		33,643	31,845
Unconsolidated Affiliates [Member]
Schedule of Equity Method Investments [Line Items]
Revenues	152,438		140,172		292,121	271,934
Expenses	112,618		104,387		219,292	203,206
Net income (loss)	39,820		35,785		72,829	68,728
Company's share of net income	19,192		17,027		34,748	32,845
Amortization of basis difference	(573)		(500)		(1,105)	(1,000)
Equity in earnings of unconsolidated affiliates	18,619		16,527		33,643	31,845
BTDI [Member] \| Unconsolidated Affiliates [Member]
Schedule of Equity Method Investments [Line Items]
Revenues	109,533		100,890		208,505	193,945
Expenses	78,142		72,416		151,437	141,684
Net income (loss)	31,391		28,474		57,068	52,261
Company's share of net income	14,966		13,616		27,211	25,014
Amortization of basis difference	(500)		(500)		(1,000)	(1,000)
Equity in earnings of unconsolidated affiliates	14,466		13,116		26,211	24,014
All Others [Member] \| Unconsolidated Affiliates [Member]
Schedule of Equity Method Investments [Line Items]
Revenues	42,905		39,282		83,616	77,989
Expenses	34,476		31,971		67,855	61,522
Net income (loss)	8,429		7,311		15,761	16,467
Company's share of net income	4,226		3,411		7,537	7,831
Amortization of basis difference	(73)		0		(105)	0
Equity in earnings of unconsolidated affiliates	$ 4,153		$ 3,411		$ 7,432	$ 7,831

Investments in Unconsolidated Affiliates

6 Months Ended

Jun. 30, 2026

Equity Method Investments and Joint Ventures [Abstract]

Investments in Unconsolidated Affiliates

11. Investments in Unconsolidated Affiliates

At June 30, 2026, the Company operates 88 imaging centers (“JV centers”) through joint ventures with health system partners.

BTDI

Touchstone Imaging of Mesquite, LLC (“TMI”), a wholly owned subsidiary of LIOI, and Baylor University Medical Center (BUMC) own a 49% and 51% interest, respectively, in BTDI. The Company accounts for TMI’s noncontrolling interest in the investment in the unconsolidated affiliate under the equity method of accounting.

All Others

The Company’s other investments in unconsolidated affiliates include Carolinas Imaging Services, LLC (“CIS”), Virtua Adult Imaging JV (“Virtua JV”), SCLTDI JV, LLC (“SCLTDI”), IH-USRS Imaging, LLC (“IH-USRS”), RLC, LLC, (“RLC”), and Tucson Medical Imaging Partners, LLC (“TMIP”). The Company has ownership interests in these entities ranging from 30% to 50%. The Company accounts for these investments in unconsolidated affiliates under the equity method of accounting.

The following is a summary of the statements of income for the investments in unconsolidated affiliates on an aggregated basis for the periods indicated (in thousands):


	THREE MONTHS ENDED JUNE 30,
	2026									2025
	BTDI			ALL OTHERS			TOTAL			BTDI			ALL OTHERS		TOTAL
Income statement:
Revenues	$	109,533		$	42,905		$	152,438		$	100,890		$	39,282	$	140,172
Expenses		78,142			34,476			112,618			72,416			31,971		104,387
Net income	$	31,391		$	8,429		$	39,820		$	28,474		$	7,311	$	35,785
Company’s share of net income	$	14,966		$	4,226		$	19,192		$	13,616		$	3,411	$	17,027
Amortization of basis difference		(500	)		(73	)		(573	)		(500	)		—		(500	)
Equity in earnings of unconsolidated affiliates	$	14,466		$	4,153		$	18,619		$	13,116		$	3,411	$	16,527


	SIX MONTHS ENDED JUNE 30,
	2026									2025
	BTDI			ALL OTHERS			TOTAL			BTDI			ALL OTHERS		TOTAL
Income statement:
Revenues	$	208,505		$	83,616		$	292,121		$	193,945		$	77,989	$	271,934
Expenses		151,437			67,855			219,292			141,684			61,522		203,206
Net income	$	57,068		$	15,761		$	72,829		$	52,261		$	16,467	$	68,728
Company’s share of net income	$	27,211		$	7,537		$	34,748		$	25,014		$	7,831	$	32,845
Amortization of basis difference		(1,000	)		(105	)		(1,105	)		(1,000	)		—		(1,000	)
Equity in earnings of unconsolidated affiliates	$	26,211		$	7,432		$	33,643		$	24,014		$	7,831	$	31,845

Segment Reporting - Additional Information (Details)	6 Months Ended
Segment Reporting - Additional Information (Details)	Jun. 30, 2026 Segment
Segment Reporting [Abstract]
Number of Operating Segments	2
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]	srt:ChiefExecutiveOfficerMember
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description	The CODM reviews revenues and Adjusted Earnings Before Interest, Taxes, Depreciation, and Amortization (“Adjusted EBITDA”) of each segment for the purpose of making operating decisions, assessing financial performance, and deciding how to allocate resources (including employees, property, and financial or capital resources) for each segment predominantly in the annual budget and forecasting process. The CODM considers budget-to-actual variances monthly when making decisions about allocating resources to the segments.

Summary of Significant Accounting Policies (Tables)

6 Months Ended

Jun. 30, 2026

Accounting Policies [Abstract]

Schedule of Disaggregation of Net Patient Service Revenue

The following table disaggregates net patient service revenue by major third-party payor source for the periods presented:


	THREE MONTHS ENDED JUNE 30,
	2026			2025
Commercial insurance		59	%		59	%
Government—Medicare		25			24
Government—Medicaid		4			5
Attorney liens		3			5
Self-pay		4			3
Other third-party payors		5			4
		100	%		100	%

	SIX MONTHS ENDED JUNE 30,
	2026			2025
Commercial insurance		58	%		58	%
Government—Medicare		24			24
Government—Medicaid		4			5
Attorney liens		3			5
Self-pay		4			3
Other third-party payors		7			5
		100	%		100	%

Schedule of Percentage of Accounts Receivable by Payor Class

The Company’s percentage of accounts receivable by payor class was as follows:


	JUNE 30,			DECEMBER 31,
	2026			2025
Commercial insurance		41	%		42	%
Attorney liens		33			36
Government—Medicare		13			12
Government—Medicaid		4			3
Self-pay		1			1
Other third-party payors		8			6
		100	%		100	%

Long-Term Debt - Additional Information (Details) - USD ($)					3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2026	Dec. 17, 2025	Dec. 12, 2025	Jul. 16, 2024	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025	Dec. 31, 2025	Dec. 31, 2021	Dec. 15, 2020
Debt Instrument [Line Items]
Maturity date description							The Refinancing Term Loan bears interest at SOFR plus 3.0%, or the Prime Rate plus 2.0%, and matures in December 2032.
Amount of IPO proceeds utilized to pay down debt		$ 406,400,000
Credit agreement third party and lender costs									$ 19,300,000
Loss on extinguishment and modification of debt					$ (1,053,000)	$ 0	$ (1,053,000)	$ 0
Write-off of amounts previously capitalized as debt issuance cost							46,000	0
Capitalized debt issuance costs							1,437,000	$ 2,871,000
Long term debt fair value	$ 825,000,000				825,000,000		$ 825,000,000		829,000,000
Amended Credit Agreement
Debt Instrument [Line Items]
Loss on extinguishment and modification of debt									8,000,000
Write-off of amounts previously capitalized as debt issuance cost									$ 5,400,000
Interest rate on the refinancing term loan							6.20%		6.70%
Percentage of unused commitment fee							0.50%		0.50%
Accounts Receivable Pledging Arrangement
Debt Instrument [Line Items]
Amount outstanding of short-term debt	1,300,000				1,300,000		$ 1,300,000		$ 1,600,000
Amount outstanding of secured long-term debt	$ 2,600,000				$ 2,600,000		2,600,000		3,300,000
IPO [Member]
Debt Instrument [Line Items]
Amount of IPO proceeds utilized to pay down debt			$ 406,400,000
Refinancing Term Loan
Debt Instrument [Line Items]
Proceeds from the refinancing term Loan		825,000,000
Debt instrument, periodic payment		2,100,000
Debt issuance cost									5,400,000
Secured Revolving Line of Credit Facility
Debt Instrument [Line Items]
Borrowing capacity under credit facility											$ 165,000,000
Revolving Credit Facility
Debt Instrument [Line Items]
Debt issuance cost									$ 5,900,000
Senior Secured Credit Facility
Debt Instrument [Line Items]
Borrowing capacity under credit facility											$ 790,000,000
Senior Secured Credit Facility \| Refinancing Term Loan
Debt Instrument [Line Items]
Borrowing capacity under credit facility		825,000,000
Senior Secured Credit Facility \| Secured Revolving Line of Credit Facility
Debt Instrument [Line Items]
Secured revolving line of credit		$ 250,000,000
First Amendment
Debt Instrument [Line Items]
Borrowing capacity under credit facility										$ 450,000,000
Third Amendment \| SOFR
Debt Instrument [Line Items]
Interest rate				4.75%
Interest floor				0.50%
Fifth Amendment \| Prime Rate
Debt Instrument [Line Items]
Interest rate		2.00%
Fifth Amendment \| SOFR
Debt Instrument [Line Items]
Interest rate		3.00%
Seventh Amendment
Debt Instrument [Line Items]
Loss on extinguishment and modification of debt							$ 1,200,000
Seventh Amendment \| SOFR
Debt Instrument [Line Items]
Interest rate	2.50%
Promissory Note \| Maximum
Debt Instrument [Line Items]
Interest rate percentage on the note	12.35%				12.35%		12.35%
Promissory Note \| Minimum
Debt Instrument [Line Items]
Interest rate percentage on the note	4.57%				4.57%		4.57%

Stock-Based Compensation - Schedule of Stock Based Compensation Expenses (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Total stock-based compensation	$ 12,737	$ 8,346	$ 25,011	$ 14,720
Stock Option [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Total stock-based compensation	3,448	0	7,087	0
Incentive Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Total stock-based compensation	163	814	418	1,056
RSAs and RSUs [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Total stock-based compensation	2,942	0	5,219	0
Holdings LLC Common Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Total stock-based compensation	6,094	7,532	12,197	13,664
ESPP [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Total stock-based compensation	$ 90	$ 0	$ 90	$ 0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Related Party Transactions

6 Months Ended

Jun. 30, 2026

Related Party Transactions

12. Related Party Transactions

Net patient service revenue, Related Party

The Company provides diagnostic imaging services and radiology services to its JV centers, which are operated through unconsolidated affiliates and, which include CIS, BTDI, SCLTDI and IH-USRS as co-owners. Based on service agreements with these entities, the Company recorded patient revenues of $8.8 million and $17.2 million during the three and six months ended June 30, 2026, respectively, and $8.8 million and $16.9 million related to these services during the three and six months ended June 30, 2025, respectively, which is included in Net patient service revenue, related party on the condensed consolidated statements of operations and comprehensive income (loss). The Company has a receivable from JV centers in the amount of $3.0 million and $2.8 million as of June 30, 2026 and December 31, 2025, respectively, which is included in Accounts receivable, related party on the condensed consolidated balance sheets.

Management fee revenue and other, Related Party

The Company provides management and administrative services based on management service agreements including staff and administrative support to its JV centers, which are operated through investments in unconsolidated affiliates. A large portion of this revenue relates to JV centers operated through BTDI, for which the Company recorded revenue of $37.4 million, $72.9 million, $34.9 million and $68.9 million related to these services during the three and six months ended June 30, 2026 and 2025, respectively, which is included in Management fee and other revenue, related party on the condensed consolidated statements of operations and comprehensive income (loss). The Company has a receivable from BTDI in the amount of $9.9 million and $9.1 million as of June 30, 2026 and December 31, 2025, respectively, which is included in Accounts receivable, related party on the condensed consolidated balance sheets.

For all other JV centers, the Company recorded management fees of $14.3 million and $28.4 million for the three and six months ended June 30, 2026, respectively, and $12.9 million and $25.8 million for the three and six months ended June 30, 2025, respectively, which are included in Management fee and other revenue, related party on the condensed consolidated statements of operations and comprehensive income (loss). The Company has a receivable from these JV centers in the amount of $7.1 million and $6.4 million as of June 30, 2026 and December 31, 2025, respectively, which is included in Accounts receivable, related party on the condensed consolidated balance sheets.

The Company also provides management services and administrative services based on management service agreements to Atrium Health and its subsidiaries (“Atrium”), which is an investor in Lumexa Imaging and, before the completion of the Company’s IPO, had the right to appoint one LII manager to Holdings LLC’s board of managers, thus resulting in a related party relationship. Atrium Health does not have the right to appoint any directors to the Company’s board of directors and is no longer considered a related party subsequent to the Company’s IPO. Atrium is an investor, along with LII, in CIS. The revenue for such services earned from Atrium was $0.6 million and $1.1 million during the three and six months ended June 30, 2025, respectively, and is included in Management fee and other revenue, related party on the condensed consolidated statements of operations and comprehensive income (loss). Atrium owed the Company $0.6 million at December 31, 2025, for such services, which are included in Accounts receivable, related party on the condensed consolidated balance sheets.

Unsecured Debt

The Company’s borrowings under the Amended Credit Agreement are guaranteed by LII and LIOI and each other wholly owned subsidiary of the Company, subject to certain exceptions. In addition, the Amended Credit Agreement allows the Company to guarantee, post collateral (e.g., security deposits) or issue letters of credit to creditors of the VIEs. Refer to Note 6 “Long-Term Debt” for further information.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-2

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-5

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-6

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

+ Details

Segment Reporting (Tables)

6 Months Ended

Jun. 30, 2026

Segment Reporting [Abstract]

Schedule of Segment Reporting Information, by Segment

The following tables present revenues and Adjusted EBITDA for each reportable segment for the three and six months ended June 30, 2026 and 2025 (in thousands):


	THREE MONTHS ENDED JUNE 30, 2026
	OUTPATIENT		PROFESSIONAL		INTERSEGMENT ELIMINATIONS			TOTAL OF REPORTABLE SEGMENTS
Revenue
Net patient service revenue	$	143,747	$	64,280	$	(4,292	)	$	203,735
Management fee and other revenue		52,462		7,965		—			60,427
Total revenues		196,209		72,245		(4,292	)		264,162
Other segment items(1)		149,844		62,165		(4,292	)		207,717
Adjusted EBITDA	$	46,365	$	10,080	$	—		$	56,445
Less:
Depreciation and amortization									(10,083	)
Income tax provision									(3,020	)
Amortization of basis difference									(573	)
Interest expense									(16,222	)
Loss on extinguishment and modification of debt									(1,053	)
Gain on disposal of property and equipment									24
Stock-based compensation									(12,737	)
Severance and executive recruiting(2)									(686	)
Strategic initiatives and implementation(3)									(2,659	)
Transaction costs(4)									(707	)
Litigation and settlements(5)									(1,173	)
Other(6)									(87	)
Adjustments for equity in earnings of unconsolidated affiliates(7)									(4,724	)
Net income								$	2,745


	THREE MONTHS ENDED JUNE 30, 2025
	OUTPATIENT		PROFESSIONAL		INTERSEGMENT ELIMINATIONS			TOTAL OF REPORTABLE SEGMENTS
Revenue
Net patient service revenue	$	138,909	$	61,400	$	(2,124	)	$	198,185
Management fee and other revenue		48,289		4,928		—			53,217
Total revenues		187,198		66,328		(2,124	)		251,402
Other segment items(1)		140,216		57,036		(2,124	)		195,128
Adjusted EBITDA	$	46,982	$	9,292	$	—			56,274
Less:
Depreciation and amortization									(9,279	)
Income tax provision									(4,809	)
Amortization of basis difference									(500	)
Interest expense									(30,097	)
Stock-based compensation									(8,346	)
Loss on disposal of property and equipment									(16	)
Severance and executive recruiting(2)									(803	)
Strategic initiatives and implementation(3)									(1,018	)
Transaction costs(4)									(3,875	)
Litigation and settlements(5)									—
Other(6)									(142	)
Adjustments for equity in earnings of unconsolidated affiliates(7)									(4,615	)
Net loss								$	(7,226	)


	SIX MONTHS ENDED JUNE 30, 2026
	OUTPATIENT		PROFESSIONAL		INTERSEGMENT ELIMINATIONS			TOTAL OF REPORTABLE SEGMENTS
Revenue
Net patient service revenue	$	281,839	$	127,026	$	(7,812	)	$	401,053
Management fee and other revenue		102,269		13,377		—			115,646
Total revenues		384,108		140,403		(7,812	)		516,699
Other segment items(1)		299,370		117,497		(7,812	)		409,055
Adjusted EBITDA	$	84,738	$	22,906	$	—		$	107,644
Less:
Depreciation and amortization									(20,005	)
Income tax provision									(4,384	)
Amortization of basis difference									(1,105	)
Interest expense									(32,553	)
Loss on extinguishment and modification of debt									(1,053	)
Loss on disposal of property and equipment									(113	)
Stock-based compensation									(25,011	)
Severance and executive recruiting(2)									(1,631	)
Strategic initiatives and implementation(3)									(3,484	)
Transaction costs(4)									(3,289	)
Litigation and settlements(5)									(1,202	)
Other(6)									(82	)
Adjustments for equity in earnings of unconsolidated affiliates(7)									(9,270	)
Net income								$	4,462


	SIX MONTHS ENDED JUNE 30, 2025
	OUTPATIENT		PROFESSIONAL		INTERSEGMENT ELIMINATIONS			TOTAL OF REPORTABLE SEGMENTS
Revenue
Net patient service revenue	$	272,339	$	121,954	$	(3,810	)	$	390,483
Management fee and other revenue		95,660		10,260		—			105,920
Total revenues		367,999		132,214		(3,810	)		496,403
Other segment items(1)		279,196		113,743		(3,810	)		389,129
Adjusted EBITDA	$	88,803	$	18,471	$	—			107,274
Less:
Depreciation and amortization									(18,330	)
Income tax provision									(8,188	)
Amortization of basis difference									(1,000	)
Interest expense									(59,946	)
Stock-based compensation									(14,720	)
Gain on disposal of property and equipment									146
Severance and executive recruiting(2)									(2,173	)
Strategic initiatives and implementation(3)									(1,886	)
Transaction costs(4)									(7,464	)
Litigation and settlements(5)									128
Other(6)									(158	)
Adjustments for equity in earnings of unconsolidated affiliates(7)									(8,596	)
Net loss								$	(14,913	)

(1)

Other segment items for both segments include certain operating expenses that are not regularly provided to the CODM on a segment basis and that are identifiable with that segment, including general and administrative expenses.

(2)

Includes severance and recruiting expenses for executive leadership departures as part of strategic organizational changes.

(3)

Includes third-party consulting, implementation and integration expenses incurred as part of the Company’s strategic transformation and optimization initiatives, specifically related to the deployment of a new technology system and labor model, as well as the development, customization and integration of a new enterprise resource planning system.

(4)

Includes costs for third-party non-recurring IPO costs, buy-side and sell-side due diligence activities to evaluate and execute potential mergers and acquisitions, integrate acquired businesses and one-time employee retention bonuses related to potential mergers and acquisitions.

(5)

Consists of litigation and settlement costs for matters not related to core operations.

(6)

Consists of other costs related to debt financing, certain de novo start-up costs related to outpatient imaging centers and certain exit costs related to closed outpatient imaging centers.

(7)

Adjusts for the Company’s proportional share of depreciation and amortization, interest expense and losses/gains on asset disposals related to unconsolidated affiliates, which are included in equity in earnings from unconsolidated affiliates on the accompanying condensed consolidated statements of operations and comprehensive income (loss).

Supplemental Cash Flow Information

6 Months Ended

Jun. 30, 2026

Supplemental Cash Flow Elements [Abstract]

Supplemental Cash Flow Information

4. Supplemental Cash Flow Information


	SIX MONTHS ENDED JUNE 30,
(in thousands)	2026		2025
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid for interest	$	31,116	$	57,075
Cash paid for income taxes, net	$	1,748	$	—
SUPPLEMENTAL DISCLOSURE OF NONCASH INVESTING AND FINANCING ACTIVITIES:
Equipment acquired under finance leases	$	17,992	$	4,414
Right of use assets acquired under operating leases	$	9,334	$	4,451
Purchase of property and equipment in accounts payable and accrued expenses	$	4,823	$	3,962

Condensed Consolidated Balance Sheets (Unaudited) - USD ($)
$ in Thousands

Jun. 30, 2026

Dec. 31, 2025

ASSETS

Cash and cash equivalents

$ 69,705

$ 58,828

Other receivables

31,552

19,015

Prepaid expenses

14,498

17,582

Total current assets

256,416

227,260

Property and equipment, net of accumulated depreciation

156,062

144,709

Operating lease right-of-use assets

77,033

76,555

Investments in unconsolidated affiliates

423,331

423,191

Intangible assets, net of accumulated amortization

39,722

41,335

Goodwill

807,554

Other assets

48,654

43,953

Total assets

^[1]

1,808,772

1,764,557

LIABILITIES AND EQUITY

Accounts payable

27,062

44,857

Accrued expenses and other current liabilities

109,167

95,561

Accounts receivable pledging arrangement

1,267

1,599

Current portion of long-term debt

14,330

13,112

Current portion of finance lease liabilities

14,597

11,552

Current portion of operating lease liabilities

11,932

12,513

Total current liabilities

178,355

179,194

Long-term debt, less current maturities

819,753

819,029

Long-term finance lease liabilities, less current maturities

41,177

33,262

Long-term operating lease liabilities, less current maturities

72,296

71,437

Deferred income taxes

43,592

40,772

Other liabilities

38,538

34,740

Total liabilities

^[1]

1,193,711

1,178,434

COMMITMENTS AND CONTINGENCIES (Note 9)

EQUITY:

Common stock, $0.001 par value, 1,000,000,000 shares authorized, 96,074,976 shares issued and outstanding at June 30, 2026 and 96,109,927 shares issued and outstanding at December 31, 2025

Additional paid-in-capital

1,241,563

1,217,087

Accumulated deficit

(626,598)

(631,060)

Total equity

615,061

586,123

TOTAL LIABILITIES AND EQUITY

1,808,772

1,764,557

Nonrelated Party

ASSETS

Accounts receivable

120,637

112,942

Related Party

ASSETS

Accounts receivable

$ 20,024

$ 18,893

[1]

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
REVENUES:
Revenues	$ 264,162	$ 251,402	$ 516,699	$ 496,403
OPERATING EXPENSES:
Cost of operations, excluding depreciation and amortization	225,285	212,265	443,040	420,662
General and administrative expenses	24,397	18,689	44,732	36,181
Depreciation and amortization	10,083	9,279	20,005	18,330
Loss (gain) on disposal of property and equipment	(24)	16	113	(146)
Total operating expenses	259,741	240,249	507,890	475,027
Equity in earnings of unconsolidated affiliates	18,619	16,527	33,643	31,845
INCOME FROM OPERATIONS	23,040	27,680	42,452	53,221
OTHER EXPENSES:
Interest expense	16,222	30,097	32,553	59,946
Loss on extinguishment and modification of debt	1,053	0	1,053	0
Total other expenses	17,275	30,097	33,606	59,946
INCOME (LOSS) BEFORE INCOME TAXES	5,765	(2,417)	8,846	(6,725)
Income tax provision	3,020	4,809	4,384	8,188
Net income	$ 2,745	$ (7,226)	$ 4,462	$ (14,913)
NET LOSS PER SHARE:
Weighted average shares outstanding: Basic	95,983,246	69,526,574	95,983,240	69,524,980
Weighted average shares outstanding: Diluted	96,039,426	69,526,574	96,011,335	69,524,980
Net income (loss) per common share : Basic	$ 0.03	$ (0.1)	$ 0.05	$ (0.21)
Net income (loss) per common share : Diluted	$ 0.03	$ (0.1)	$ 0.05	$ (0.21)
Patient Service Revenue
REVENUES:
Revenues	$ 194,902	$ 189,347	$ 383,894	$ 373,564
Patient Service Revenue Related Party
REVENUES:
Revenues	8,833	8,838	17,159	16,919
Management and Other Revenue
REVENUES:
Revenues	8,708	4,822	14,385	10,145
Management Fee and Other Revenue Related Party
REVENUES:
Revenues	$ 51,719	$ 48,395	$ 101,261	$ 95,775

Income Taxes

6 Months Ended

Jun. 30, 2026

Income Tax Disclosure [Abstract]

Income Taxes

7. Income Taxes

For the three and six months ended June 30, 2026, income tax expense was $3.0 million and $4.4 million, respectively. For the three and six months ended June 30, 2025, income tax expense was $4.8 million and $8.2 million, respectively. The Company’s effective tax rate for the three and six months ended June 30, 2026 were 52.4% and 49.6% compared to (199.0)% and (121.8)% for the same periods in 2025. The difference in the effective tax rate is primarily due to the change in the Company’s tax-paying components as a result of the Equity Reorganization, changes in non-deductible compensation and the related impacts to the valuation allowance.

- Definition

The entire disclosure for income tax.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 740
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477617/942-740-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480738/235-10-S50-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 740
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478822/944-740-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 231
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482663/740-10-55-231

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12C
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12C

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12B

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477891/740-270-50-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
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-Publisher FASB
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-13

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Publisher FASB
-URI https://asc.fasb.org/740/tableOfContent

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
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-URI https://asc.fasb.org/1943274/2147482685/740-10-50-14

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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-Topic 740
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-Name Accounting Standards Codification
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482603/740-30-50-2

+ Details

Accrued Expenses and Other Current Liabilities

6 Months Ended

Jun. 30, 2026

Payables and Accruals [Abstract]

Accrued Expenses and Other Current Liabilities

5. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following (in thousands):


	JUNE 30,		DECEMBER 31,
	2026		2025
Accrued compensation and benefits	$	42,896	$	39,625
Contract labor		7,006		7,753
Medical claims payable		2,318		3,912
Profit sharing plan		7,550		14,870
Medical malpractice accrual		7,094		6,395
Taxes payable		4,229		421
Accrued professional fees		11,519		8,671
Accrued severance		30		1,978
Other accrued expenses		26,525		11,936
Total	$	109,167	$	95,561

Summary of Significant Accounting Policies (Policies)

6 Months Ended

Jun. 30, 2026

Accounting Policies [Abstract]

Principles of Consolidation and Basis of Financial Statement Presentation

Use of Estimates

Variable Interest Entities

Revenues

Net Patient Service Revenues

The following table disaggregates net patient service revenue by major third-party payor source for the periods presented:


	THREE MONTHS ENDED JUNE 30,
	2026			2025
Commercial insurance		59	%		59	%
Government—Medicare		25			24
Government—Medicaid		4			5
Attorney liens		3			5
Self-pay		4			3
Other third-party payors		5			4
		100	%		100	%

	SIX MONTHS ENDED JUNE 30,
	2026			2025
Commercial insurance		58	%		58	%
Government—Medicare		24			24
Government—Medicaid		4			5
Attorney liens		3			5
Self-pay		4			3
Other third-party payors		7			5
		100	%		100	%

Management Fee and Other Revenue, Related Party

Management Fee and Other Revenue

Accounts Receivable

The Company’s percentage of accounts receivable by payor class was as follows:


	JUNE 30,			DECEMBER 31,
	2026			2025
Commercial insurance		41	%		42	%
Attorney liens		33			36
Government—Medicare		13			12
Government—Medicaid		4			3
Self-pay		1			1
Other third-party payors		8			6
		100	%		100	%

Concentration of Credit Risk and Significant Customers

No single customer exceeded 10% of net patient service revenue during the three or six months ended June 30, 2026 and 2025.

Holdings LLC Common Units

Net Income (Loss) Per Share

Holdings LLC Incentive Unit Plan

Stock-based Compensation

Cloud Computing Software Implementation Costs

Investments in Unconsolidated Affiliates

Segment Reporting

Recent Accounting Pronouncements

Supplemental Cash Flow Information - Schedule of Supplemental Cash Flow Information (Details) - USD ($)	6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025
Supplemental Cash Flow Elements [Abstract]
Cash paid for interest	$ 31,116	$ 57,075
Cash paid for income taxes, net	1,748	0
SUPPLEMENTAL DISCLOSURE OF NONCASH INVESTING AND FINANCING ACTIVITIES:
Equipment acquired under finance leases	17,992	4,414
Right of use assets acquired under operating leases	9,334	4,451
Purchase of property and equipment in accounts payable and accrued expenses	$ 4,823	$ 3,962

Summary of Significant Accounting Policies - Schedule of Percentage of Accounts Receivable by Payor Class (Details) - Accounts Receivable [Member] - Customer Concentration Risk [Member]	6 Months Ended	12 Months Ended
	Jun. 30, 2026	Dec. 31, 2025
Disaggregation of Revenue [Line Items]
Percentage of accounts receivable	100.00%	100.00%
Self-pay [Member]
Disaggregation of Revenue [Line Items]
Percentage of accounts receivable	1.00%	1.00%
Other third-party payors [Member]
Disaggregation of Revenue [Line Items]
Percentage of accounts receivable	8.00%	6.00%
Commercial insurance [Member]
Disaggregation of Revenue [Line Items]
Percentage of accounts receivable	41.00%	42.00%
Attorney liens [Member]
Disaggregation of Revenue [Line Items]
Percentage of accounts receivable	33.00%	36.00%
Government-Medicare [Member]
Disaggregation of Revenue [Line Items]
Percentage of accounts receivable	13.00%	12.00%
Government-Medicaid [Member]
Disaggregation of Revenue [Line Items]
Percentage of accounts receivable	4.00%	3.00%

Net Income (Loss) Per Common Share

6 Months Ended

Jun. 30, 2026

Earnings Per Share [Abstract]

Net Income (Loss) Per Common Share

3. Net Income (Loss) Per Common Share

The following table sets forth the computation of basic and diluted net income (loss) per common share for the periods indicated (in thousands, except for common share and per common share data):


	THREE MONTHS ENDED JUNE 30,					SIX MONTHS ENDED JUNE 30,
	2026		2025			2026		2025
Numerator:
Net income (loss)	$	2,745	$	(7,226	)	$	4,462	$	(14,913	)
Denominator:
Weighted-average common shares outstanding, basic		95,983,246		69,526,574			95,983,240		69,524,980
Shares issuable upon exercise or vesting of dilutive stock options, RSAs or RSUs		56,180		—			28,095		—
Weighted-average common shares outstanding, diluted		96,039,426		69,526,574			96,011,335		69,524,980
Net income (loss) per share attributable to common stockholders:
Basic	$	0.03	$	(0.10	)	$	0.05	$	(0.21	)
Diluted	$	0.03	$	(0.10	)	$	0.05	$	(0.21	)

For the three and six months ended June 30, 2026, stock options, RSUs and common shares available for issuance under the ESPP, representing 4.6 million potentially dilutive securities were outstanding, but were excluded from the calculation of diluted net income per common share because including them would have had an anti-dilutive effect.

For the three and six months ended June 30, 2025, Incentive Units, representing 12.3 million potentially dilutive securities were outstanding, but were excluded from the calculation of diluted net loss per common share because including them would have had an anti-dilutive effect.

For the purposes of determining the basic and diluted weighted-average number of common shares outstanding for the three and six months ended June 30, 2025, the Company retrospectively reflected the Equity Reorganization that occurred (See Note 1) in connection with the IPO. As such, the basic and diluted weighted average number of common shares outstanding for those periods reflect the contribution by the Company of shares of Common Stock to Holdings LLC on a 1 share of Common Stock to 9 units of Holdings LLC ratio, assuming that all such shares of Common Stock were issued and outstanding as of the beginning of the earliest period presented.

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Jun. 30, 2026	Mar. 31, 2026	Jun. 30, 2025	Mar. 31, 2025	Jun. 30, 2026	Jun. 30, 2025
Pay vs Performance Disclosure
Net Income (Loss)	$ 2,745	$ 1,717	$ (7,226)	$ (7,687)	$ 4,462	$ (14,913)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended		12 Months Ended
	Jun. 30, 2026	Mar. 31, 2026	Jun. 30, 2025	Mar. 31, 2025	Jun. 30, 2026	Jun. 30, 2025	Dec. 31, 2025
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income (loss)	$ 2,745	$ 1,717	$ (7,226)	$ (7,687)	$ 4,462	$ (14,913)
Adjustments to reconcile net income (loss) to net cash provided by operating activities
Depreciation and amortization	10,083		9,279		20,005	18,330
Amortization of operating lease right-of-use assets					7,956	7,424
Amortization of debt issuance costs					1,437	2,871
Amortization of cloud computing implementation costs					760	184
Write-off of debt issuance costs related to extinguishment of debt					46	0
Equity in earnings of unconsolidated affiliates	(18,619)		(16,527)		(33,643)	(31,845)
Distributions from investments in unconsolidated affiliates					36,869	32,820
Loss (gain) on disposal of property and equipment					113	(146)
Deferred income taxes					2,820	1,477
Stock-based compensation					25,011	14,720
Other					(535)	0
Changes in operating assets and liabilities:
Accounts receivable					(7,695)	(6,870)
Accounts receivable, related party					(1,131)	(2,035)
Capitalized cloud computing implementation costs					(1,647)	(1,421)
Other receivables					(12,537)	(5,410)
Prepaid expenses					3,034	(7,028)
Other assets					(4,723)	(11,311)
Accounts payable					(18,596)	1,214
Accrued expenses and other current liabilities					18,085	(11,002)
Other liabilities					3,798	7,018
Operating lease liabilities					(8,156)	(5,966)
Net cash provided by (used in) operating activities					35,733	(11,889)
CASH FLOWS FROM INVESTING ACTIVITIES:
Proceeds from sale or disposal of property and equipment					40	713
Acquisition of intangible asset					(600)	0
Purchases of property and equipment					(14,985)	(5,602)
Contributions to investments in unconsoldiated affiliates					(3,366)	0
Net cash used in investing activities					(18,911)	(4,889)
CASH FLOWS FROM FINANCING ACTIVITIES:
Payment of third-party debt issuance costs					(154)	0
Proceeds from long-term debt					9,536	496
Payments of long-term debt					(8,393)	(7,821)
Proceeds from revolving line of credit					0	5,000
Payments of finance lease liabilities					(6,602)	(2,998)
Capital contributions					0	715
Repayments on accounts receivable pledging arrangement					(332)	0
Net cash used in financing activities					(5,945)	(4,608)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS					10,877	(21,386)
CASH AND CASH EQUIVALENTS, beginning of period		$ 58,828		$ 26,131	58,828	26,131	$ 26,131
CASH AND CASH EQUIVALENTS, end of period	$ 69,705		$ 4,745		$ 69,705	$ 4,745	$ 58,828

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	1,000,000,000	1,000,000,000
Common stock, shares outstanding	96,074,976	96,109,927
Common stock, shares issued	96,074,976	96,109,927
Assets, Current [Abstract]
Prepaid expenses	$ 14,498	$ 17,582
Other receivables	31,552	19,015
Property and equipment, net of accumulated depreciation	156,062	144,709
Operating lease right-of-use assets	77,033	76,555
Goodwill	807,554	807,554
Investments in unconsolidated affiliates	423,331	423,191
Other assets	48,654	43,953
Liabilities, Current [Abstract]
Accounts payable	27,062	44,857
Accrued expenses and other current liabilities	109,167	95,561
Current portion of operating lease liabilities	11,932	12,513
Other liabilities	38,538	34,740
Long-term operating lease liabilities, less current maturities	72,296	71,437
Related Party [Member]
Assets, Current [Abstract]
Accounts receivable	20,024	18,893
Variable Interest Entity, Primary Beneficiary [Member]
Assets, Current [Abstract]
Accounts receivable	60,623	49,560
Prepaid expenses	1,111	1,502
Other receivables	5,482	4,463
Property and equipment, net of accumulated depreciation	18,173	17,669
Operating lease right-of-use assets	10,457	9,541
Goodwill	101,802	101,802
Investments in unconsolidated affiliates	54,020	54,087
Other assets	23,356	21,554
Liabilities, Current [Abstract]
Accounts payable	349	373
Accrued expenses and other current liabilities	18,662	18,150
Current portion of operating lease liabilities	1,721	1,647
Other liabilities	28,296	25,724
Long-term operating lease liabilities, less current maturities	9,302	8,492
Variable Interest Entity, Primary Beneficiary [Member] \| Related Party [Member]
Assets, Current [Abstract]
Accounts receivable	$ 3,094	$ 5,811

Stock-Based Compensation (Tables)

6 Months Ended

Jun. 30, 2026

Share-Based Payment Arrangement [Abstract]

Schedule of Stock Based Compensation Expenses

The following table presents the components of stock-based compensation expense for the Employee Awards for the periods indicated (in thousands):


	THREE MONTHS ENDED JUNE 30,				SIX MONTHS ENDED JUNE 30,
	2026		2025		2026		2025
Holdings LLC Common Units	$	6,094	$	7,532	$	12,197	$	13,664
Incentive Units		163		814		418		1,056
Stock Options		3,448		—		7,087		—
RSAs and RSUs		2,942		—		5,219		—
ESPP		90		—		90		—
Total	$	12,737	$	8,346	$	25,011	$	14,720

Accrued Expenses and Other Current Liabilities (Tables)

6 Months Ended

Jun. 30, 2026

Payables and Accruals [Abstract]

Schedule of Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following (in thousands):


	JUNE 30,		DECEMBER 31,
	2026		2025
Accrued compensation and benefits	$	42,896	$	39,625
Contract labor		7,006		7,753
Medical claims payable		2,318		3,912
Profit sharing plan		7,550		14,870
Medical malpractice accrual		7,094		6,395
Taxes payable		4,229		421
Accrued professional fees		11,519		8,671
Accrued severance		30		1,978
Other accrued expenses		26,525		11,936
Total	$	109,167	$	95,561

Variable Interest Entities

6 Months Ended

Jun. 30, 2026

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Variable Interest Entities

10. Variable Interest Entities

The Company’s VIEs consist of both VIE Physician Practices and Franchise Centers.

VIE Physician Practices

The VIE Physician Practices are wholly owned, from an equity ownership perspective and for certain regulatory reasons, by certain physicians (the “Physician Owners”) who are employed by the Company or a VIE Physician Practice. The VIE Physician Practices were established to operate as medical radiology practices and provide their patients with professional interpretation services. At various points between 2018 and 2023, via the establishment or acquisition of the MSOs and execution of the ASAs and other contractual agreements, the Company acquired a controlling financial interest in the VIE Physician Practices (described below in detail). Through the ASAs, the MSOs have exclusive responsibility for the provision of non-medical services required for the day-to-day operation and management of each of the VIE Physician Practices, including establishing annual capital and operating budgets, and making recommendations to the VIE Physician Practices in establishing the guidelines for the employment and compensation for the physicians and other employees of the VIE Physician Practices. Via other contractual agreements, the Company has the right to designate an appropriate licensed person(s) to purchase the equity interest of the VIE Physician Practices for a nominal amount in the event of a transfer event at the Company’s discretion.

In assessing whether the Company should consolidate the VIE Physician Practices, the Company evaluated whether it has a variable interest in the VIE Physician Practices, whether the VIE Physician Practices are VIEs, and whether the Company has a controlling financial interest in the VIE Physician Practices. The Company concluded that it has variable interests in the VIE Physician Practices on the basis that the Company has the right to receive income as an ongoing management fee under the ASAs, which effectively absorbs all of the residual interests of the VIE Physician Practices. The Company also has the implicit obligation to absorb losses of the VIE Physician Practices and to additionally provide, in certain circumstances, cash advances to the VIE Physician Practices if the VIE Physician Practices have insufficient funds. The Company did not provide any such cash advances to the VIE Physician Practices during the six months ended June 30, 2026 or 2025. The Company determined the VIE Physician Practices are VIEs due to insufficient equity

at risk and/or the holders of the equity at risk in the VIE Physician Practices (i.e., the Physician Owners) lacking the power, through voting rights or similar rights, to direct the activities that most significantly impact the VIE Physician Practices’ economic performance.

The contractual arrangements described above allow the Company to direct the activities that most significantly impact the economic performance of the VIE Physician Practices. Accordingly, the Company is the primary beneficiary of the VIE Physician Practices and consolidates the VIE Physician Practices under the VIE model.

The table below illustrates the assets and liabilities of the VIE Physician Practices (in thousands):


	JUNE 30,		DECEMBER 31,
	2026		2025
Assets
Current assets	$	62,194	$	56,239
Non-current assets		205,787		202,549
Total assets of consolidated VIEs		267,981		258,788
Liabilities
Current liabilities		15,748		17,038
Non-current liabilities		35,875		32,334
Total liabilities of consolidated VIEs		51,623		49,372
Total net assets of consolidated VIEs	$	216,358	$	209,416

Franchise Centers

The Franchise Centers operate as franchisees of AHI and are wholly owned, from an equity ownership perspective and for certain regulatory reasons, by certain radiologists (the “Franchisees”) who have contracts with and provide clinical services to the patients of the Franchise Centers. The Franchise Centers were established to operate as medical radiology practices and imaging centers offering patients MRI, CT, and ultrasound imaging services. Through the franchise agreements and management service agreements (“MSAs”), AHI has exclusive responsibility for the provision of non-medical services required for the day-to-day operation and management of each of the Franchise Centers, including establishing annual capital and operating budgets and makes recommendations to the Franchise Centers in establishing the guidelines for the physicians and other employees of the Franchise Centers. The franchise agreements also restrict the Franchisees’ ability to transfer the ownership interest without AHI’s approval.

In assessing whether AHI should consolidate the Franchise Centers, the Company evaluated whether AHI holds a variable interest in the Franchise Centers, if the Franchise Centers are VIEs, and whether AHI has a controlling financial interest in the Franchise Centers. The Company concluded that AHI has the right to receive income as an ongoing management fee under the MSAs, which effectively absorbs all of the residual interest of the Franchise Centers. AHI also has the implicit obligation to absorb losses of the Franchise Centers and to additionally provide, in certain circumstances, cash advances to the Franchise Centers, if the Franchise Centers have insufficient funds. AHI did not provide any such cash advances to the Franchise Centers during the six months ended June 30, 2026 or 2025. The Company determined that the Franchise Centers are considered VIEs because their equity at risk is insufficient to finance their activities without additional support.

The contractual arrangements above allow AHI to direct the activities that most significantly impact the Franchise Centers’ economic performance. Thus, AHI is the primary beneficiary and consolidates the Franchise Centers.

Total assets and liabilities included in the Company’s condensed consolidated balance sheets associated with the Franchise Centers were $10.1 million and $7.2 million and $6.7 million and $5.0 million, respectively, as of June 30, 2026 and December 31, 2025, respectively.

As a direct result of the nominal initial equity contributions by the Physician Owners and the Franchisees and the provisions of the contractual arrangements described above, the interests held by the noncontrolling interest holders of the Company’s VIEs (inclusive of the VIE Physician Practices and the Franchise Centers) lack economic substance and do not provide them with any right to participate in residual profits or losses generated by the Company’s VIEs. These rights are instead implicit in the corporate governance laws governing the relevant VIE’s constitutive documents by virtue of the fact that such noncontrolling interest holders are the sole owners of the equity of the relevant VIE. However, after paying relevant expenses, including clinical staff salaries as well as administrative service fees to the Company, the VIEs do not have residual profits remaining. Additionally, because the Company absorbs all expected losses of its VIEs through its deferral of administrative service fees and the Company expects that its VIEs will continue to have a

shortfall on their payment of such administrative service fees, noncontrolling interest holders in the VIEs are not expected to be allocated any residual profits, losses, dividends or liquidation proceeds. Therefore, the noncontrolling interests in the VIEs have no material value and the income and expenses recognized by the VIEs are attributable in totality to the Company.

The Company has not identified any VIEs during the six months ended June 30, 2026 or 2025, for which the Company determined that it is not the primary beneficiary and thus did not consolidate. No VIEs were added and no VIEs were deconsolidated during the six months ended June 30, 2026 or 2025.

Long-Term Debt (Tables)

6 Months Ended

Jun. 30, 2026

Debt Disclosure [Abstract]

Summary of Long-Term Debt

The following is a summary of the Company’s long-term debt (in thousands):


	JUNE 30,			DECEMBER 31,
	2026			2025
Senior secured term loan	$	822,938		$	825,000
Promissory notes		20,645			17,441
Accounts receivable pledging arrangement		1,267			1,599
Total debt obligations		844,850			844,040
Less debt issuance costs and discount		(9,500	)		(10,300	)
Long-term debt, net of debt issuance costs		835,350			833,740
Less accounts receivable pledging arrangement		(1,267	)		(1,599	)
Less current maturities of long-term debt		(14,330	)		(13,112	)
Long-term debt, less current maturities	$	819,753		$	819,029

Schedule of Maturities of Long-Term Debt Excluding Accounts Receivable Pledging Arrangement

Scheduled maturities of long-term debt as of June 30, 2026, excluding the Accounts Receivable Pledging Arrangement, were as follows (in thousands):


Years Ending December 31,
2026 (remaining six months)	$	7,069
2027		14,505
2028		13,598
2029		11,395
2030		10,440
Thereafter		786,576
Total	$	843,583

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

+ Details

Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in-Capital [Member]	Accumulated Deficit [Member]
Beginning Balance, Shares at Dec. 31, 2024		69,523,830
Beginning Balance at Dec. 31, 2024	$ 161,654	$ 70	$ 745,540	$ (583,956)
Capital contributions , Shares		32,885
Capital contributions	660		660
Stock-based compensation	6,374		6,374
Net income (loss)	(7,687)			(7,687)
Ending Balance, Shares at Mar. 31, 2025		69,556,715
Ending Balance at Mar. 31, 2025	161,001	$ 70	752,574	(591,643)
Beginning Balance, Shares at Dec. 31, 2024		69,523,830
Beginning Balance at Dec. 31, 2024	161,654	$ 70	745,540	(583,956)
Capital contributions , Shares		2,741
Net income (loss)	(14,913)
Ending Balance, Shares at Jun. 30, 2025		69,559,456
Ending Balance at Jun. 30, 2025	162,176	$ 70	760,975	(598,869)
Beginning Balance, Shares at Mar. 31, 2025		69,556,715
Beginning Balance at Mar. 31, 2025	161,001	$ 70	752,574	(591,643)
Capital contributions	55		55
Stock-based compensation	8,346		8,346
Net income (loss)	(7,226)			(7,226)
Ending Balance, Shares at Jun. 30, 2025		69,559,456
Ending Balance at Jun. 30, 2025	162,176	$ 70	760,975	(598,869)
Beginning Balance, Shares at Dec. 31, 2025		96,109,927
Beginning Balance at Dec. 31, 2025	586,123	$ 96	1,217,087	(631,060)
Forfeiture of restricted stock awards, shares		(29,192)
Forfeiture of restricted stock units related to retention bonus	(494)		(494)
Stock-based compensation	12,274		12,274
Net income (loss)	1,717			1,717
Ending Balance, Shares at Mar. 31, 2026		96,080,735
Ending Balance at Mar. 31, 2026	599,620	$ 96	1,228,867	(629,343)
Beginning Balance, Shares at Dec. 31, 2025		96,109,927
Beginning Balance at Dec. 31, 2025	586,123	$ 96	1,217,087	(631,060)
Net income (loss)	4,462
Ending Balance, Shares at Jun. 30, 2026		96,074,976
Ending Balance at Jun. 30, 2026	615,061	$ 96	1,241,563	(626,598)
Beginning Balance, Shares at Mar. 31, 2026		96,080,735
Beginning Balance at Mar. 31, 2026	599,620	$ 96	1,228,867	(629,343)
Forfeiture of restricted stock awards, shares		(5,759)
Forfeiture of restricted stock units related to retention bonus	(41)		(41)
Stock-based compensation	12,737		12,737
Net income (loss)	2,745			2,745
Ending Balance, Shares at Jun. 30, 2026		96,074,976
Ending Balance at Jun. 30, 2026	$ 615,061	$ 96	$ 1,241,563	$ (626,598)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

- Definition

Amount of equity (deficit) attributable to parent. Excludes temporary equity and equity attributable to noncontrolling interest.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 7: http://www.xbrl.org/2003/role/exampleRef
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+ Details

Summary of Significant Accounting Policies - Schedule of Disaggregation of Net Patient Service Revenue (Details) - Revenue Benchmark [Member] - Product Concentration Risk [Member]	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Disaggregation of Revenue [Line Items]
Percentage of revenues	100.00%	100.00%	100.00%	100.00%
Self-pay [Member]
Disaggregation of Revenue [Line Items]
Percentage of revenues	4.00%	3.00%	4.00%	3.00%
Other third-party payors [Member]
Disaggregation of Revenue [Line Items]
Percentage of revenues	7.00%	5.00%	5.00%	4.00%
Commercial insurance [Member]
Disaggregation of Revenue [Line Items]
Percentage of revenues	59.00%	59.00%	58.00%	58.00%
Government-Medicare [Member]
Disaggregation of Revenue [Line Items]
Percentage of revenues	25.00%	24.00%	24.00%	24.00%
Government-Medicaid [Member]
Disaggregation of Revenue [Line Items]
Percentage of revenues	4.00%	5.00%	4.00%	5.00%
Attorney liens [Member]
Disaggregation of Revenue [Line Items]
Percentage of revenues	3.00%	5.00%	3.00%	5.00%

Segment Reporting

6 Months Ended

Jun. 30, 2026

Segment Reporting [Abstract]

Segment Reporting

13. Segment Reporting

In January 2025, the Company experienced a strategic shift in connection with changes to its executive leadership, including the hiring of a new Chief Executive Officer (“CEO”). As a result, at the beginning of 2025, the Company began providing its operating results to the CEO, who is the Company’s CODM on the basis of a single segment. As the CODM progressed in her role, however, she started reviewing disaggregated financial information based upon two segments (the “June Segment Update”). In response, the Company revised its view of reportable segments based on the CODM’s methods for managing the organization and allocating resources.

The CODM reviews revenues and Adjusted Earnings Before Interest, Taxes, Depreciation, and Amortization (“Adjusted EBITDA”) of each segment for the purpose of making operating decisions, assessing financial performance, and deciding how to allocate resources (including employees, property, and financial or capital resources) for each segment predominantly in the annual budget and

forecasting process. The CODM considers budget-to-actual variances monthly when making decisions about allocating resources to the segments.

Adjusted EBITDA is defined by the Company as net income (loss) determined in accordance with US GAAP, before interest expense, provision for income taxes, depreciation and amortization, unit-based compensation expense and the impact, which may be recurring in nature, of transaction costs, one-time litigation and settlement expenses associated with claims made against the Company, costs associated with strategic initiatives and implementation, goodwill impairment charges, severance and executive recruiting costs, gains or losses on dispositions and other similar or infrequent items (although the Company may not have had such charges in the periods presented). Adjusted EBITDA includes adjustments to reflect the Company’s share of Adjusted EBITDA from unconsolidated affiliates.

The Company’s reportable segments are strategic business units that offer different services or structures for delivering outpatient imaging services. They are managed separately because each business requires a different operational strategy for managing performance and allocating resources. The Outpatient segment consists of imaging centers that are owned or operated by the Company (either wholly owned or via unconsolidated affiliate), where the Company performs the imaging scan and provides the radiologist’s interpretation service (i.e., read). Revenues are also earned through the provision of management services to operate the centers for certain of the Company’s unconsolidated affiliate partners. The Professional segment consists of professional interpretation services, where the imaging scan itself is performed at the hospital or point of care and not by the Company or its unconsolidated affiliates. The Company eliminates any intersegment transactions in consolidation.

Historically, corporate overhead expenses were allocated to each segment on the basis of net patient service revenue for each segment. During the third quarter of 2025, the Company changed its approach to allocating certain segment expenses. Physician compensation expense is now allocated based on the effort associated with services performed for each segment. Corporate overhead expenses are allocated to each segment based on estimated relative usage of these overhead costs.

The Company does not report balance sheet information by segment since it is not reviewed by its CODM. The CODM uses consolidated expense information to manage operations, and the CODM is not regularly provided disaggregated expenses by segment.

The following tables present revenues and Adjusted EBITDA for each reportable segment for the three and six months ended June 30, 2026 and 2025 (in thousands):


	THREE MONTHS ENDED JUNE 30, 2026
	OUTPATIENT		PROFESSIONAL		INTERSEGMENT ELIMINATIONS			TOTAL OF REPORTABLE SEGMENTS
Revenue
Net patient service revenue	$	143,747	$	64,280	$	(4,292	)	$	203,735
Management fee and other revenue		52,462		7,965		—			60,427
Total revenues		196,209		72,245		(4,292	)		264,162
Other segment items(1)		149,844		62,165		(4,292	)		207,717
Adjusted EBITDA	$	46,365	$	10,080	$	—		$	56,445
Less:
Depreciation and amortization									(10,083	)
Income tax provision									(3,020	)
Amortization of basis difference									(573	)
Interest expense									(16,222	)
Loss on extinguishment and modification of debt									(1,053	)
Gain on disposal of property and equipment									24
Stock-based compensation									(12,737	)
Severance and executive recruiting(2)									(686	)
Strategic initiatives and implementation(3)									(2,659	)
Transaction costs(4)									(707	)
Litigation and settlements(5)									(1,173	)
Other(6)									(87	)
Adjustments for equity in earnings of unconsolidated affiliates(7)									(4,724	)
Net income								$	2,745


	THREE MONTHS ENDED JUNE 30, 2025
	OUTPATIENT		PROFESSIONAL		INTERSEGMENT ELIMINATIONS			TOTAL OF REPORTABLE SEGMENTS
Revenue
Net patient service revenue	$	138,909	$	61,400	$	(2,124	)	$	198,185
Management fee and other revenue		48,289		4,928		—			53,217
Total revenues		187,198		66,328		(2,124	)		251,402
Other segment items(1)		140,216		57,036		(2,124	)		195,128
Adjusted EBITDA	$	46,982	$	9,292	$	—			56,274
Less:
Depreciation and amortization									(9,279	)
Income tax provision									(4,809	)
Amortization of basis difference									(500	)
Interest expense									(30,097	)
Stock-based compensation									(8,346	)
Loss on disposal of property and equipment									(16	)
Severance and executive recruiting(2)									(803	)
Strategic initiatives and implementation(3)									(1,018	)
Transaction costs(4)									(3,875	)
Litigation and settlements(5)									—
Other(6)									(142	)
Adjustments for equity in earnings of unconsolidated affiliates(7)									(4,615	)
Net loss								$	(7,226	)


	SIX MONTHS ENDED JUNE 30, 2026
	OUTPATIENT		PROFESSIONAL		INTERSEGMENT ELIMINATIONS			TOTAL OF REPORTABLE SEGMENTS
Revenue
Net patient service revenue	$	281,839	$	127,026	$	(7,812	)	$	401,053
Management fee and other revenue		102,269		13,377		—			115,646
Total revenues		384,108		140,403		(7,812	)		516,699
Other segment items(1)		299,370		117,497		(7,812	)		409,055
Adjusted EBITDA	$	84,738	$	22,906	$	—		$	107,644
Less:
Depreciation and amortization									(20,005	)
Income tax provision									(4,384	)
Amortization of basis difference									(1,105	)
Interest expense									(32,553	)
Loss on extinguishment and modification of debt									(1,053	)
Loss on disposal of property and equipment									(113	)
Stock-based compensation									(25,011	)
Severance and executive recruiting(2)									(1,631	)
Strategic initiatives and implementation(3)									(3,484	)
Transaction costs(4)									(3,289	)
Litigation and settlements(5)									(1,202	)
Other(6)									(82	)
Adjustments for equity in earnings of unconsolidated affiliates(7)									(9,270	)
Net income								$	4,462


	SIX MONTHS ENDED JUNE 30, 2025
	OUTPATIENT		PROFESSIONAL		INTERSEGMENT ELIMINATIONS			TOTAL OF REPORTABLE SEGMENTS
Revenue
Net patient service revenue	$	272,339	$	121,954	$	(3,810	)	$	390,483
Management fee and other revenue		95,660		10,260		—			105,920
Total revenues		367,999		132,214		(3,810	)		496,403
Other segment items(1)		279,196		113,743		(3,810	)		389,129
Adjusted EBITDA	$	88,803	$	18,471	$	—			107,274
Less:
Depreciation and amortization									(18,330	)
Income tax provision									(8,188	)
Amortization of basis difference									(1,000	)
Interest expense									(59,946	)
Stock-based compensation									(14,720	)
Gain on disposal of property and equipment									146
Severance and executive recruiting(2)									(2,173	)
Strategic initiatives and implementation(3)									(1,886	)
Transaction costs(4)									(7,464	)
Litigation and settlements(5)									128
Other(6)									(158	)
Adjustments for equity in earnings of unconsolidated affiliates(7)									(8,596	)
Net loss								$	(14,913	)

(1)

(2)

Includes severance and recruiting expenses for executive leadership departures as part of strategic organizational changes.

(3)

(4)

(5)

Consists of litigation and settlement costs for matters not related to core operations.

(6)

Consists of other costs related to debt financing, certain de novo start-up costs related to outpatient imaging centers and certain exit costs related to closed outpatient imaging centers.

(7)

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details