Heartflow, Inc.
For the period ended Sep 30, 2025. Filed Nov 12, 2025.
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A company's report for each of its first three quarters. The financial statements are not audited. It shows how the business has moved since the last annual report, and what management says changed.
Sep 30, 2025 · Filed Nov 12, 2025
What changed in Management’s Discussion and Analysis?
Read the current filingPrevious report: 10-Q
Period ended 2025-06-30; filed 2025-09-19.
0001464521-25-000012
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsCurrent report: 10-Q
Period ended 2025-09-30; filed 2025-11-12.
0001464521-25-000019
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsThe baseline is this issuer’s latest earlier reporting period of the same form that was filed before the current report. A previous 10-Q is a different quarter, not a year-over-year comparison. Amendments are excluded.
Compared 498 previous paragraphs and 508 current paragraphs.
265 unchanged; 149 reworded; 87 added; 76 removed; 8 previous and 7 current paragraphs rearranged.
Tables are not compared: 4 previous and 4 current tables excluded. Dates, whitespace, punctuation and numbering changes are ignored; changes to financial figures remain significant.
A changed paragraph is not evidence that risk increased or decreased. An unchanged paragraph does not establish that risk stayed the same.
Added paragraphs (87)
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diagnosis and management of CAD.
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second commercial product, and we expect to broaden our market education efforts as payor coverage
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for Heartflow Plaque Analysis increases. Heartflow Plaque Analysis is currently covered by certain
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•Seasonality we experience throughout the year, including due to staff availability, vacations, weather
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the three month periods as indicated:
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partially offset by capitalized contract fulfillment costs. The role of the production team is to support our
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patient case volume.
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customers and the related capitalization of contract fulfillment costs, and the pricing and
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offset by the varying levels of support provided by the production team in our clinical trials and research
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contract fulfillment costs.
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fair value of the derivative liability until their conversion upon our IPO. All of our common stock warrants
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were net exercised in October 2025.
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and 2024:
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Revenue increased $13.3 million, or 41%, to $46.3 million during the three months ended September 30,
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2025, compared to $32.9 million during the three months ended September 30, 2024. The increase in
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Cost of revenue increased $2.9 million, or 36%, to $10.9 million during the three months ended
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September 30, 2025, compared to $8.0 million during the three months ended September 30, 2024. This
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increase was primarily attributable to an increase of $2.2 million in personnel and related expenses, $0.3
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million in third-party hosting fees, $0.2 million in royalties, and $0.1 million in computer hardware
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expenses. Personnel and related expenses included $127,000 and $71,000 of stock-based compensation
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three months ended September 30, 2025 increased to 77% as compared to 76% for the three months
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ended September 30, 2024. The increase in our gross margin for the three months ended September 30,
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productivity partially offset by our continued investment in the hiring and training of additional personnel in
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Research and development expenses increased $5.4 million, or 46%, to $17.3 million during the three
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months ended September 30, 2025, compared to $11.9 million during the three months ended September
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of $3.6 million in personnel and related expenses directly associated with an increase in headcount,
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clinical trials and research and development efforts, $0.3 million in software-related costs, $0.2 million in
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third-party hosting fees and $0.1 million in allocated overhead. Personnel and related expenses included
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$1.0 million and $0.6 million of stock-based compensation costs during the three months ended
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Selling, general and administrative expenses increased $5.2 million, or 19%, to $33.2 million during the
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three months ended September 30, 2025, compared to $28.0 million during the three months ended
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attributable to an increase of $4.4 million in personnel and related expenses directly associated with an
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increase in headcount,$0.5 million in computer hardware and software-related costs, $0.5 million in
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advertising and other promotional expenses, $0.4 million in travel expenses, partially offset by a decrease
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expenses included $2.9 million and $1.7 million of stock-based compensation costs for the three months
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September 30, 2025, compared to an expense of $4.5 million during the three months ended September
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30, 2024. This decreased expense was mainly attributable to the repayment in full of our 2024 Term Loan
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in August 2025 and the conversion of our 2025 Convertible Notes to common stock upon IPO in August
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September 30, 2025, compared to an income of $0.3 million during the three months ended September
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30, 2024. The increase was primarily attributable to a $32.1 million charge from the remeasurement and
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Removed paragraphs (76)
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management of CAD.
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transactions with customers, our existing cash and cash equivalents together with the net proceeds from
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our August 2025 IPO, will be sufficient to fund our planned operating expenses and capital expenditure
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•We experience seasonality throughout the year based on a number of factors, including staff
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thethree month periods asindicated:
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exercised or expire and to the estimated fair value of the derivative liability until the convertible notes are
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repaid or converted.
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compared to $31.1 million during the three months ended June 30, 2024. The increase in revenue was
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Cost of revenue increased $3.4 million, or 48%, to $10.6 million during the three months ended June 30,
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2025, compared to $7.2 million during the three months ended June 30, 2024. This increase was primarily
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attributable to an increase of $1.9 million in personnel and related expenses, $0.8 million in allocated
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overhead, $0.3 million in equipment expenses, $0.2 million in amortization of capitalized internal-use
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software, and $0.2 million in third-party hosting fees, partially offset by a net decrease of $0.2 million in
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capitalized and amortized contract fulfillment costs. Personnel and related expenses included $45,000
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and $78,000 of stock-based compensation costs during the three months ended June 30, 2025 and 2024,
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respectively. Gross margin for the three months ended June 30, 2025 decreased to 75% as compared to
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77% for the three months ended June 30, 2024. The decrease in our gross margin for the three months
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Research and development expenses increased $5.1 million, or 51%, to $15.0 million during the three
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months ended June 30, 2025, compared to $9.9 million during the three months ended June 30, 2024.
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$2.8 million in personnel and related expenses directly associated with an increase in headcount, $0.7
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$0.2 million in software-related costs and $1.0 million in clinical trial expenses. Personnel and related
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expenses included $0.4 million and $0.5 million of stock-based compensation costs during the three
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Selling, general and administrative expenses increased $3.4 million, or 12%, to $31.5 million during the
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three months ended June 30, 2025, compared to $28.1 million during the three months ended June 30,
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increase of $2.6 million in personnel and related expenses directly associated with an increase in
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headcount, $0.7 million in software-related costs, $0.4 million in travel expenses, $0.3 million in
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advertising and other promotional expenses, and $0.1 million in professional fees, including legal, audit
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and consulting fees, partially offset by a decrease of $0.6 million in allocated overhead and $0.5 million in
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2025, compared to an expense of $4.9 million during the three months ended June 30, 2024. This
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our 2024 Term Loan and 2025 Convertible Notes, offset by a lower aggregate outstanding principal
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notes in January 2025. In addition, during the three months ended June 30, 2025, lower cash balances
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and interest rates earned on money market funds resulted in a lower offset against interest expense in
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comparison to the three months ended June 30, 2024. As of June 30, 2025 and 2024, the aggregate
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outstanding principal balance (including interest paid-in-kind) under our 2024 Term Loan was $115.1
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million and $138.1 million, respectively.
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the remeasurement and recognition of our common stock warrant liability during the three months ended
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Provision for income taxes was $59,000 for the three months ended June 30, 2025, compared to
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Comparison of Six Months Ended June 30, 2025 and 2024
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The following table summarizes our results ofoperations for the six months ended June 30, 2025 and
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Revenue increased $22.7 million, or 39%, to $80.6 million during the six months ended June 30, 2025,
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Reworded paragraphs (149)
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leading cause of death worldwide. As of June 30, 2025, our Heartflow Platform has been used to assess
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leading cause of death worldwide. As of September 30, 2025, our Heartflow Platform has been used to
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CAD in almost 500,000 patients, including 132,000 in 2024 alone. We believe that we are the most widely
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assess CAD in more than 500,000 patients, including 132,000 in 2024 alone. We believe that we are the
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adopted AI-powered test for CAD. Our novel platform leverages AI and advanced computational fluid
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most widely adopted AI-powered test for CAD. Our novel platform leverages AI and advanced
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dynamics to create a personalized 3D model of a patient’s heart from a single coronary computed
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computational fluid dynamics to create a personalized 3D model of a patient’s heart from a single
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tomography angiography (“CCTA”), a specialized type of scan that provides detailed images of the heart’s
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coronary computed tomography angiography (“CCTA”), a specialized type of scan that provides detailed
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arteries. Our Heartflow Platform delivers actionable insights on blood flow, stenosis, plaque volume and
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images of the heart’s arteries. Our Heartflow Platform delivers actionable insights on blood flow, stenosis,
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plaque composition thereby overcoming the limitations of traditional non-invasive imaging tests which rely
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plaque volume and plaque composition thereby overcoming the limitations of traditional non-invasive
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on indirect measures of coronary disease and lead to higher false negative and false positive rates as
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imaging tests which rely on indirect measures of coronary disease and lead to higher false negative and
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demonstrated by our PRECISE trial. We believe the differentiated accuracy and clinical utility of our
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false positive rates as demonstrated by our PRECISE trial. We believe the differentiated accuracy and
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Heartflow Platform, along with its ability to enhance workflows, will continue to support our growth and
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clinical utility of our Heartflow Platform, along with its ability to enhance workflows, will continue to support
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advance the “CCTA + Heartflow” pathway as the definitive standard for the non-invasive diagnosis and
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our growth and advance the “CCTA + Heartflow” pathway as the definitive standard for the non-invasive
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We have experienced considerable revenue growth since webegan commercializing the Heartflow
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We have experienced considerable revenue growth since we began commercializing the Heartflow
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in our installed base. For the three months ended June 30, 2025 and 2024, we recognized revenue of
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in our installed base. For the three months ended September 30, 2025 and 2024, we recognized revenue
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$43.4 million and $31.1 million, respectively, and for the six months ended June 30, 2025 and 2024, we
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of $46.3 million and $32.9 million, respectively, and for the nine months ended September 30, 2025 and
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recognized revenue of $80.6 million and $57.9 million, respectively. Substantially all of our revenue is
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2024, we recognized revenue of $126.9 million and $90.8 million, respectively. Substantially all of our
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generated on a “pay-per-click” basis each time a physician chooses to review either our Heartflow FFRCT
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revenue is generated on a “pay-per-click” basis each time a physician chooses to review either our
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Analysis, Heartflow Plaque Analysis, or both and we recognize usage-driven fee revenue upon delivery of
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Heartflow FFRCT Analysis, Heartflow Plaque Analysis, or both, and we recognize usage-driven fee
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the requested analysis to the physician. Heartflow FFRCT Analysis has served as our commercial
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revenue upon delivery of the requested analysis to the physician. Heartflow FFRCT Analysis has served as
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foundation, representing 98% of our total revenue as of June 30, 2025. In the second half of 2023, we
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our commercial foundation, representing 98% of our total revenue as of September 30, 2025. In the
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initiated limited market education efforts for Heartflow Plaque Analysis, our second commercial product.
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second half of 2023, we initiated limited market education efforts for Heartflow Plaque Analysis, our
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Our Heartflow RoadMap Analysis is generally provided as a workflow efficiency tool to drive customer
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government andthird-party payors. Our Heartflow RoadMap Analysis is generally provided as a workflow
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retention and loyalty and is not a stand-alone product.
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efficiency tool to drive customer retention and loyalty and is not a stand-alone product.
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borrowings under our term loans and revenue received from our customers. As of June 30, 2025, we had
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borrowings under our term loans and revenue received from our customers. As of September 30, 2025,
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$80.2 million in cash and cash equivalents. In January and March 2025, we issued $98.3 million in
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we had $291.2 million in cash and cash equivalents. In January and March 2025, we issued $98.3 million
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aggregate principal amount of the 2025 Convertible Notes to investors, including related parties, with
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in aggregate principal amount of the 2025 Convertible Notes to investors, including related parties, with
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share. The cash proceeds from the IPO were approximately $332.8 million, net of underwriting discounts
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share. The cash proceeds from our IPO were approximately $332.3 million, net of underwriting discounts
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and commissions and estimated offering costs of $31.4 million. Additionally, upon the closing of our IPO,
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and commissions and estimated offering costs of $31.8 million. Additionally, upon the closing of our IPO,
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to continue to incur losses as we grow and transition to operating as a public company. As of June 30,
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to continue to incur losses as we grow and transition to now operating as a public company. As of
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2025, we had an accumulated deficit of $1.0 billion.
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September 30, 2025, we had an accumulated deficit of $1.1 billion.
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availability, vacations, weather and other macro economic events.
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and other macro economic events.
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percentage of our U.S. revenue cases attributable to office and clinic-based accounts was 31% and 28%
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percentage of our U.S. revenue cases attributable to office and clinic-based accounts was 32% and 29%
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for the three months ended June 30, 2025 and 2024, respectively, and 31% and 30% for the sixmonths
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for the three months ended September 30, 2025 and 2024, respectively, and 31% and 28% for the nine
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our revenue during the three and six months ended June 30, 2025 and 2024. However, the decision-
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our revenue during the three and nine months ended September 30, 2025 and 2024. However, the
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making function for some of these accounts is concentrated in a relatively small number of customers,
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decision-making function for some of these accounts is concentrated in a relatively small number of
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such that the loss of one customer could result in a disproportionate loss across our accounts. For
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customers, such that the loss of one customer could result in a disproportionate loss across our accounts.
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example, for the year ended December 31, 2024, our top two largest customers, both large health
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For example, for the year ended December 31, 2024, our top two largest customers, both large health
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variety of factors including the number ofaccounts in our installed base, the volume of Heartflow Platform
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variety of factors including the number of accounts in our installed base, the volume of Heartflow Platform
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which includes facilities expenses, equipment, depreciation and technology services. The role of the
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which includes facilities expenses, equipment, depreciation and technology services. These costs are
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production team is to support our patient case volume revenue by performing defined quality-related
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patient case volume revenue by performing defined quality-related activities on CCTA scans submitted by
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activities on CCTA scans submitted by our customers for analysis. The portion of these costs that
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our customers for analysis. The portion of these costs that supports patient case volume revenue is
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and development, which are allocated as research and development expense, and the capitalization of
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warrant liability until the warrants are exercised and we continued to record adjustments to the estimated
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costs during the three months ended September 30, 2025 and 2024, respectively. Gross margin for the
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of $0.3 million in allocated overhead, $0.2 million in professional fees, including legal, audit and consulting
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to support our increasing revenue case volume.
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common stock warrant liability and $0.2 million of change in fair value of derivative liability. The increase
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million, consisting primarilyof $332.8 million in net proceeds from our IPO, $72.8 million in net proceeds
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Based on our current operating plan, we believe that the expected cash generated from revenue
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production team to support our increasing patient case volume.
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increased expense was attributable to amortization of debt issuance costs and debt discount related to
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balance under our 2024 Term Loan related to the conversion of $23.0 million in principal to convertible
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equivalents, will be sufficient to meet our capital requirements and fund our operations for at least the
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As of June 30, 2025, the aggregate outstanding principal balance under the 2024 Term Loan was $115.1
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accounts receivable, a $0.9 million increase in prepaid expenses and other current assets, a $0.9 million
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$1.4 million in proceeds from the exercise of stock options, offset by $1.1 million in exit and prepayment