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Quest Diagnostics for in-office screening of chronic diseases.

Square for point-of-care medical testing.

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• QuantaFlo: A proprietary medical device used by healthcare providers to measure arterial blood flow for the early diagnosis of peripheral artery disease (PAD).

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Major Customers of Semler Scientific (SMLR)

Semler Scientific (SMLR) primarily sells its QuantaFlo system and related services to other companies and healthcare organizations, rather than directly to individuals. The company's business model focuses on equipping healthcare providers with tools for early detection and management of chronic diseases, particularly peripheral artery disease (PAD).

Semler Scientific's customer base is generally broad and fragmented across various types of healthcare providers. Its public filings do not indicate that a single customer or a small group of named customers accounts for a significant portion of their revenue (typically requiring disclosure if exceeding 10%). Therefore, no specific public customer companies with associated symbols are named in their disclosures.

Based on their business description, Semler Scientific's major customers can be best described by the following categories of healthcare organizations:

• Physician Groups: These are medical practices and clinics of varying sizes that utilize the QuantaFlo system to screen their patient populations for conditions like PAD, aiming to improve patient outcomes and comply with value-based care initiatives.
• Independent Physician Associations (IPAs): IPAs are organizations formed by groups of independent physicians and other healthcare providers to contract with managed care organizations. They often adopt technologies like QuantaFlo to enhance care coordination, manage chronic diseases, and improve performance under risk-based contracts.
• Other Healthcare Organizations: This broad category includes entities such as Accountable Care Organizations (ACOs), managed care organizations, and other value-based care entities that focus on population health management, chronic disease prevention, and improving quality metrics.

As no specific public companies are identified as major individual customers in Semler Scientific's public disclosures, no customer symbols can be provided.

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Dr. Murphy-Chutorian has served as Semler Scientific's Chief Executive Officer since October 2012, with a brief hiatus in April 2023, and was appointed interim Chief Financial Officer on October 30, 2025, following the resignation of Renae Cormier. He brings over 30 years of diverse healthcare experience, having held positions as a clinician, academician, inventor, entrepreneur, CEO, chairman of the board, and consultant to financial firms. He is credited as a named inventor on more than 30 patents and has successfully guided over 50 products through various regulatory approval processes. From 2005 to 2012, Dr. Murphy-Chutorian served as the managing director of Select Healthcare Capital, LLC, an investment firm. He also founded MicroHeart, Inc. in 1997, a company focused on designing, developing, and manufacturing clinical devices.

Dennis Rosenberg is a senior-level executive with more than 25 years of experience in marketing, including internet marketing. He has worked extensively with numerous medical technology companies, such as Bacchus Vascular, Covidien, VNUS Medical Technologies, and Eclipse Surgical Technologies. His marketing consulting clients have included Neuronetics, Novasys, SI-Bone, and Semler Scientific. Mr. Rosenberg pursued studies in computer programming, film and video production, and graphic design at New York University.

Andrew B. Weinstein holds the position of Senior Vice President - Finance & Accounting at Semler Scientific. He was mentioned as participating in the company's first-quarter 2023 financial results conference call.

Daniel E. Conger serves as the Vice President - Finance at Semler Scientific.

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Key Risks to Semler Scientific (SMLR)

1. Legal and Regulatory Risks: Semler Scientific faces significant legal and regulatory challenges, primarily stemming from an ongoing Department of Justice (DOJ) investigation into potential False Claims Act violations related to its QuantaFlo device. Initial settlement talks with the DOJ have reportedly collapsed, raising the specter of a formal lawsuit with potential damages in the tens of millions or more. The company is also subject to class-action lawsuits, which could result in additional settlements, reputational damage, or even delisting risks. These legal and regulatory headwinds have contributed to stock volatility and investor concern.
2. Product Dependency and Patent Expiration: Semler Scientific's business is heavily reliant on its primary product, QuantaFlo, a blood flow assessment tool. This dependence makes the company vulnerable to market shifts or competitive innovations in the cardiovascular testing industry. Furthermore, the patent for QuantaFlo is set to expire in December 2027, which could lead to increased competition from major players entering the market and potentially significantly impact the business.
3. Customer Concentration: The company has a high degree of customer concentration, with its three largest customers and their affiliates accounting for a substantial portion of its revenues. For example, in the third quarter of 2023, these customers represented 36%, 28%, and 11% of total revenues. For the full year 2023, two largest customers comprised 36% and 35% of revenues. The loss of any of these major customers could have a material adverse effect on Semler Scientific's revenues and financial performance.

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The primary clear emerging threats for Semler Scientific (SMLR) stem directly from its recently announced corporate strategy to adopt Bitcoin as its primary treasury reserve asset:

• Bitcoin Price Volatility: The company's balance sheet and financial results are now materially exposed to the extreme and unpredictable price fluctuations of Bitcoin. Significant downturns in Bitcoin's value could lead to substantial impairments of its digital asset holdings.
• Cryptocurrency Regulatory Uncertainty: The global regulatory landscape for digital assets is still evolving and largely undefined. Future adverse regulations, including stricter controls, new taxes, or even potential prohibitions in certain jurisdictions, could negatively impact the value, liquidity, and ability to manage Semler's Bitcoin reserves.
• Digital Asset Cybersecurity Risks: Holding a significant portion of its treasury in Bitcoin introduces substantial cybersecurity risks, including potential theft, hacking, or loss of private keys. While security measures can mitigate these risks, they remain an inherent and critical threat to digital asset custody.

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Semler Scientific (SMLR) primarily focuses on products and services for the diagnosis and management of chronic diseases.

• QuantaFlo (Peripheral Arterial Disease - PAD): The U.S. peripheral artery disease market was valued at approximately $2.35 billion in 2024, with projections to grow at a Compound Annual Growth Rate (CAGR) of 4.8% from 2025 to 2034. Another estimate places the global peripheral arterial disease treatment market at $2.95 billion in 2024, expected to reach $6.11 billion by 2034 at a CAGR of 7.56%. North America held the largest share of the peripheral arterial disease market in 2024.
• CardioVanta (Heart Failure and Cardiac Arrhythmia Monitoring): Semler Scientific's subsidiary, CardioVanta, targets multibillion-dollar markets in cardiac care. Heart failure alone affects over 6 million Americans and costs the U.S. healthcare system more than $30 billion annually.
• Insulin Insights (Diabetes Management): The U.S. diabetes monitoring, treatment, and drug delivery market was valued at nearly $48 billion in 2024 and is projected to increase to $79 billion by 2031, with a CAGR of 7.3%.

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Semler Scientific (SMLR) is positioned for future financial growth driven by a combination of its healthcare product expansion and its distinctive Bitcoin treasury strategy.

1. Expansion of its Cardiovascular Product Line: Semler Scientific anticipates growth and cash generation from its new FDA-cleared cardiovascular products and services. The company has explicitly stated "green shoots from the cardiovascular product line that we introduced to our large enterprise customer base this year," and launched its wholly-owned subsidiary, CardioVanta, Inc., to focus on heart failure and cardiac arrhythmia monitoring.
2. Expanded Indications for QuantaFlo: The company is actively pursuing new 510(k) clearance from the U.S. Food and Drug Administration (FDA) to broaden the labeling and applications of its flagship product, QuantaFlo. This expansion aims to enable QuantaFlo to aid in the diagnosis of a wider array of cardiovascular diseases beyond its current use for peripheral arterial disease (PAD).
3. Strategic Bitcoin Accumulation: Semler Scientific has adopted Bitcoin as its primary treasury reserve asset and intends to aggressively grow its Bitcoin holdings. The company plans to achieve this through the use of operating cash flow and proceeds from debt and equity financings. While not traditional product revenue, this strategy has significantly contributed to Semler Scientific's reported net income, with a notable unrealized Bitcoin gain of $83.8 million in Q2 2025, and is considered a core financial growth driver. The company has set ambitious targets for Bitcoin accumulation, aiming for 10,000 Bitcoin by year-end 2025, 42,000 by year-end 2026, and 105,000 by year-end 2027.

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Share Repurchases

• Semler Scientific authorized a $20.0 million stock repurchase program on March 14, 2022.
• As of June 30, 2025, the company had repurchased 148,500 shares for approximately $4.99 million under the March 2022 program.

Share Issuance

• In April 2025, Semler Scientific entered a new at-the-market (ATM) offering agreement to issue and sell up to $500.0 million of its common stock.
• During Q2 2025, the company issued approximately 4.1 million shares under its ATM offering, raising $156.6 million in net proceeds, and an additional 1.1 million shares were issued through July 31, 2025, for $47.8 million in net proceeds.
• In 2025, management proposed to increase authorized common stock to 210 million shares from 50 million to provide capital flexibility, specifically to fund its Bitcoin treasury program and healthcare expansion.

Inbound Investments

• In January 2025, Semler Scientific priced an upsized offering of $85.0 million in 4.25% convertible senior notes due 2030, with an initial conversion price of $76.44 per share.

Outbound Investments

• In May 2024, Semler Scientific adopted Bitcoin as its primary treasury reserve asset and initially purchased 581 bitcoins for approximately $40 million.
• As of July 31, 2025, the company's total Bitcoin holdings were 5,021, with an aggregate purchase amount of $475.8 million, funded by operating cash flow, monetization of a minority investment, and proceeds from equity and debt offerings.
• Semler Scientific has ambitious Bitcoin accumulation targets, aiming to hold 10,000 bitcoins by year-end 2025, 42,000 by year-end 2026, and 105,000 by year-end 2027.
• In June 2025, Semler Scientific launched CardioVanta™, a wholly-owned subsidiary focused on initiatives for the early detection of heart failure and cardiac arrhythmia.

Capital Expenditures

• Capital expenditures were reported as $0.83 million in 2023, $2.16 million in 2022, and $0.83 million in 2021.