0001799191-26-000017 | 10-Q | XBRL Viewer

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Variable Interest Entities (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025	Jun. 30, 2025	Dec. 31, 2024
Current assets:
Cash	$ 41,094	$ 33,565	$ 30,292	$ 49,669
Accounts receivable, net	66,349	58,998
Other receivables	360	322
Inventories	20,011	16,875
Prepaid expenses and other current assets	1,176	2,987
Total current assets	128,990	112,747
Property and equipment, net	10,583	10,684
Other assets	657	606
Intangible assets, net	9,585	11,015
Goodwill	7,230	7,230
Total assets	178,233	164,656
Current liabilities:
Accounts payable	60,279	43,167
Accrued expenses and other current liabilities	27,435	20,639
Amounts due to affiliates	27,435	20,639
Total current liabilities	94,939	70,962
Other non-current liabilities	30	28
Total liabilities	203,147	180,376
Variable interest entity
Current assets:
Cash	14,667	4,133
Accounts receivable, net	66,311	59,103
Other receivables	0	268
Inventories	20,006	16,874
Prepaid expenses and other current assets	541	790
Total current assets	101,525	81,168
Property and equipment, net	12	29
Other assets	605	554
Intangible assets, net	4,066	4,376
Goodwill	2,679	2,679
Total assets	108,887	88,806
Current liabilities:
Accounts payable	58,951	40,864
Accrued expenses and other current liabilities	23,406	14,546
Total current liabilities	346,171	309,806
Other non-current liabilities	25	0
Total liabilities	346,196	309,806
Variable interest entity \| Related party
Current liabilities:
Amounts due to affiliates	$ 263,814	$ 254,396

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Jun. 30, 2026	Dec. 31, 2025
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, shares issued (in shares)	102,202,753	100,596,918
Common stock, shares outstanding (in shares)	100,468,979	98,863,144
Series A preferred shares, par value (in usd per share)	$ 0.0001	$ 0.0001
Series A preferred shares, authorized (in shares)	10,000,000	10,000,000
Series A preferred shares, shares issued (in shares)	193,507	193,507
Series A preferred shares, outstanding (in shares)	193,507	193,507
Treasury stock (in shares)	1,733,774	1,733,774

Accrued Expenses and Other Current Liabilities - Summary of Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Payables and Accruals [Abstract]
Compensation, including bonuses, fringe benefits, and payroll taxes	$ 5,613	$ 7,093
Accrued insurance reserve	2,158	2,282
Directors and officers insurance premiums	270	794
Deferred acquisition and contingent consideration	125	125
Accrued interest	868	878
Repayments on advances	220	1,630
Accrued capitated leakage	8,802	1,681
Accrued sub-capitation	3,135	1,851
Other liabilities	6,244	4,305
Total accrued expenses and other current liabilities	$ 27,435	$ 20,639

Debt - Summary of Senior Secured Convertible Note (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025	Aug. 09, 2022
Debt Instrument [Line Items]
Senior Secured Convertible Note, due August 9, 2027	$ 85,889
Facility Agreement
Debt Instrument [Line Items]
Less: Unamortized debt issuance costs			$ 4,924
Facility Agreement \| Convertible Notes
Debt Instrument [Line Items]
Senior Secured Convertible Note, due August 9, 2027	85,889	$ 85,889
Less: Unamortized debt issuance costs	796	1,123	$ 3,663
Less: Unamortized debt discount	5,226	7,366
Long-term debt, net of unamortized debt discount and issuance costs	$ 79,867	$ 77,400

- 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

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+ Details

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References

+ Details

Segment Information (Tables)

6 Months Ended

Jun. 30, 2026

Segment Reporting [Abstract]

Summary of Financial Information for the Company's Segments

Summarized financial information for the Company’s segments is shown in the following tables:


(in thousands)	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Revenue
Patient services	$	58,827	$	55,891	$	117,914	$	108,959
Specialty pharmacy	98,608		62,573		186,149		111,866
Clinical trials & other	3,847		1,338		4,660		3,383
Consolidated revenue	$	161,282	$	119,802	$	308,723	$	224,208

Direct costs
Intravenous (IV) drug costs	$	28,965	$	32,800	$	58,732	$	64,213
Clinician salaries and benefits	16,431		14,011		31,769		28,085
Network medical expense	9,497		1,783		16,107		1,783
Medical supplies and other	1,878		2,556		3,546		4,149
Total patient services (A)	$	56,771	$	51,150	$	110,154	$	98,230
Specialty pharmacy (B)	77,346		51,086		148,089		90,949
Clinical trials & other (C)	—		65		—		279
Total segment direct costs	$	134,117	$	102,301	$	258,243	$	189,458
Depreciation expense
Patient services	$	816	$	767	$	1,553	$	1,522
Specialty pharmacy	3		4		6		6
Clinical trials & other	—		—		—		32
Total segment depreciation expense	$	819	$	771	$	1,559	$	1,560

Amortization of intangible assets
Patient services	$	716	$	718	$	1,431	$	1,437

Clinical trials & other	—		55		—		110
Total segment amortization	$	716	$	773	$	1,431	$	1,547

Operating income
Patient services	$	524	$	3,256	$	4,776	$	7,770
Specialty pharmacy	21,259		11,483		38,054		20,911
Clinical trials & other	3,847		1,218		4,660		2,962
Total segment operating income	$	25,630	$	15,957	$	47,490	$	31,643
Other items not allocated to segments:






Selling, general and administrative expense	$	29,943	$	26,907	$	58,155	$	52,283
Non-segment depreciation and amortization	303		261		464		482
Total consolidated operating loss	$	(4,616)	$	(11,211)	$	(11,129)	$	(21,122)
Interest expense, net	1,859		1,870		3,793		7,440
Change in fair value of derivative warrant liabilities	(6)		53		(174)		96
Change in fair value of conversion option derivative liabilities	3,243		3,987		(1,753)		7,296


(in thousands)	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Other, net	77		19		(714)		771

Consolidated loss before provision for income taxes	$	(9,789)	$	(17,140)	$	(12,281)	$	(36,725)


(in thousands)	June 30, 2026		December 31, 2025
Assets
Capitated accounts receivable	$	1,937	$	3,213
FFS accounts receivable	29,385		35,376
IV drug inventory	8,984		8,079
Other assets	21,159		27,989
Patient services	61,465		74,657

Oral drug accounts receivable	18,564		7,457
Oral drug inventory	11,027		8,796
Other assets	9,493		431
Specialty pharmacy	39,084		16,684

Clinical trials & other	4,974		5,436
Non-segment assets	72,710		67,879
Total assets	$	178,233	$	164,656

- Definition

Tabular disclosure of segment reporting. Includes, but is not limited to, reconciliation of reportable segment amount to corresponding consolidated total.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 280
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+ Details

Marketable Securities and Fair Value Measurements (Tables)

6 Months Ended

Jun. 30, 2026

Fair Value Disclosures [Abstract]

Summary of Investment Securities Classified as Available-for-sale

The Company’s investments in cash equivalents at June 30, 2026 and December 31, 2025 is as follows:


	June 30, 2026
(in thousands)	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Cash equivalents:
Money Market Fund	$	39,081	$	—	$	—	$	39,081


	December 31, 2025
(in thousands)	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Cash equivalents:
Money Market Fund	$	27,230	$	—	$	—	$	27,230

The contractual maturities of the Company's investments in cash equivalents as of June 30, 2026 and December 31, 2025 is as follows:


June 30, 2026 (in thousands)	Due in One Year or Less		Due After One Year through Five Years		Due After Five Years		Total
Cash equivalents:
Money Market Fund	$	39,081	$	—	$	—	$	39,081


December 31, 2025 (in thousands)	Due in One Year or Less		Due After One Year through Five Years		Due After Five Years		Total
Cash equivalents:
Money Market Fund	$	27,230	$	—	$	—	$	27,230

Summary of Carrying Amounts of Financial Instruments

The following table presents the carrying amounts of the Company’s recurring and non-recurring fair value measurements at June 30, 2026 and December 31, 2025:


	June 30, 2026
(in thousands)	Total		Level 1		Level 2		Level 3
Financial assets:
Cash equivalents	$	39,081	$	—	$	39,081	—


Financial liabilities:
Derivative warrant liabilities	$	89	$	—	$	89	$	—

Optional redemption derivative liabilities	10,838		—		—		10,838


	December 31, 2025
(in thousands)	Total		Level 1		Level 2		Level 3
Financial assets:
Cash equivalents	$	27,230	$	—	$	27,230	$	—


Financial liabilities:
Derivative warrant liabilities	$	264	$	—	$	264	$	—

Conversion option derivative liabilities	12,591		—		—		12,591

Summary of Changes in Fair Value of Level 3 Warrant Liabilities

The following table presents information about the Company’s Level 3 financial liabilities that are measured at fair value on a recurring basis at June 30, 2026:


(in thousands)	Derivative Liabilities







Balance at December 31, 2024	$	385
Decrease in fair value included in other expense	12,206
Balance at December 31, 2025	$	12,591
Change in fair value included in other expense	(1,753)
Balance at June 30, 2026	$	10,838

Summary of Assumptions used in the Valuation of Derivative Liabilities

A summary of the level 3 fair value measurements inputs used in the valuations is as follows:


	June 30, 2026
		Optional Redemption Derivative Liability
Unit price		$	5.43
Term (in years)		1.11
Volatility		80.00		%
Risk-free rate		3.94		%
Dividend yield		—
Cost of equity		—


	December 31, 2025
		Conversion Option Derivative Liability
Unit price		$	3.56
Term (in years)		1.61
Volatility		114.00		%
Risk-free rate		3.45		%
Dividend yield		—
Cost of equity		—

- Definition

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-9

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aa)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aaa)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

+ Details

Share-Based Compensation - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025
Number of shares
Balance at the beginning (in shares)	4,022,196	7,488,859
Granted (in shares)	0	0
Exercised (in shares)	(96,137)	(2,645,017)
Forfeited (in shares)	0	(285,112)
Expired (in shares)	(67,084)	(77,469)
Balance at the end (in shares)	3,858,975	4,481,261
Vested options exercisable at the end (in shares)	3,254,855	3,374,192
Weighted average exercise price
Balance at the beginning (in dollars per share)	$ 2.23	$ 1.67
Granted (in dollars per share)	0	0
Exercised (in dollars per share)	1.16	0.89
Forfeited (in dollars per share)	0	1.83
Expired (in dollars per share)	1.02	2.58
Balance at the end (in dollars per share)	2.28	2.11
Vested options exercisable at the end (in dollars per share)	$ 2.34	$ 2.10
Weighted average remaining contractual term (years)
Balance at the end (in years)	5 years 6 months 7 days	6 years 1 month 28 days
Vested options exercisable at the end (in years)	5 years 2 months 8 days	5 years 6 months
Aggregate intrinsic value (in thousands)	$ 13,386	$ 3,351
Vested options exercisable	$ 11,222	$ 2,898

Marketable Securities and Fair Value Measurements - Summary of Changes in Fair Value of Level 3 Warrant Liabilities (Details) - Derivative Liabilities - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2026	Dec. 31, 2025
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 12,591	$ 385
Change in fair value included in other expense	(1,753)	12,206
Ending balance	$ 10,838	$ 12,591

Significant Risks and Uncertainties Including Business and Credit Concentrations

6 Months Ended

Jun. 30, 2026

Risks and Uncertainties [Abstract]

Significant Risks and Uncertainties Including Business and Credit Concentrations

Credit Risk

Financial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash, accounts receivable, and investment securities.

Cash accounts in a financial institution may, at times, exceed the Federal Deposit Insurance Corporation coverage of $250 per account ownership category. The Company has not experienced losses on these accounts, and management believes the Company is not exposed to significant risks on such accounts.

The Company’s accounts receivable has implicit collection risk. The Company grants credit without collateral to its patients, most of whom are local residents and are insured under third-party payor agreements. The Company believes this risk is partially mitigated by the Company’s establishment of long-term agreements and relationships with third-party payors that provide the Company with insight into historic collectability and improve the collections process.

Revenue Concentration Risk

The concentration of net revenue on a percentage basis for major payors for the three and six months ended June 30, 2026 and 2025 are as follows:


	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Percentage of Patient Services Net Revenue:
Payor A	12	%	13	%	12	%	14	%
Payor C	13	%	N/A		11	%	N/A

The concentration of gross receivables on a percentage basis for major payors at June 30, 2026 and December 31, 2025 are as follows:


	June 30, 2026		December 31, 2025
Percentage of Gross Receivables of Patient Services Revenue:

Payor B	10	%	10	%

All of the Company’s revenue is generated from customers located in the United States.

Vendor Concentration Risk

The concentration of cost of sales (drug procurement) on a percentage basis for major vendors for the three and six months ended June 30, 2026 and 2025 are as follows:


	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Percentage of Direct Costs:
Vendor A	91	%	100	%	92	%	100	%

The concentration of gross payables on a percentage basis for major payors at June 30, 2026 and December 31, 2025 are as follows:


	June 30, 2026		December 31, 2025
Percentage of Gross Payables:
Vendor A	80	%	77	%
Vendor B	14	%	N/A

- Definition

The entire disclosure for any concentrations existing at the date of the financial statements that make an entity vulnerable to a reasonably possible, near-term, severe impact. This disclosure informs financial statement users about the general nature of the risk associated with the concentration, and may indicate the percentage of concentration risk as of the balance sheet date.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (d)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-21

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (d)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-21

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (c)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-21

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (c)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-21

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-21

Reference 6: http://www.xbrl.org/2003/role/exampleRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 3A
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482836/275-10-55-3A

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2A
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-2A

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-1

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 275
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/275/tableOfContent

+ Details

Marketable Securities and Fair Value Measurements - Summary of Assumptions used in the Valuation of Derivative Liabilities (Details) - Derivative Liabilities	Jun. 30, 2026 $ / shares yr	Dec. 31, 2025 $ / shares yr
Unit price
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair value measurements inputs \| $ / shares	5.43	3.56
Term (in years)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair value measurements inputs \| yr	1.11	1.61
Volatility
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair value measurements inputs	0.8000	1.1400
Risk-free rate
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair value measurements inputs	0.0394	0.0345
Dividend yield
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair value measurements inputs	0	0
Cost of equity
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair value measurements inputs	0	0

Leases - Summary of Lessee, Operating Lease, Liability, Maturity and Finance Lease, Liability, Fiscal Year Maturity (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Operating Leases
2026 (remaining six months)	$ 4,445
2027	7,954
2028	6,232
2029	4,734
2030	2,891
Thereafter	1,987
Total future lease payment	28,243
Less: amount representing interest	(3,634)
Present value of future lease payment (lease liabilities)	24,609
Lease liabilities, current	7,225	$ 7,156
Lease liabilities, noncurrent	17,384	$ 19,131
Finance Leases
2026 (remaining six months)	19
2027	29
2028	0
2029	0
2030	0
Thereafter	0
Total future lease payment	48
Less: amount representing interest	(1)
Present value of future lease payment (lease liabilities)	47
Lease liabilities, current	$ 37
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Lease liabilities, current
Lease liabilities, noncurrent	$ 10
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Lease liabilities, noncurrent

Property and Equipment, Net (Tables)

6 Months Ended

Jun. 30, 2026

Property, Plant, and Equipment [Abstract]

Summary of Property and Equipment, Net

Property and equipment, net, consist of the following:


(in thousands)	Useful lives	June 30, 2026		December 31, 2025
Computers and software	60 months	$	6,317	$	5,106
Office furniture	84 months	813		812
Leasehold improvements	Shorter of lease term or estimated useful life	13,252		12,849
Medical equipment	60 months	2,339		1,497
Construction in progress		556		1,137
Finance lease ROU assets	Shorter of lease term or estimated useful life	170		209
Less: accumulated depreciation		(12,864)		(10,926)
Total property and equipment, net		$	10,583	$	10,684

Leases - Additional Information (Details) $ in Thousands	6 Months Ended
Leases - Additional Information (Details) $ in Thousands	Jun. 30, 2026 USD ($) lease	Jun. 30, 2025 USD ($)
Lessee, Lease, Description [Line Items]
Operating cash payment for operating leases	$ 4,448	$ 4,419
Increase in lease liability and right-of-use asset	$ 1,342
Florida
Lessee, Lease, Description [Line Items]
Number of lease modifications \| lease	4
California
Lessee, Lease, Description [Line Items]
Number of lease modifications \| lease	2
Minimum
Lessee, Lease, Description [Line Items]
Operating lease term (in years)	1 year
Operating cash payment for operating leases	$ 2
Maximum
Lessee, Lease, Description [Line Items]
Operating lease term (in years)	10 years
Operating cash payment for operating leases	$ 64

Leases

6 Months Ended

Jun. 30, 2026

Leases [Abstract]

Leases

The Company leases clinics, office buildings, and certain equipment under noncancellable financing and operating lease agreements that expire at various dates through June 2033.

The initial terms of operating leases range from 1 to 10 years and certain leases provide for free rent periods, periodic rent increases, and renewal options. Monthly payments for these leases range from $2 to $64. All lease agreements generally require the Company to pay maintenance, repairs, property taxes, and insurance costs, which are generally variable amounts based on actual costs incurred during each applicable period.

The Company has determined that periods covered by options to extend the Company's leases are excluded from the lease terms as it is not reasonably certain the Company will exercise such options.

Lease Expense

The components of lease expense were as follows for the three and six months ended June 30, 2026 and 2025:


	Three Months Ended June 30,				Six Months Ended June 30,
(in thousands)	2026		2025		2026		2025
Operating lease costs:	$	2,020	$	2,172	$	4,059	$	4,440
Finance lease costs:
Amortization of ROU asset	$	9	$	9	$	17	$	19
Interest expense	$	1	$	1	$	2	$	3
Other lease costs:
Short-term lease costs	$	—	$	3	$	2	$	6
Variable lease costs	$	648	$	532	$	1,157	$	1,014

Operating and other lease costs are presented as part of selling, general, and administrative expenses. The components of finance lease costs appear in depreciation and amortization and interest expense.

Maturity of Lease Liabilities

The aggregate future lease payments for the Company's leases in years subsequent to June 30, 2026 are as follows:


(in thousands)	Operating Leases		Finance Leases
2026 (remaining six months)	$	4,445	$	19
2027	7,954		29
2028	6,232		—
2029	4,734		—
2030	2,891		—
Thereafter	1,987		—
Total future lease payment	$	28,243	$	48
Less: amount representing interest	(3,634)		(1)
Present value of future lease payment (lease liabilities)	$	24,609	$	47
Reported as:
Lease liabilities, current	$	7,225	$	37
Lease liabilities, noncurrent	17,384		10
Total lease liabilities	$	24,609	$	47

Lease Term and Discount Rate

The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company's leases as of June 30, 2026 and 2025:


	June 30, 2026		June 30, 2025
Weighted-average remaining lease term (in years)
Operating	3.87		4.35
Finance	1.21		2.21
Weighted-average discount rate
Operating	6.90	%	6.70	%
Finance	6.73	%	6.71	%

Supplemental Cash Flow Information

The following table provides certain cash flow and supplemental noncash information related to the Company's lease liabilities for the three months ended June 30, 2026 and 2025.


(in thousands)	Six Months Ended June 30, 2026		Six Months Ended June 30, 2025
Supplemental cash flow information
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash payment for operating leases	$	4,448	$	4,419
Financing cash payments for finance leases	20		22
Lease liabilities arising from obtaining right-of-use assets:
Operating leases	$	2,090	$	1,253

Lease Modifications

During the six months ended June 30, 2026, the Company extended its lease terms for four clinics in Florida and two clinic in California. These extensions constitute lease modifications that qualify as a change of accounting for the original leases and not separate contracts. Accordingly, for the six months ended June 30, 2026, the Company recognized the difference of $1,342 as an increase to the operating lease liability and to the operating lease right-of-use asset.

Leases

The Company leases clinics, office buildings, and certain equipment under noncancellable financing and operating lease agreements that expire at various dates through June 2033.

The Company has determined that periods covered by options to extend the Company's leases are excluded from the lease terms as it is not reasonably certain the Company will exercise such options.

Lease Expense

The components of lease expense were as follows for the three and six months ended June 30, 2026 and 2025:


	Three Months Ended June 30,				Six Months Ended June 30,
(in thousands)	2026		2025		2026		2025
Operating lease costs:	$	2,020	$	2,172	$	4,059	$	4,440
Finance lease costs:
Amortization of ROU asset	$	9	$	9	$	17	$	19
Interest expense	$	1	$	1	$	2	$	3
Other lease costs:
Short-term lease costs	$	—	$	3	$	2	$	6
Variable lease costs	$	648	$	532	$	1,157	$	1,014

Maturity of Lease Liabilities

The aggregate future lease payments for the Company's leases in years subsequent to June 30, 2026 are as follows:


(in thousands)	Operating Leases		Finance Leases
2026 (remaining six months)	$	4,445	$	19
2027	7,954		29
2028	6,232		—
2029	4,734		—
2030	2,891		—
Thereafter	1,987		—
Total future lease payment	$	28,243	$	48
Less: amount representing interest	(3,634)		(1)
Present value of future lease payment (lease liabilities)	$	24,609	$	47
Reported as:
Lease liabilities, current	$	7,225	$	37
Lease liabilities, noncurrent	17,384		10
Total lease liabilities	$	24,609	$	47

Lease Term and Discount Rate

The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company's leases as of June 30, 2026 and 2025:


	June 30, 2026		June 30, 2025
Weighted-average remaining lease term (in years)
Operating	3.87		4.35
Finance	1.21		2.21
Weighted-average discount rate
Operating	6.90	%	6.70	%
Finance	6.73	%	6.71	%

Supplemental Cash Flow Information

The following table provides certain cash flow and supplemental noncash information related to the Company's lease liabilities for the three months ended June 30, 2026 and 2025.


(in thousands)	Six Months Ended June 30, 2026		Six Months Ended June 30, 2025
Supplemental cash flow information
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash payment for operating leases	$	4,448	$	4,419
Financing cash payments for finance leases	20		22
Lease liabilities arising from obtaining right-of-use assets:
Operating leases	$	2,090	$	1,253

Lease Modifications

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Revenue
Total operating revenue	$ 161,282	$ 119,802	$ 308,723	$ 224,208
Operating expenses
Selling, general and administrative expense	29,943	26,907	58,155
Depreciation and amortization	1,838	1,805	3,454	3,589
Total operating expenses	165,898	131,013	319,852	245,330
Loss from operations	(4,616)	(11,211)	(11,129)	(21,122)
Other non-operating expense (income)
Interest expense, net	1,859	1,870	3,793	7,440
Change in fair value of derivative warrant liabilities	(6)	53	(174)	96
Change in fair value of conversion option derivative liabilities	3,243	3,987	(1,753)	7,296
Other, net	77	19	(714)	771
Total other non-operating expense (income)	5,173	5,929	1,152	15,603
Loss before provision for income taxes	(9,789)	(17,140)	(12,281)	(36,725)
Income tax benefit (expense)	0	131	0	131
Net loss	(9,789)	(17,009)	(12,281)	(36,594)
Net loss attributable to common stockholders, basic	(8,241)	(13,991)	(10,330)	(30,072)
Net loss attributable to common stockholders, diluted	$ (8,241)	$ (13,991)	$ (10,330)	$ (30,072)
Net loss per share attributable to common stockholders:
Basic (in dollars per share)	$ (0.08)	$ (0.15)	$ (0.10)	$ (0.35)
Diluted (in dollars per share)	$ (0.08)	$ (0.15)	$ (0.10)	$ (0.35)
Weighted-average number of shares outstanding:
Basic (in shares)	103,031,493	93,203,665	102,419,949	85,195,734
Diluted (in shares)	103,031,493	93,203,665	102,419,949	85,195,734
Patient services
Revenue
Total operating revenue	$ 58,827	$ 55,891	$ 117,914	$ 108,959
Operating expenses
Direct costs	56,771	51,150	110,154	98,230
Specialty Pharmacy
Revenue
Total operating revenue	98,608	62,573	186,149	111,866
Operating expenses
Direct costs	77,346	51,086	148,089	90,949
Clinical trials & other
Revenue
Total operating revenue	3,847	1,338	4,660	3,383
Operating expenses
Direct costs	$ 0	$ 65	$ 0	$ 279

Summary of Significant Accounting Policies (Policies)	6 Months Ended
Summary of Significant Accounting Policies (Policies)	Jun. 30, 2026
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation The accompanying condensed consolidated financial statements include the accounts of Starling, its subsidiaries, all of which are controlled by Starling through majority voting control, and variable interest entities (“VIEs”) for which Starling is the primary beneficiary. The Company consolidates entities in which it has a controlling financial interest based on either the variable interest entity or voting interest model. All significant intercompany balances and transactions have been eliminated in consolidation.
Variable Interest Entities	Variable Interest Entities The Company consolidates entities for which it has a variable interest and is determined to be the primary beneficiary. Revenues, expenses, and net income (loss) from these subsidiaries are included in the consolidated amounts as presented on the Condensed Consolidated Statements of Operations. The Company holds, as a result of entering into master services agreements ("MSAs"), variable interests in Starling PCs, which it cannot legally own. As of June 30, 2026, Starling held variable interests in Starling CA, Starling Oncology FL, LLC, a Professional Corporation ("Starling FL"), Starling Oncology OR, a Professional Corporation ("Starling OR"), and Starling Oncology TX, a Professional Corporation ("Starling TX"), all of which are VIEs. The Company is the primary beneficiary of the Starling PCs and thus, consolidates the Starling PCs in its financial statements. As discussed in Note 16, the noncontrolling shareholders hold nominal interests in the VIEs and do not participate in the income or loss of the VIEs.
Segment Reporting	Segment Reporting The Company presents the financial statements by segment in accordance with ASC Topic No. 280, Segment Reporting (“ASC 280”) to provide investors with transparency into how the chief operating decision maker (“CODM”) manages the business. The Company determined the CODM is its Chief Executive Officer. The CODM reviews financial information and allocates resources across three operating segments: patient services, specialty pharmacy, and clinical trials & other. Each of the operating segments is also a reporting segment as described further in Note 19.
Use of Estimates	Use of Estimates The preparation of the consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could materially differ from those estimates under different assumptions or conditions. Significant items subject to such estimates and assumptions include judgments related to fee-for-service ("FFS") revenue recognition, estimated FFS accounts receivable and the allowance for credit losses, useful lives and recoverability of long-lived assets, recoverability of goodwill, fair value of share-based compensation, fair value of liability classified instruments, and judgments related to deferred income taxes.
Net Loss Per Share	Net Loss Per Share Basic and diluted net loss per share attributable to common stockholders is presented in conformity with the two-class method required for participating securities. The Company's Series A Convertible Preferred Stock is classified as a participating security in accordance with ASC 260. Under the two-class method, basic and diluted net loss per share attributable to common stockholders is computed by dividing the basic and diluted net loss attributable to common stockholders by the basic and diluted weighted-average number of shares of common stock outstanding during the period. Diluted net income per share attributable to common stockholders adjusts basic net income per share for the potentially dilutive impact of stock options, restricted stock units ("RSUs"), Medical RSUs (defined in Note 14), public warrants, private placement warrants, common warrants, pre-funded warrants, and Senior Secured Convertible Notes (defined in Note 11). The treasury stock method is used to calculate the potentially dilutive effect of stock options, RSUs, public warrants, and private placement warrants. The if-converted method is used to calculate the potentially dilutive effect of the Senior Secured Notes. In both methods, diluted net income (loss) attributable to common stockholders and diluted weighted-average shares outstanding are adjusted to account for the impact of the assumed issuance of potential shares of common stock that are dilutive, subject to dilution sequencing rules. For the periods presented, the public and private placement warrants are out of the money; therefore, the public and private placement warrants are anti-dilutive and excluded from diluted net loss per share.
Fair Value Measurements	Fair Value Measurements The Company accounts for fair value measurements under ASC Topic No. 820, Fair Value Measurements (“ASC 820”). The Company uses valuation approaches that maximize the use of observable inputs and minimize the use of unobservable inputs to the extent possible. The Company determines fair value based on assumptions that market participants would use in pricing an asset or liability in the principal or most advantageous market. When considering market participant assumptions in fair value measurements, the following fair value hierarchy distinguishes between observable and unobservable inputs, which are categorized in one of the following levels (see Note 7 for further discussion): Level 1inputs: Unadjusted quoted prices in active markets for identical assets or liabilities accessible to the reporting entity at the measurement date. Level 2inputs: Other than quoted prices included in Level 1 inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the asset or liability. Level 3inputs: Unobservable inputs for the asset or liability used to measure fair value to the extent that observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at measurement date. The Company's fair value measurement for cash and cash equivalents, accounts receivable, other receivables, and accounts payable approximates fair value because of the short maturity and high liquidity of these instruments. Fair value measurement of investment securities available for sale is based upon quoted prices from active markets, if available (Level 1). If quoted prices are not available, fair values are measured using independent pricing models or other model-based valuation methodologies. Level 2 investment securities include money market securities purchased in the secondary market that use pricing inputs other than quoted prices in active markets and fair value is determined using pricing models or other valuation methodologies such as broker price indications, which are based on quoted prices for identical or similar notes, which are Level 2 input measures. Contingent considerations are valued using a present value factor using credit rating yields which are considered to be a Level 3 fair value measurement. Fair value measurements used for the goodwill and intangible assets are based on the discounted cash flow method within the income approach and guideline public company method to value the reporting units, which is considered to be a Level 3 fair value measurement. The unobservable inputs utilized in determining the fair value of goodwill based on the income approach primarily include estimated future cash flows, discounted at a rate that approximates the cost of capital of a market participant. Inputs used to calculate the fair value based on the market approach include the revenue and EBITDA multiples based on guidelines for similar publicly traded companies and recent transactions. Fair value measurements of derivative warrants liability are based on the Black-Scholes Model, which is considered to be Level 3 fair value measurements. The primary unobservable input utilized in determining the fair value of the derivative warrants is the expected volatility of the common stock. Fair value measurements of the convertible note warrant and conversion option derivative liabilities are based on the Black-Derman-Toy model implemented in the Binomial Lattice and Black-Scholes Models, which are considered to be Level 3 fair value measurements. The primary unobservable input utilized in determining the fair value of the convertible note warrant and conversion option derivative liabilities is the expected volatility of the common stock. The senior secured convertible note, which is carried at amortized cost, is considered to be a Level 2 fair value measurement due to observable inputs, such as the term matched risk-free rate and the credit spread, which is used to calculate the discount rate as of the valuation date.
Cash and Cash Equivalents	Cash and Cash Equivalents Cash primarily consists of deposits with banking institutions. The Company considers all highly liquid investments that are both readily convertible into cash and mature within three months from the date of purchase to be cash equivalents.
Accounts Receivable and Allowance for Credit Losses	Accounts Receivable and Allowance for Credit Losses The Company’s accounts receivables are recorded and stated at the amount expected to be collected determined by each payor, net of an allowance for credit losses, under ASC Topic No. 310, Receivables (“ASC 310”). In accordance with ASC Topic No. 326, Financial Instruments — Credit Losses (“ASC 326”), the Company recognizes credit losses based on a forward-looking current expected credit losses (“CECL”) model. The Company segregates accounts receivables into portfolio segments based on shared risk characteristics, such as line of business and payor type, for evaluation of expected credit losses. The Company makes estimates of expected credit losses based upon its assessment of various factors, including the age of accounts receivable balances, default-based statistics, current economic conditions, reasonable and supportable forecasts of future economic conditions, and other factors that may affect its ability to collect from customers. The allowance for credit losses is developed using a loss rate method and is recognized in the Condensed Consolidated Statement of Operations. The uncollectible accounts receivables are written off on a quarterly basis in the period when collection activities cease due to a final determination that all or a portion of the balance is no longer collectible and if there is no pending litigation activity related to the receivable.
Goodwill	Goodwill The Company accounts for goodwill under Accounting Standards Codification Topic No. 350, Intangibles - Goodwill and Other (“ASC 350”). Goodwill represents the excess of the aggregate purchase price paid over the fair value of the net assets acquired in the Company's business combinations. Goodwill is not amortized but is required to be evaluated for impairment at least annually or whenever events or changes in circumstances indicate that the carrying value may not be recoverable. The Company performs its annual testing of impairment for goodwill in the fourth quarter of each year. When impairment indicators are identified, the Company compares the reporting unit’s fair value to its carrying amount, including goodwill. An impairment loss is recognized as the difference, if any, between the reporting unit’s carrying amount and its fair value to the extent the difference does not exceed the total amount of goodwill allocated to the reporting unit. The Company performed a qualitative assessment as of June 30, 2026 and determined it was not necessary to perform the two-step quantitative analysis.
Debt	Debt The Company accounts for debt net of debt issuance costs and debt discount. Debt issuance costs and debt discount are capitalized, netted against the related debt for presentation purposes, and amortized to interest expense over the terms of the related debt using the effective interest method. The Company accounts for bifurcated, debt-classified embedded features separately as derivative liabilities pursuant to ASC Topic No. 815, Derivatives and Hedging ("ASC 815"). Bifurcated, debt-classified embedded features are recorded at fair value on the Company's balance sheet with subsequent changes in fair value recorded in the Condensed Consolidated Statement of Operations each reporting period.
Investments in Marketable Securities	Investments in Marketable Securities The Company's investments in marketable securities are classified as available-for-sale and are carried at fair value. The Company accounts for its investment securities available for sale using the fair value election pursuant to ASC 825, Financial Instruments ("ASC 825"), where changes in fair value are recorded in unrealized gains (losses), net on the Company's Condensed Consolidated Statements of Operations. The Company determines the appropriate classification of these investments at the time of purchase and reevaluates such designation at each balance sheet date. The Company’s marketable securities are classified as current assets if the maturity date is less than one year from the balance sheet date. Interest income and accretion on marketable securities are included in interest income in the Consolidated Statements of Operations. Realized gains and losses on sales of securities, and other-than-temporary declines in the fair value of marketable securities, if any, are included as a component of other income (expense), net in the Condensed Consolidated Statements of Operations. The cost of securities sold is based on the First In, First Out method. At each reporting period, the Company evaluates available-for-sale marketable securities, to the extent the fair value option is not elected, for any credit-related impairment when the fair value of the investment is less than its amortized cost. If the Company determines that the decline in fair value is below the carrying value and this decline is other-than-temporary, credit-related impairment is recognized in the Consolidated Statement of Operations in accordance with ASC 320, Debt Securities.
Comprehensive Loss	Comprehensive Loss Comprehensive loss includes net loss to common stockholders as well as other changes in equity that result from transactions and economic events other than those with stockholders. There was no difference between comprehensive loss and net loss to common stockholders for the periods presented.
Recently Issued and Adopted Accounting Standards	Recently Issued and Adopted Accounting Standards In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvement to Income Tax Disclosures ("ASU 2023-09"). The new standard requires a public business entity (PBE) to disclose, on an annual basis, a tabular rate reconciliation using both percentages and currency amounts, broken out into specified categories with certain reconciling items further broken out by nature and jurisdiction to the extent those items exceed a specified threshold. In addition, all entities are required to disclose income taxes paid, net of refunds received disaggregated by federal, state/local, and foreign and by jurisdiction if the amount is at least 5% of total income tax payments, net of refunds received. For PBEs, the new standard is effective for annual periods beginning after December 15, 2024, with early adoption permitted. An entity may apply the amendments in this ASU prospectively by providing the revised disclosures for the year ending December 31, 2025 and continuing to provide the pre-ASU disclosures for the prior periods, or may apply the amendments retrospectively by providing the revised disclosures for all periods presented. The Company adopted ASU 2023-09 as of December 31, 2025. The adoption did not have a material impact on the Company's financial statements. In November 2024, the FASB issued ASU 2024-03, “Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40).” ASU 2024-03 does not change the expense captions an entity presents on the face of the income statement; rather it requires disaggregation of certain expense captions into specified categories in disclosures within the footnotes to the financial statements. ASU 2024-03 requires footnote disclosure about specific expenses to disaggregate, in a tabular presentation, each relevant expense caption on the face of the income statement that includes any of the following natural expenses: (1) purchases of inventory, (2) employee compensation, (3) depreciation, (4) intangible asset amortization and (5) depreciation, depletion and amortization recognized as part of oil- and gas-production activities or other types of depletion expenses. The tabular disclosure would also include certain other expenses, when applicable. ASU 2024-03 does not change or remove existing expense disclosure requirements; however, it may affect where that information appears in the footnotes to the financial statements. ASU 2024-03 is effective for annual periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. The requirements will be applied prospectively with the option for retrospective application. Early adoption is permitted. The Company will adopt ASU 2024-03 at the beginning of fiscal year 2027. The Company is currently evaluating the disclosure requirements and its effect on the Consolidated Financial Statements

Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Inventory [Line Items]
Total	$ 20,011	$ 16,875
Oral drug inventory
Inventory [Line Items]
Total	11,027	8,796
IV drug inventory
Inventory [Line Items]
Total	$ 8,984	$ 8,079

Share-Based Compensation (Tables)

6 Months Ended

Jun. 30, 2026

Share-Based Payment Arrangement [Abstract]

Summary of Stock Option Activity

Stock option activity during the six months ended June 30, 2026 and 2025 is as follows:


Stock options	Number of shares	Weighted average exercise price		Weighted average remaining contractual term (years)	Aggregate intrinsic value (in thousands)
Balance at January 1, 2026	4,022,196	$	2.23
Granted	—	—
Exercised	(96,137)	1.16
Forfeited	—	—
Expired	(67,084)	1.02
Balance at June 30, 2026	3,858,975	$	2.28	5.52	$	13,386
Vested Options Exercisable at June 30, 2026	3,254,855	$	2.34	5.19	$	11,222


Stock options	Number of shares	Weighted average exercise price		Weighted average remaining contractual term (years)	Aggregate intrinsic value (in thousands)
Balance at January 1, 2025	7,488,859	$	1.67
Granted	—	—
Exercised	(2,645,017)	0.89
Forfeited	(285,112)	1.83
Expired	(77,469)	2.58
Balance at June 30, 2025	4,481,261	$	2.11	6.16	$	3,351
Vested Options Exercisable at June 30, 2025	3,374,192	$	2.10	5.50	$	2,898

Summary of the Activity for the RSUs and RSAs

A summary of the activity for the RSUs for the six months ended June 30, 2026 and 2025, respectively, are shown in the following table:


	Six Months Ended June 30,
	2026			2025
	Number of Shares	Weighted Average Grant Date Fair Value		Number of Shares	Weighted Average Grant Date Fair Value
Unvested at beginning of year	3,436,019	$	1.25	1,509,737	$	0.94
Granted	2,401,435	3.01		3,935,704	1.19
Vested	(1,441,843)	1.93		(1,700,884)	0.93
Forfeited	(176,183)	2.12		(387,710)	1.00
Unvested at end of year	4,219,428	$	1.98	3,356,847	$	1.23

A summary of the activity for the equity-classified Medical RSUs for the six months ended June 30, 2026 and 2025, respectively, is shown in the following table:


	Six Months Ended June 30,
	2026	2025
Balance at beginning of period	—	—
Granted	332,803	997,806
Vested	(332,803)	(997,806)
Forfeited	—	—
Balance at end of period	—	—

Description of the Business	6 Months Ended
Description of the Business	Jun. 30, 2026
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of the Business	Description of the Business Overview of the Business On August 3, 2026, The Oncology Institute, Inc. changed its corporate name to "Starling Oncology, Inc." (“Starling”). Unless the context dictates otherwise, references in these notes to the financial statements, the “Company,” “we,” “us,” “our,” and similar words are references to Starling and its consolidated subsidiaries and affiliated entities, as appropriate, including its consolidated variable interest entities (“VIEs”). Through wholly-owned subsidiaries and affiliated entities, Starling operates combined community clinics and infusion suites staffed with providers who administer latest-generation cancer treatments including chemotherapy, immunotherapy, oncolytics, and radiation oncology. Additionally, Starling provides coordinated case management, drug formulary management, and fully-delegated networks of care providers, all of which we use to drive improved treatment outcomes at an affordable cost to our patients and payors. Additionally, Starling operates a specialty pharmacy that includes both in-office and mail-order dispensing for complementary oral and self-injectable medications taken by our patients concurrent with their in-office cancer therapies. On March 31, 2025, the Company entered into a Research Services Agreement ("RSA") with Helios CR, Inc. ("Helios"), effective May 5, 2025, pursuant to which the Helios operates our Clinical Trials & other segment under a profit sharing arrangement with the Company. As part of the RSA, there is a Transition Services Agreement, pursuant to which certain administrative and professional services are provided by Helios for a certain period of time. Additionally, the Company pays a management fee to Helios on a periodic basis for certain shared services. The Company recognized a $2,398 loss due to the write-off of the segment's net assets for the year ended December 31, 2025. The Company has 125 oncologists and mid-level professionals across 65 clinics located within five states: California, Florida, Arizona, Oregon and Nevada. Starling Oncology CA, a Professional Corporation ("Starling CA"), one of the Starling professional corporations (each a "Starling PC"), is comprised of the clinics located in California, Nevada, and Arizona. The Company has contractual relationships with multiple payors, serving Medicare, including Medicare Advantage, Medi-Cal, and commercial patients.

Property and Equipment, Net - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Property and Equipment, Net
Less: accumulated depreciation	$ (12,864)	$ (10,926)
Total property and equipment, net	$ 10,583	$ 10,684
Computers and software
Property and Equipment, Net
Useful lives	60 months	60 months
Property and equipment, gross	$ 6,317	$ 5,106
Office furniture
Property and Equipment, Net
Useful lives	84 months	84 months
Property and equipment, gross	$ 813	$ 812
Leasehold improvements
Property and Equipment, Net
Property and equipment, gross	$ 13,252	$ 12,849
Medical equipment
Property and Equipment, Net
Useful lives	60 months	60 months
Property and equipment, gross	$ 2,339	$ 1,497
Construction in progress
Property and Equipment, Net
Property and equipment, gross	556	1,137
Finance lease ROU assets
Property and Equipment, Net
Property and equipment, gross	$ 170	$ 209

Debt

6 Months Ended

Jun. 30, 2026

Debt Disclosure [Abstract]

Debt

Senior Secured Convertible Note

On August 9, 2022, Starling entered into a Facility Agreement (the “Facility Agreement”) with certain lenders (“Lenders”) and Deerfield Partners L.P. (“Agent”), pursuant to which, Starling obtained cash loans from the Lenders in the amount of $110,000, in exchange for which, Starling issued to each Lender a secured convertible promissory note (each, a“Senior Secured Convertible Note”), payable to such Lenders in an amount equal to the unpaid principal amount of loans held by such Lender.

The Senior Secured Convertible Notes mature on August 9, 2027 (the “Maturity Date”) and bear interest at the rate of 4.00% per annum from August 9, 2022, on the outstanding principal amount, any overdue interest and any other amounts and obligations. Starting on October 1, 2022, the interest is paid in cash quarterly in arrears. In case of any prepayment, repayment or redemption of the Senior Secured Convertible Notes, the Company is obligated to pay any accrued and unpaid interest on the principal, along with a make whole amount and an exit fee.

The Facility Agreement requires the Company to meet certain operational and reporting requirements, including, but not limited to, customary regulatory, financial reporting, and disclosure requirements. Additionally, limitations are placed on the Company's ability to merge with other companies and enter into other debt arrangements and permitted investments are limited to amounts specified in the Facility Agreement. The Facility Agreement also provides certain restrictions on dividend payments and equity transactions and requires the Company to make prepayments under specified circumstances. Financial covenants in the Facility Agreement require the Company to maintain minimum net quarterly revenues of $100,000 during fiscal year 2026 and thereafter. Additionally, the Company entered into a registration rights agreement with the parties to the Facility Agreement that requires the Company for the resales by the Lenders of shares of common stock issued or issuable upon conversion or exercise of the Senior Secured Convertible Notes or the warrants issuable under the Facility Agreement and calls certain penalties for failure to maintain the effectiveness of the registration statement.

On February 26, 2025, the Company, the Lenders, and the Agent, entered into the Limited Consent and Amendment No. 1 to Facility Agreement (the “Consent and Amendment”), which amended the Facility Agreement, dated as of August 9, 2022. The Consent and Amendment, among other things, provided for (i) Lenders’ consents to the waiver of certain restrictions imposed by the Facility Agreement regarding the issuance and sale of the Company’s equity and equity-linked securities, (ii) the removal of a financial covenant that required the Company to hold at least $40,000 of cash or cash equivalents in accounts that were subject to control agreements in favor of the Agent, (iii) amendment and restatement of the Company’s financial reporting covenant under the Facility Agreement in its entirety, and (iv) granting participation rights permitting the Lenders to purchase common stock and/or warrants exercisable for common stock in up to two equity offerings that occurred by no later than February 26, 2026 (“Participation Rights”). The Consent and Amendment was accounted for as a debt modification in accordance with ASC 470.

In connection with the Consent and Amendment, the Company executed the Optional Redemption feature (as described below) and made a partial prepayment of the Senior Secured Convertible Notes issued pursuant to the Facility Agreement in an

aggregate principal amount of approximately $20,000 together with accrued and unpaid interest thereon. As part of the prepayment, the Lenders also waived any and all make whole amounts that would otherwise be due and owing thereto under the Facility Documents in respect of the prepayment. As a result of the prepayment, the Company recognized a loss on extinguishment of debt within interest expense of $2,900 during the quarter ended March 31, 2025, which consisted of a proportionate write-off of unamortized financing costs related to the Facility Agreement.

Additionally, on March 24, 2025, in connection with the Private Placement (described in Note 13. Stockholders’ Equity) certain Lenders exercised participation rights and entered into an exchange agreement pursuant to which such Lenders agreed to exchange approximately $4,100 aggregate principal amount of the Senior Secured Convertible Notes for 37,232.83 shares of common-equivalent Preferred Stock (convertible into 3,723,283 shares of Common Stock) and warrants to purchase 1,861,642 shares of Common Stock at the same prices being paid by the investors in the Private Placement. The fair value of the common-equivalent Preferred Stock and warrants issued was $4,100. The exchange was accounted for as a partial debt extinguishment under ASC 470. As a result, the Company recognized a loss on extinguishment of debt within interest expense of $600 during the three months ended March 31, 2025, which consisted of a proportionate write-off of unamortized financing costs related to the Facility Agreement.

The Company was in compliance with the covenants of the Facility Agreement (as amended) as of June 30, 2026.

On July 1, 2026, the Company repaid approximately $86 million aggregate principal amount of the Senior Secured Convertible Notes, which represented the entire aggregate amount outstanding. See Note 20. Subsequent Events for more information

Conversion Options

The Senior Secured Convertible Notes contain several embedded conversion options (the “Conversion Options”) that grant the holders of the Senior Secured Convertible Notes the ability to convert the Senior Secured Convertible Notes at any time on or after the date of issuance of the notes. The Conversion Options are convertible into shares of the Company’s common stock (such converted shares, “Conversion Shares”) and, in certain circumstances, a combination of cash and shares of the Company’s common stock, or a combination of cash, other assets and securities or other property of any Company successor entity. The Conversion Shares or settlement amounts shall be computed on the basis of a predefined formula, with a set conversion price of $8.567 as one of the inputs and a conversion cap of 14,663,019 shares. The if-converted value did not exceed the principal amount as of June 30, 2026. No Conversion Shares were issued as of June 30, 2026.

The Company evaluated the Conversion Options of the Senior Secured Convertible Notes under ASC 815 and concluded that they require bifurcation from the host contract as a separate unit of account. The Conversion Options do not meet the criteria to be classified in shareholders’ equity and hence, are accounted for as a derivative liability remeasured at fair value at each balance sheet date with changes in fair value reported in earnings.

The Conversion Options contain certain limits on exercise if, after giving effect to the exercise, the Lender would beneficially own a number of shares of common stock of the Company in excess of those permissible under the terms of the Senior Secured Convertible Notes. The number of shares to be issued against these notes and conversion price are each subject to adjustments provided under the terms of Senior Secured Convertible Note.

The holder shall receive dividends on the Senior Secured Convertible Notes and distributions of any kind made to the holders of common stock, other than dividends of, or distributions in, shares, to the same extent as if the holder had converted the Senior Secured Convertible Notes into such shares and had held such shares on the record date for such dividends and distributions any limitations on conversion options.

Optional Redemption

The Facility Agreement also provides the Company the right to redeem the outstanding principal amount of each note (“Optional Redemption”) for the Optional Redemption Price. The Company may not effect any such Optional Redemption unless, the Company also effects an optional redemption under all other notes in accordance with the terms thereof, on a pro rata basis, based upon the respective applicable original principal amount of each of the notes outstanding as of the date the notice for Optional Redemption is delivered to the holders.

The Company evaluated the Optional Redemption feature of the Senior Secured Convertible Notes under ASC 815 and concluded that it requires bifurcation from the host contract as a separate unit of account. The Optional Redemption feature does not meet the criteria to be classified in shareholders’ equity and hence, is accounted for as a derivative liability remeasured at fair value at each balance sheet date with changes in fair value reported in earnings.

If the principal redemption amount specified in an Optional Redemption notice is less than the entire principal amount then outstanding, the principal amount specified in each conversion notice shall be applied (i) first, to reduce, on a dollar-for-dollar basis, the principal amount of the note in excess of the principal redemption amount until such excess principal amount is reduced to zero and (ii) to reduce, on a dollar-for-dollar basis, the principal redemption amount until all of such principal redemption amount shall have been converted.

Convertible Note Warrants

The Facility Agreement also provides for the issuance of warrants (the “Convertible Note Warrants”) on each date any principal amount of any Senior Secured Convertible Note is paid, repaid, redeemed, or prepaid at any time prior to the Maturity Date. Convertible Note Warrants are exercisable from their original issue date to August 9, 2027, for purchase of an aggregate amount of Conversion Shares into which such principal amount of Senior Secured Convertible Note was convertible, immediately prior to such payment, at an exercise price of $8.567. The holder of Convertible Note Warrants may pay the exercise price in cash or exercise the warrant on a cashless basis or through a reduction of an amount of principal outstanding under any Senior Secured Convertible Note held by such holder. In the event that the Convertible Note Warrant has not been exercised in full as of the last business day during its term, the holder shall be deemed to have exercised the purchase rights represented by the Convertible Note Warrant in full as a cashless exercise, in which event the Company shall issue the number of shares to the holder computed on the basis of a predefined formula.

The Company evaluated the Convertible Note Warrants of the Senior Secured Convertible Note under ASC 815 and concluded that they require bifurcation from the host contract as a separate unit of account. The Convertible Note Warrants do not meet the criteria to be classified in shareholders’ equity and hence, are accounted for as a derivative liability remeasured at fair value at each balance sheet date with changes in fair value reported in earnings.

The Convertible Note Warrant holder shall be entitled to receive any dividend or distribution made by the Company to the holders of common stock to the same extent as if the holder had exercised the Convertible Note Warrants in full in a cash exercise.

The number of shares to be issued against these warrants and exercise price are each subject to adjustments provided under the terms of Convertible Note Warrants. The Convertible Note Warrants contain certain limits on exercise if, after giving effect to the exercise, the Lender would beneficially own a number of shares of common stock of the Company in excess of those permissible under the terms of the Convertible Note Warrants. Further, the Convertible Note Warrants can be fully or partially settled in cash in certain cases in accordance with the terms of issuance such as when shares issuable upon exercise of the warrants exceed a predefined number, upon occurrence of predefined events of default and upon occurrence of predefined events that will bring a fundamental change in the Company such as merger, consolidation, business combination, recapitalization, reorganization, reclassification or other similar event.

As of June 30, 2026 and December 31, 2025, there were no Convertible Note Warrants outstanding, respectively. See Note 20 - Subsequent Events.

Allocation of Proceeds

The Company allocated total issuance proceeds of $110,000 among the Senior Secured Convertible Note and Convertible Note Warrants based on fair value. Upon issuance of the Convertible Note Warrants, the Company recorded Convertible Note Warrants, Optional Redemption, and Conversion Options of $0, $0 and $28,160, which were recorded as a debt discount to the Senior Secured Convertible Note of $110,000. The Company will amortize the debt discount over a period of 5 years (of which 1.10 years remain).

The total issuance costs of $4,924 were allocated among the Senior Secured Convertible Note, Convertible Note Warrants, Optional Redemption, and Conversion Options, by allocating costs of $0, $0, and $1,261 to the Convertible Note Warrants, Optional Redemption, and Conversion Options with the residual cost of $3,663 being allocated to the Senior Secured Convertible Note (in addition to the debt discount). The Company expensed issuance costs allocated to Warrants, Optional Redemption, and Conversion Options at inception and amortizes the costs allocated to the Senior Secured Convertible Notes over a period of 5 years (of which 1.10 remain).

Amounts Outstanding and Recognized during the Periods Presented

The Senior Secured Convertible Notes as of June 30, 2026 and December 31, 2025 consists of the following:


(in thousands)	June 30, 2026		December 31, 2025
Senior Secured Convertible Note, due August 9, 2027	$	85,889	$	85,889

Less: Unamortized debt issuance costs	796		1,123
Less: Unamortized debt discount	5,226		7,366
Long-term debt, net of unamortized debt discount and issuance costs	$	79,867	$	77,400

As of June 30, 2026 and 2025, the estimated fair value (Level 2) of the Senior Secured Convertible Notes was $85,889 and $73,991, respectively.

The amortization of the debt issuance costs was charged to interest expense for all periods presented. For the three months ended June 30, 2026 and 2025, the effective yield was 10.64%. The amount of debt issuance costs included in interest expense for the three and six months ended June 30, 2026 was $1,256 and $2,467, respectively. The amount of debt issuance costs included in interest expense for the three and six months ended June 30, 2025 was $1,129 and $6,003, respectively. The Company had interest expense of $868 and $1,727 on the Facility Agreement term loan for the three and six months ended June 30, 2026. The Company had interest expense of $863 and $1,878 on the Facility Agreement term loan for the three and six months ended June 30, 2025. There was $868 of accrued interest as of June 30, 2026 and 2025, respectively. There was $878 accrued interest as of December 31, 2025.

On August 9, 2022, the Company also entered into the Guarantee and Security Agreement (“Guarantee Agreement”) with the Agent for the purpose of providing a guarantee of all the obligations under the Facility Agreement (refer to Note 15. Commitments and Contingencies for detail).

Additionally, the Lenders' Agent holds shares of common and preferred stock of the Company as of June 30, 2026, and December 31, 2025.

Debt Maturities

The following table summarizes the stated debt maturity related to the Senior Secured Convertible Notes as of June 30, 2026:


(in thousands)
2026 (remaining six months)	$	—
2027	85,889
Total debt	$	85,889

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

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+ Details

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Current assets:
Cash and cash equivalents	$ 41,094	$ 33,565
Accounts receivable, net	66,349	58,998
Other receivables	360	322
Inventories	20,011	16,875
Prepaid expenses and other current assets	1,176	2,987
Total current assets	128,990	112,747
Property and equipment, net	10,583	10,684
Operating right of use assets	21,188	22,374
Intangible assets, net	9,585	11,015
Goodwill	7,230	7,230
Other assets	657	606
Total assets	178,233	164,656
Current liabilities:
Accounts payable	60,279	43,167
Current portion of operating lease liabilities	7,225	7,156
Accrued expenses and other current liabilities	27,435	20,639
Total current liabilities	94,939	70,962
Operating lease liabilities	17,384	19,131
Derivative warrant liabilities	89	264
Derivative liabilities	10,838	12,591
Long-term debt, net of unamortized debt issuance costs	79,867	77,400
Other non-current liabilities	30	28
Total liabilities	203,147	180,376
Commitments and contingencies (Note 15)
Stockholders’ deficit:
Common Stock, $0.0001 par value, authorized 500,000,000 shares; 102,202,753 shares issued and 100,468,979 shares outstanding at June 30, 2026 and 100,596,918 shares issued and 98,863,144 shares outstanding at December 31, 2025	10	10
Series A Convertible Preferred Stock, $0.0001 par value, authorized 10,000,000 shares; 193,507 shares issued and outstanding at June 30, 2026 and December 31, 2025	0	0
Additional paid-in capital	259,795	256,708
Treasury Stock at cost, 1,733,774 shares at June 30, 2026 and December 31, 2025	(1,019)	(1,019)
Accumulated deficit	(283,700)	(271,419)
Total stockholders’ deficit	(24,914)	(15,720)
Total liabilities and stockholders’ deficit	$ 178,233	$ 164,656

Share-Based Compensation - Additional Information (Details) - USD ($)	3 Months Ended			6 Months Ended		12 Months Ended
	Jun. 30, 2026	Mar. 31, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025	Dec. 31, 2022	Dec. 31, 2025	Dec. 31, 2024	Nov. 06, 2020
Share-based Compensation Arrangement by Share-based Payment Award
Granted (in shares)				0	0
Aggregate intrinsic value of vested	$ 93,000		$ 7,100,000	$ 429,000	$ 7,277,000
Common stock issued for options exercised				111,000	2,340,000
Total fair value of common shares vested				$ 1,682,000	$ 791,000
Issuance of common stock upon exercise of options (in shares)				96,137	2,645,017
Stock options
Share-based Compensation Arrangement by Share-based Payment Award
Term of award (in years)				10 years
Maximum total number of common shares for which stock options may be granted (in shares)									15,640,000
Compensation costs recognized	59,000		$ 107,000	$ 117,000	$ 213,000
Unrecognized compensation cost	$ 229,000			$ 229,000
Unrecognized compensation cost expected to be recognized over a weighted average period (in years)				1 year 4 months 17 days
Common stock issued for options exercised				$ 111,000
Tax benefit from stock options exercised				$ 318,000
Stock options \| 2021 Plan
Share-based Compensation Arrangement by Share-based Payment Award
Maximum total number of common shares for which stock options may be granted (in shares)	9,808,797			9,808,797
Granted (in shares)	0		0
Stock options \| First anniversary of grant date
Share-based Compensation Arrangement by Share-based Payment Award
Percentage of stock options				25.00%
Stock options \| Equal monthly-basis vesting through fourth anniversary of grant date
Share-based Compensation Arrangement by Share-based Payment Award
Percentage of stock options				75.00%
RSUs
Share-based Compensation Arrangement by Share-based Payment Award
Compensation costs recognized	$ 1,011,000		$ 644,000	$ 1,568,000	$ 860,000
Number of shares outstanding (in shares)	4,219,428			4,219,428			3,436,019
Weighted-average grant date fair value (in dollars per share)				$ 3.01	$ 1.19
RSUs and RSAs
Share-based Compensation Arrangement by Share-based Payment Award
Unrecognized compensation cost expected to be recognized over a weighted average period (in years)				3 years 5 months 4 days
Unrecognized compensation expense	$ 7,691,000			$ 7,691,000
Medical RSUs
Share-based Compensation Arrangement by Share-based Payment Award
Compensation costs recognized	$ 0		$ 0	$ 1,032,000	$ 1,137,000
Number of shares outstanding (in shares)	0		0	0	0		0	0
Award requisite service period (in years)		1 year				1 year
Granted (in shares)	332,803		997,806	332,803	997,806
Fair value of the liability-classified medical RSU outstanding	$ 0		$ 0	$ 0	$ 0
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award
Compensation costs recognized	$ 0		$ 0	$ 39,000	$ 0
Capital shares reserved for future issuance (in shares)	3,591,088			3,591,088
Purchase price of common stock, percent				85.00%
Shares issued in period (in shares)	0			84,392

Inventories (Tables)

6 Months Ended

Jun. 30, 2026

Inventory Disclosure [Abstract]

Summary of Inventories

The Company’s inventories as of June 30, 2026 and December 31, 2025 were as follows:


(in thousands)	June 30, 2026		December 31, 2025
Oral drug inventory	$	11,027	$	8,796
IV drug inventory	8,984		8,079
Total	$	20,011	$	16,875

Debt - Summary of Debt Maturity (Details) $ in Thousands	Jun. 30, 2026 USD ($)
Debt Disclosure [Abstract]
2026 (remaining six months)	$ 0
2027	85,889
Total debt	$ 85,889

Summary of Significant Accounting Policies (Details)	3 Months Ended				6 Months Ended
Summary of Significant Accounting Policies (Details)	Jun. 30, 2026 USD ($)	Mar. 31, 2026 USD ($)	Jun. 30, 2025 USD ($)	Mar. 31, 2025 USD ($)	Jun. 30, 2026 USD ($) segment	Jun. 30, 2025 USD ($)	Dec. 31, 2025 USD ($)	Dec. 31, 2024 USD ($)
Accounting Policies [Abstract]
Cash and cash equivalents	$ 41,094,000		$ 30,292,000		$ 41,094,000	$ 30,292,000	$ 33,565,000	$ 49,669,000
Accumulated deficit	(283,700,000)				(283,700,000)		(271,419,000)
Net loss attributable to Starling	(9,789,000)	$ (2,492,000)	$ (17,009,000)	$ (19,585,000)	(12,281,000)	(36,594,000)
Net cash provided by (used in) operating					$ 9,725,000	$ (15,190,000)
Number of operating segments \| segment					3
Number of reportable segments \| segment					3
Allowance for credit losses	0				$ 0		$ 0
Goodwill impairment charges	$ 0

- Definition

Amount of impairment loss from asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References + Details

- Definition

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

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+ Details

- Definition

Amount of accumulated undistributed earnings (deficit).

+ References

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+ Details

Property and Equipment, Net - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Property, Plant, and Equipment [Abstract]
Depreciation expense	$ 1,122	$ 1,032	$ 2,023	$ 2,042

Revenue - Additional Information (Details) - USD ($)	Jun. 30, 2026	Dec. 31, 2025	Jan. 01, 2025
Revenue from Contract with Customer [Abstract]
Contract with customer, asset	$ 0	$ 0	$ 0
Contract liabilities	$ 0	$ 0	$ 0

Marketable Securities and Fair Value Measurements

6 Months Ended

Jun. 30, 2026

Fair Value Disclosures [Abstract]

Marketable Securities and Fair Value Measurements

Marketable Securities

The Company accounted for its investment securities as available for sale using the fair value election pursuant to ASC 825, where changes in fair value are recorded in Other, net non-operating income (expense) on the Company's Condensed Consolidated Statements of Operations. The Company’s investments in cash equivalents at June 30, 2026 and December 31, 2025 is as follows:


	June 30, 2026
(in thousands)	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Cash equivalents:
Money Market Fund	$	39,081	$	—	$	—	$	39,081


	December 31, 2025
(in thousands)	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Cash equivalents:
Money Market Fund	$	27,230	$	—	$	—	$	27,230

The contractual maturities of the Company's investments in cash equivalents as of June 30, 2026 and December 31, 2025 is as follows:


June 30, 2026 (in thousands)	Due in One Year or Less		Due After One Year through Five Years		Due After Five Years		Total
Cash equivalents:
Money Market Fund	$	39,081	$	—	$	—	$	39,081


December 31, 2025 (in thousands)	Due in One Year or Less		Due After One Year through Five Years		Due After Five Years		Total
Cash equivalents:
Money Market Fund	$	27,230	$	—	$	—	$	27,230

Accrued interest receivable on cash equivalents was $82 and $53 at June 30, 2026 and December 31, 2025, respectively, and is included within other receivables in the Condensed Consolidated Balance Sheets.

Fair Value Measurements

The following table presents the carrying amounts of the Company’s recurring and non-recurring fair value measurements at June 30, 2026 and December 31, 2025:


	June 30, 2026
(in thousands)	Total		Level 1		Level 2		Level 3
Financial assets:
Cash equivalents	$	39,081	$	—	$	39,081	—


Financial liabilities:
Derivative warrant liabilities	$	89	$	—	$	89	$	—

Optional redemption derivative liabilities	10,838		—		—		10,838


	December 31, 2025
(in thousands)	Total		Level 1		Level 2		Level 3
Financial assets:
Cash equivalents	$	27,230	$	—	$	27,230	$	—


Financial liabilities:
Derivative warrant liabilities	$	264	$	—	$	264	$	—

Conversion option derivative liabilities	12,591		—		—		12,591

There were no transfers between levels for the six months ended June 30, 2026 and twelve months ended December 31, 2025.

The Company measures its investments (including cash equivalents, marketable securities, and non-current investments) at fair value on a recurring basis and classifies those instruments within Level 2 of the fair value hierarchy. Investment securities, including U.S. Treasury Bills purchased in the secondary market and U.S. Treasury bonds, are classified within Level 2 of the fair value hierarchy because pricing inputs are other than quoted prices in active markets, which are either directly or indirectly observable as of the reporting date, and fair value is determined using models or other valuation methodologies.

The Company measures its private derivative warrants on a recurring basis and classifies those instruments within Level 2 of the fair value hierarchy because the valuation is based on the observable input of a similar instrument. The Company measures its convertible note warrant derivative liability, optional redemption derivative liability and conversion option derivative liability on a recurring basis and classifies those instruments within level 3 of the fair value hierarchy because unobservable inputs are used to measure fair value. See Note 2 for a summary of the Company’s policies relating to fair value measurements, and Note 11 for more detail on the convertible note warrant, optional redemption, and conversion option derivative liabilities.

The following table presents information about the Company’s Level 3 financial liabilities that are measured at fair value on a recurring basis at June 30, 2026:


(in thousands)	Derivative Liabilities







Balance at December 31, 2024	$	385
Decrease in fair value included in other expense	12,206
Balance at December 31, 2025	$	12,591
Change in fair value included in other expense	(1,753)
Balance at June 30, 2026	$	10,838

As of June 30, 2026 and December 31, 2025, the optional redemption and conversion option derivative were valued using a Black-Scholes, which is considered to be a Level 3 fair value measurement. A summary of the level 3 fair value measurements inputs used in the valuations is as follows:


	June 30, 2026
		Optional Redemption Derivative Liability
Unit price		$	5.43
Term (in years)		1.11
Volatility		80.00		%
Risk-free rate		3.94		%
Dividend yield		—
Cost of equity		—


	December 31, 2025
		Conversion Option Derivative Liability
Unit price		$	3.56
Term (in years)		1.61
Volatility		114.00		%
Risk-free rate		3.45		%
Dividend yield		—
Cost of equity		—

Uncertainty of Fair Value Measurement from Use of Significant Unobservable Inputs

The inputs to estimate the fair value of the Company’s conversion option and optional redemption derivative liabilities were the market price of the Company’s common stock, their remaining expected term, the volatility of the Company’s common stock price and the risk-free interest rate over the expected term. Significant changes in any of those inputs in isolation can result in a significant change in the fair value measurement.

Generally, an increase in the market price of the Company’s shares of common stock, an increase in the volatility of the Company’s shares of common stock, and an increase in the remaining term of the derivative liabilities would each result in a directionally similar change in the estimated fair value of the Company’s derivative liabilities. Such changes would increase the associated liability while decreases in these assumptions would decrease the associated liability. An increase in the risk-free interest rate would result in a decrease in the estimated fair value measurement and thus a decrease in the associated liability. The Company has not, and does not plan to, declare dividends on its common stock and, as such, there is no change in the estimated fair value of the derivative warrant liabilities due to the dividend assumption.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

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-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478119/940-820-50-1

+ Details

Goodwill and Intangible Assets -Summary of Goodwill (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Goodwill [Line Items]
Goodwill	$ 7,230	$ 7,230
Patient services
Goodwill [Line Items]
Goodwill	2,679	2,679
Specialty pharmacy
Goodwill [Line Items]
Goodwill	4,551	4,551
Clinical trials & other
Goodwill [Line Items]
Goodwill	$ 0	$ 0

- Definition

Amount, after accumulated impairment loss, of asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References

+ 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

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

Accrued Expenses and Other Current Liabilities (Tables)

6 Months Ended

Jun. 30, 2026

Payables and Accruals [Abstract]

Summary of Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities as of June 30, 2026 and December 31, 2025 consist of the following:


(in thousands)	June 30, 2026		December 31, 2025
Compensation, including bonuses, fringe benefits, and payroll taxes	$	5,613	$	7,093
Accrued insurance reserve	2,158		2,282
Directors and officers insurance premiums	270		794
Deferred acquisition and contingent consideration	125		125
Accrued interest	868		878
Repayments on advances	220		1,630
Accrued capitated leakage	8,802		1,681
Accrued sub-capitation	3,135		1,851
Other liabilities	6,244		4,305
Total accrued expenses and other current liabilities	$	27,435	$	20,639

Share-Based Compensation -Summary of RSAs (Details) - $ / shares	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Restricted Stock Units and Restricted Stock Awards
Number of Shares
Balance at the beginning (in shares)			3,436,019	1,509,737
Granted (in shares)			2,401,435	3,935,704
Vested (in shares)			(1,441,843)	(1,700,884)
Forfeited (in shares)			(176,183)	(387,710)
Balance at the end (in shares)	4,219,428	3,356,847	4,219,428	3,356,847
Weighted Average Grant Date Fair Value
Balance at the beginning (in dollars per share)			$ 1.25	$ 0.94
Granted (in dollars per share)			3.01	1.19
Vested (in dollars per share)			1.93	0.93
Forfeited (in dollars per share)			2.12	1.00
Balance at the ending (in dollars per share)	$ 1.98	$ 1.23	$ 1.98	$ 1.23
Medical RSUs
Number of Shares
Balance at the beginning (in shares)			0	0
Granted (in shares)	332,803	997,806	332,803	997,806
Vested (in shares)			(332,803)	(997,806)
Forfeited (in shares)			0	0
Balance at the end (in shares)	0	0	0	0

Debt (Tables)

6 Months Ended

Jun. 30, 2026

Debt Disclosure [Abstract]

Summary of Long-Term Debt, Net of Unamortized Debt Issuance Costs

The Senior Secured Convertible Notes as of June 30, 2026 and December 31, 2025 consists of the following:


(in thousands)	June 30, 2026		December 31, 2025
Senior Secured Convertible Note, due August 9, 2027	$	85,889	$	85,889

Less: Unamortized debt issuance costs	796		1,123
Less: Unamortized debt discount	5,226		7,366
Long-term debt, net of unamortized debt discount and issuance costs	$	79,867	$	77,400

Summary of Maturities of Long-Term Debt

The following table summarizes the stated debt maturity related to the Senior Secured Convertible Notes as of June 30, 2026:


(in thousands)
2026 (remaining six months)	$	—
2027	85,889
Total debt	$	85,889

- 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

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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+ Details

CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS’ EQUITY (DEFICIT) - USD ($) $ in Thousands	Total	Common Stock	Preferred Stock	Treasury Stock	Additional Paid in Capital	Accumulated Deficit
Balance at beginning (in shares) at Dec. 31, 2024		77,470,886
Balance at beginning at Dec. 31, 2024	$ 3,589	$ 8	$ 0	$ (1,019)	$ 215,413	$ (210,813)
Balance at beginning (in shares) at Dec. 31, 2024			165,045
Changes in Stockholders' Equity
Net loss	(19,585)					(19,585)
Issuance of common stock upon vesting of RSUs (in shares)		1,023,867
Issuance of common stock upon exercise of options (in shares)		160,537
Issuance of common stock upon exercise of options	137				137
Issuance of common stock upon private placement, net (in shares)		12,006,510
Issuance of common stock upon private placement, net	15,359	$ 1			15,358
Issuance of preferred stock upon exchange of debt for equity (in shares)			37,233
Issuance of preferred stock upon exchange of debt for equity	4,111				4,111
Share-based compensation expense	1,458				1,458
Balance at ending (in shares) at Mar. 31, 2025		90,661,800
Balance at ending at Mar. 31, 2025	5,069	$ 9	$ 0	(1,019)	236,477	(230,398)
Balance at ending (in shares) at Mar. 31, 2025			202,278
Balance at beginning (in shares) at Dec. 31, 2024		77,470,886
Balance at beginning at Dec. 31, 2024	3,589	$ 8	$ 0	(1,019)	215,413	(210,813)
Balance at beginning (in shares) at Dec. 31, 2024			165,045
Changes in Stockholders' Equity
Net loss	$ (36,594)
Issuance of common stock upon exercise of options (in shares)	2,645,017
Balance at ending (in shares) at Jun. 30, 2025		95,013,596
Balance at ending at Jun. 30, 2025	$ (8,985)	$ 9	$ 0	(1,019)	239,432	(247,407)
Balance at ending (in shares) at Jun. 30, 2025			193,706
Balance at beginning (in shares) at Mar. 31, 2025		90,661,800
Balance at beginning at Mar. 31, 2025	5,069	$ 9	$ 0	(1,019)	236,477	(230,398)
Balance at beginning (in shares) at Mar. 31, 2025			202,278
Changes in Stockholders' Equity
Net loss	(17,009)					(17,009)
Issuance of common stock upon vesting of RSUs (in shares)		642,020
Issuance of common stock upon exercise of options (in shares)		2,484,480
Issuance of common stock upon exercise of options	2,203				2,203
Issuance of common stock upon exercise of warrants (in shares)		368,096
Conversion of preferred stock to common stock (in shares)		857,200	(8,572)
Share-based compensation expense	752				752
Balance at ending (in shares) at Jun. 30, 2025		95,013,596
Balance at ending at Jun. 30, 2025	$ (8,985)	$ 9	$ 0	(1,019)	239,432	(247,407)
Balance at ending (in shares) at Jun. 30, 2025			193,706
Balance at beginning (in shares) at Dec. 31, 2025	98,863,144	100,596,918
Balance at beginning at Dec. 31, 2025	$ (15,720)	$ 10	$ 0	(1,019)	256,708	(271,419)
Balance at beginning (in shares) at Dec. 31, 2025	193,507		193,507
Changes in Stockholders' Equity
Net loss	$ (2,492)					(2,492)
Issuance of common stock upon vesting of RSUs (in shares)		1,000,918
Issuance of common stock upon exercise of options (in shares)		25,330
Issuance of common stock upon exercise of options	21				21
Share issuances through employee stock purchase plan (in shares)		84,392
Share issuances through employee stock purchase plan	220				220
Share-based compensation expense	1,686				1,686
Balance at ending (in shares) at Mar. 31, 2026		101,707,558
Balance at ending at Mar. 31, 2026	$ (16,285)	$ 10	$ 0	(1,019)	258,635	(273,911)
Balance at ending (in shares) at Mar. 31, 2026			193,507
Balance at beginning (in shares) at Dec. 31, 2025	98,863,144	100,596,918
Balance at beginning at Dec. 31, 2025	$ (15,720)	$ 10	$ 0	(1,019)	256,708	(271,419)
Balance at beginning (in shares) at Dec. 31, 2025	193,507		193,507
Changes in Stockholders' Equity
Net loss	$ (12,281)
Issuance of common stock upon exercise of options (in shares)	96,137
Balance at ending (in shares) at Jun. 30, 2026	100,468,979	102,202,753
Balance at ending at Jun. 30, 2026	$ (24,914)	$ 10	$ 0	(1,019)	259,795	(283,700)
Balance at ending (in shares) at Jun. 30, 2026	193,507		193,507
Balance at beginning (in shares) at Mar. 31, 2026		101,707,558
Balance at beginning at Mar. 31, 2026	$ (16,285)	$ 10	$ 0	(1,019)	258,635	(273,911)
Balance at beginning (in shares) at Mar. 31, 2026			193,507
Changes in Stockholders' Equity
Net loss	(9,789)					(9,789)
Issuance of common stock upon vesting of RSUs (in shares)		424,388
Issuance of common stock upon exercise of options (in shares)		70,807
Issuance of common stock upon exercise of options	90				90
Share-based compensation expense	$ 1,070				1,070
Balance at ending (in shares) at Jun. 30, 2026	100,468,979	102,202,753
Balance at ending at Jun. 30, 2026	$ (24,914)	$ 10	$ 0	$ (1,019)	$ 259,795	$ (283,700)
Balance at ending (in shares) at Jun. 30, 2026	193,507		193,507

Segment Information - Summary of Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Segment Reporting
Total assets	$ 178,233	$ 164,656
Operating segments \| Patient services
Segment Reporting
Total assets	61,465	74,657
Operating segments \| Patient services \| Capitated accounts receivable
Segment Reporting
Total assets	1,937	3,213
Operating segments \| Patient services \| FFS accounts receivable
Segment Reporting
Total assets	29,385	35,376
Operating segments \| Patient services \| IV drug inventory
Segment Reporting
Total assets	8,984	8,079
Operating segments \| Patient services \| Other assets
Segment Reporting
Total assets	21,159	27,989
Operating segments \| Specialty pharmacy
Segment Reporting
Total assets	39,084	16,684
Operating segments \| Specialty pharmacy \| Other assets
Segment Reporting
Total assets	9,493	431
Operating segments \| Specialty pharmacy \| Oral drug accounts receivable
Segment Reporting
Total assets	18,564	7,457
Operating segments \| Specialty pharmacy \| Oral drug inventory
Segment Reporting
Total assets	11,027	8,796
Operating segments \| Clinical trials & other
Segment Reporting
Total assets	4,974	5,436
Items not allocated to segments
Segment Reporting
Total assets	$ 72,710	$ 67,879

Accrued Expenses and Other Current Liabilities

6 Months Ended

Jun. 30, 2026

Payables and Accruals [Abstract]

Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities as of June 30, 2026 and December 31, 2025 consist of the following:


(in thousands)	June 30, 2026		December 31, 2025
Compensation, including bonuses, fringe benefits, and payroll taxes	$	5,613	$	7,093
Accrued insurance reserve	2,158		2,282
Directors and officers insurance premiums	270		794
Deferred acquisition and contingent consideration	125		125
Accrued interest	868		878
Repayments on advances	220		1,630
Accrued capitated leakage	8,802		1,681
Accrued sub-capitation	3,135		1,851
Other liabilities	6,244		4,305
Total accrued expenses and other current liabilities	$	27,435	$	20,639

The Company has agreed to indemnify members of the Board and certain officers if they are named or threatened to be named as a party to any proceeding by reason of the fact that they acted in such capacity. The Company entered into a $964 financing arrangement beginning November 2025 with a maturity date of September 2026 at 7.49% annual interest rate to pay 11 monthly principal payments of approximately $80 to $90 in premiums for directors’ and officers’ (“D&O”) insurance coverage through September 2026 to protect against such losses. The principal outstanding balance was $270 and $794 as of June 30, 2026 and December 31, 2025, respectively.

Revenue

6 Months Ended

Jun. 30, 2026

Revenue from Contract with Customer [Abstract]

Revenue

The Company recognizes revenue in accordance with ASC 606 on the basis of its satisfaction of outstanding performance obligations. The Company typically fulfills its performance obligations over time, either over the course of a single treatment (fee-for-service or "FFS"), a month (capitation), or a number of months (clinical research). The Company also has revenue that is satisfied at a point in time (specialty pharmacy).

Disaggregation of Revenue

The Company categorizes revenue based on various factors such as the nature of contracts, payors, order to billing arrangements, and cash flows received by the Company, as follows:


(in thousands)	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Patient services
Capitated revenue	$	27,974	$	18,843	$	54,905	$	36,338
FFS revenue	30,853		37,048		63,009		72,621
Subtotal	58,827		55,891		117,914		108,959
Specialty pharmacy revenue	98,608		62,573		186,149		111,866
Clinical research trials and other revenue	3,847		1,338		4,660		3,383
Total	$	161,282	$	119,802	$	308,723	$	224,208

Refer to Note 19 for Segment Reporting for disaggregation of revenue by reporting segment.

Contract Asset and Liabilities

Under ASC 606, contract assets represent rights to payment for performance contingent on something other than the passage of time and accounts receivable are rights to payment for performance without contingencies. The Company does not have any contract assets as of June 30, 2026, January 1, 2025, and December 31, 2025. Refer to Note 4 for accounts receivable as of June 30, 2026 and December 31, 2025.

Contract liabilities represent cash that has been received for contracts, but for which performance is still unsatisfied. As of January 1, 2025, December 31, 2025, and June 30, 2026, the contract liabilities amounted to $0. During the three month periods ended June 30, 2026 and 2025, the Company recognized no revenue related to deferred capitation revenue received (contract liability) as of the beginning of each respective period.

Remaining Unsatisfied Performance Obligations

The accounting terms for the Company’s patient services and specialty pharmacy contracts do not extend past a year in duration. Additionally, the Company applies the ‘as invoiced’ practical expedient to its clinical research contracts.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Publisher FASB
-URI https://asc.fasb.org/606/tableOfContent

+ Details

Goodwill and Intangible Assets

6 Months Ended

Jun. 30, 2026

Intangible Asset, Goodwill and Other [Abstract]

Goodwill and Intangible Assets

Intangible Assets

As of June 30, 2026, the Company’s intangible assets, net consists of the following:


(in thousands)	Weighted average amortization period	Gross carrying amount		Accumulated amortization		Net carrying amount
Intangible assets
Amortizing intangible assets:
Payor contracts	13 years	$	22,191	$	(15,115)	$	7,076
Trade names	10 years	6,650		(4,227)		2,423
Noncompete agreements	8 years	852		(766)		86
Total intangible assets		$	29,693	$	(20,108)	$	9,585

As of December 31, 2025, the Company’s intangible assets, net consists of the following:


(in thousands)	Weighted average amortization period	Gross carrying amount		Accumulated amortization		Net carrying amount
Intangible assets
Amortizing intangible assets:
Payor contracts	13 years	$	22,191	$	(14,095)	$	8,096
Trade names	10 years	6,650		(3,900)		2,750
Clinical contracts and noncompete agreements	8 years	926		(757)		169
Total intangible assets		$	29,767	$	(18,752)	$	11,015

The estimated aggregate amortization expense for each of the five succeeding fiscal years as of June 30, 2026 is as follows:


(in thousands)	Amount
Year ending December 31:
2026 (remaining six months)	$	1,409
2027	2,713
2028	2,615
2029	453
2030	453

Thereafter	1,942
Total	$	9,585

The aggregate amortization expense during the three months ended June 30, 2026 and 2025 was $716 and $773, respectively. The aggregate amortization expense during the six months ended June 30, 2026 and 2025 was 1,431 and $1,547, respectively.

Goodwill

The Company evaluates goodwill at the reporting unit level, which, for the Company, is at the level of the reportable segments, specialty pharmacy, patient services, and clinical trials & other. The goodwill allocated to each of the reporting units as of June 30, 2026 and December 31, 2025 is as follows:


(in thousands)	June 30, 2026		December 31, 2025
Patient services	$	2,679	$	2,679
Specialty pharmacy	4,551		4,551
Clinical trials & other	—		—
Total goodwill	$	7,230	$	7,230

The accumulated goodwill impairment for patient services was $26,179 as of June 30, 2026, December 31, 2025 and January 1, 2025. The accumulated goodwill impairment for clinical trials & others was $632 as of June 30, 2026 and December 31, 2025. There was no accumulated goodwill impairment for specialty pharmacy as of June 30, 2026, December 31, 2025 and January 1, 2025.

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
Income Taxes (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Income Tax Disclosure [Abstract]
Income tax expense (benefit)	$ 0	$ (131)	$ 0	$ (131)
Effective income tax rate reconciliation, percent	0.00%	0.00%

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (ee)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Section 50
-Paragraph 22
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

Reference 3: http://www.xbrl.org/2003/role/exampleRef
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-Name Accounting Standards Codification
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-Paragraph 3A
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-URI https://asc.fasb.org/1943274/2147483475/205-20-45-3A

Reference 4: http://www.xbrl.org/2003/role/exampleRef
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-Paragraph 4
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-URI https://asc.fasb.org/1943274/2147476153/220-40-55-4

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 220
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-Name Accounting Standards Codification
-Section 55
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147476153/220-40-55-21

Reference 6: http://www.xbrl.org/2003/role/exampleRef
-Topic 220
-SubTopic 40
-Name Accounting Standards Codification
-Section 55
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147476153/220-40-55-14

Reference 7: 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 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 270
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (i)
-Publisher FASB
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Publisher FASB
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Reference 10: http://www.xbrl.org/2003/role/exampleRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482663/740-10-55-231

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 6.I.7)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479360/740-10-S99-1

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 8
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-8

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-9

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-10

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(9))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477250/944-220-S99-1

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Section 45
-Paragraph 2
-Subparagraph (a)
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-Topic 740
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482659/740-20-45-2

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h))
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-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

+ Details

Marketable Securities and Fair Value Measurements - Summary of Carrying Amounts of Financial Instruments (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Financial assets:
Cash equivalents	$ 39,081	$ 27,230
Financial liabilities:
Derivative warrant liabilities	89	264
Optional redemption derivative liabilities	10,838	12,591
Level 1
Financial assets:
Cash equivalents	0	0
Financial liabilities:
Derivative warrant liabilities	0	0
Optional redemption derivative liabilities	0	0
Level 2
Financial assets:
Cash equivalents	39,081	27,230
Financial liabilities:
Derivative warrant liabilities	89	264
Optional redemption derivative liabilities	0	0
Level 3
Financial assets:
Cash equivalents	0	0
Financial liabilities:
Derivative warrant liabilities	0	0
Optional redemption derivative liabilities	$ 10,838	$ 12,591

Stockholders' Equity (Deficit) (Details)			6 Months Ended		12 Months Ended
Stockholders' Equity (Deficit) (Details)	Mar. 24, 2025 USD ($) $ / shares shares	Dec. 12, 2021 day $ / shares shares	Jun. 30, 2026 USD ($) vote $ / shares shares	Jun. 30, 2025 USD ($)	Dec. 31, 2025 USD ($) $ / shares shares	Nov. 12, 2021 $ / shares shares
Common and Preferred Shares
Common stock, shares issued (in shares)			102,202,753		100,596,918
Common stock, shares outstanding (in shares)			100,468,979		98,863,144
Number of common stock, vote per share (in votes) \| vote			1
Dividends, common stock \| $			$ 0		$ 0
Preferred stock, shares authorized (in shares)			10,000,000		10,000,000	10,000,000
Preferred stock, par value (in usd per share) \| $ / shares			$ 0.0001		$ 0.0001	$ 0.0001
Preferred stock, liquidation preference per share (in dollars per share) \| $ / shares						$ 0.0001
Preferred stock, shares outstanding (in shares)			193,507		193,507
Shares issued upon conversion (in shares)			100
Maximum percent of common stock allowed			4.90%
Threshold number of business days before sending notice of redemption to warrant holders (in days) \| day		3
Proceeds from private placement, net of offering costs \| $			$ 0	$ 15,359,000
Common stock, par value (in dollars per share) \| $ / shares			$ 0.0001		$ 0.0001
Exchange agreement warrants acquired in agreement (in shares)	37,232.83
Exchange Agreement, units without warrants
Common and Preferred Shares
Proceeds from private placement, net of offering costs \| $	$ 16,500,000
Sale of stock, price (in dollars per share) \| $ / shares	$ 2.2084
Number of shares issued in transaction (in shares)	12,006,510
Common stock, par value (in dollars per share) \| $ / shares	$ 0.0001
Exchange agreement warrants acquired in agreement (in shares)	3,723,283
Class of warrants, common stock, exercise price percentage	4.90%
Exchange Agreement, units without warrants \| Common Class A
Common and Preferred Shares
Shares issued per unit held (in shares)	2
Private Placement
Common and Preferred Shares
Exchange agreement, principal amount of debt exchanged for securities (in shares) \| $	$ 4,100,000
At The Market Offering \| B. Riley Securities
Common and Preferred Shares
Number of shares issued in transaction (in shares)					2,800,000
Gross proceeds from sale of common stock \| $					$ 9,600,000
Debt issuance costs \| $					$ 384,000
At The Market Offering \| Sales Agent, BTIG
Common and Preferred Shares
Number of shares issued in transaction (in shares)					1,400,000
Gross proceeds from sale of common stock \| $					$ 4,800,000
Debt issuance costs \| $					$ 192,000
Public and Private Warrants
Common and Preferred Shares
Term from closing of IPO		30 days
Warrants term (in years)		5 years
Public Warrants
Common and Preferred Shares
Number of warrants outstanding (in shares)			5,749,986
Number of securities called by each warrant (in shares)		1
Warrants price per share (in usd per share) \| $ / shares		$ 11.50
Warrant redemption maximum common share price (in dollars per share) \| $ / shares		$ 18.00
Threshold trading days (in days) \| day		20
Threshold consecutive trading days (in days) \| day		30
Warrants price per share (in usd per share) \| $ / shares		$ 0.01
Minimum threshold written notice period for redemption of public warrants		30 days
Private Warrants
Common and Preferred Shares
Number of warrants outstanding (in shares)			2,187,283
Pre-Funded Warrants \| Exchange Agreement, units without warrants
Common and Preferred Shares
Number of securities called by each warrant (in shares)	1
Warrants price per share (in usd per share) \| $ / shares	$ 0.0001
Sale of stock, price (in dollars per share) \| $ / shares	$ 2.2082
Number of securities called by warrants or rights (in shares)	2,886,614
Common Warrants
Common and Preferred Shares
Number of warrants outstanding (in shares)			8,216,918
Common Warrants \| Exchange Agreement, units without warrants
Common and Preferred Shares
Warrants price per share (in usd per share) \| $ / shares	$ 1.1980
Number of securities called by warrants or rights (in shares)	7,446,562
Common Warrants \| Exchange Agreement, units without warrants \| Certain convertible debt lenders
Common and Preferred Shares
Number of securities called by warrants or rights (in shares)	1,861,642

Inventories

6 Months Ended

Jun. 30, 2026

Inventory Disclosure [Abstract]

Inventories

The Company purchases intravenous chemotherapy drugs and oral prescription drugs from various suppliers, however substantially from one supplier.

The Company’s inventories as of June 30, 2026 and December 31, 2025 were as follows:


(in thousands)	June 30, 2026		December 31, 2025
Oral drug inventory	$	11,027	$	8,796
IV drug inventory	8,984		8,079
Total	$	20,011	$	16,875

Accounts Receivable - Schedule of Accounts Receivable (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	$ 66,349	$ 58,998
Oral drug accounts receivable (Specialty Pharmacy)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	18,564	7,457
Capitated accounts receivable (Patient Services)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	1,937	3,213
FFS accounts receivable, net (Patient Services)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	29,385	35,376
Other trade receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	$ 16,463	$ 12,952

Net Loss Per Share - Summary of Computation of Diluted Net Loss Per Share (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Convertible note
Basic and diluted net income (loss) per share of common stock:
Antidilutive securities excluded from computation of earnings per share (in shares)	10,838,000	10,842,525	10,838,000	10,842,525
Stock options
Basic and diluted net income (loss) per share of common stock:
Antidilutive securities excluded from computation of earnings per share (in shares)	3,858,975	4,481,261	3,858,975	4,481,261
RSUs
Basic and diluted net income (loss) per share of common stock:
Antidilutive securities excluded from computation of earnings per share (in shares)	4,219,428	3,356,847	4,219,428	3,356,847
Public Warrants
Basic and diluted net income (loss) per share of common stock:
Antidilutive securities excluded from computation of earnings per share (in shares)	5,749,986	5,749,986	5,749,986	5,749,986
Private Warrants
Basic and diluted net income (loss) per share of common stock:
Antidilutive securities excluded from computation of earnings per share (in shares)	2,187,283	2,187,283	2,187,283	2,187,283
Common Warrants in connection with private placement and exchange agreement
Basic and diluted net income (loss) per share of common stock:
Antidilutive securities excluded from computation of earnings per share (in shares)	8,216,918	8,628,980	8,216,918	8,628,980

Leases (Tables)

6 Months Ended

Jun. 30, 2026

Leases [Abstract]

Summary of Lease, Cost

The components of lease expense were as follows for the three and six months ended June 30, 2026 and 2025:


	Three Months Ended June 30,				Six Months Ended June 30,
(in thousands)	2026		2025		2026		2025
Operating lease costs:	$	2,020	$	2,172	$	4,059	$	4,440
Finance lease costs:
Amortization of ROU asset	$	9	$	9	$	17	$	19
Interest expense	$	1	$	1	$	2	$	3
Other lease costs:
Short-term lease costs	$	—	$	3	$	2	$	6
Variable lease costs	$	648	$	532	$	1,157	$	1,014

The following table provides certain cash flow and supplemental noncash information related to the Company's lease liabilities for the three months ended June 30, 2026 and 2025.


(in thousands)	Six Months Ended June 30, 2026		Six Months Ended June 30, 2025
Supplemental cash flow information
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash payment for operating leases	$	4,448	$	4,419
Financing cash payments for finance leases	20		22
Lease liabilities arising from obtaining right-of-use assets:
Operating leases	$	2,090	$	1,253

Summary of Operating Lease Maturity

The aggregate future lease payments for the Company's leases in years subsequent to June 30, 2026 are as follows:


(in thousands)	Operating Leases		Finance Leases
2026 (remaining six months)	$	4,445	$	19
2027	7,954		29
2028	6,232		—
2029	4,734		—
2030	2,891		—
Thereafter	1,987		—
Total future lease payment	$	28,243	$	48
Less: amount representing interest	(3,634)		(1)
Present value of future lease payment (lease liabilities)	$	24,609	$	47
Reported as:
Lease liabilities, current	$	7,225	$	37
Lease liabilities, noncurrent	17,384		10
Total lease liabilities	$	24,609	$	47

Summary of Finance Lease Maturity

The aggregate future lease payments for the Company's leases in years subsequent to June 30, 2026 are as follows:


(in thousands)	Operating Leases		Finance Leases
2026 (remaining six months)	$	4,445	$	19
2027	7,954		29
2028	6,232		—
2029	4,734		—
2030	2,891		—
Thereafter	1,987		—
Total future lease payment	$	28,243	$	48
Less: amount representing interest	(3,634)		(1)
Present value of future lease payment (lease liabilities)	$	24,609	$	47
Reported as:
Lease liabilities, current	$	7,225	$	37
Lease liabilities, noncurrent	17,384		10
Total lease liabilities	$	24,609	$	47

Summary of Weighted Average Discount Rates

The following table provides the weighted average remaining lease terms and weighted average discount rates for the Company's leases as of June 30, 2026 and 2025:


	June 30, 2026		June 30, 2025
Weighted-average remaining lease term (in years)
Operating	3.87		4.35
Finance	1.21		2.21
Weighted-average discount rate
Operating	6.90	%	6.70	%
Finance	6.73	%	6.71	%

Summary of Significant Accounting Policies	6 Months Ended
Summary of Significant Accounting Policies	Jun. 30, 2026
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Unaudited Interim Financial Information The accompanying interim condensed consolidated financial statements are unaudited and have been prepared in accordance with Article 10 of Regulation S-X issued by the U.S. Securities and Exchange Commission ("SEC"). Accordingly, they do not include all of the information and note disclosures required by U.S. generally accepted accounting principles ("GAAP") for complete consolidated financial statements. However, the Company believes that the disclosures are adequate to ensure the information is not misleading. In the opinion of management, all adjustments (of normal and recurring nature) considered necessary for fair presentation have been reflected in these interim statements. As such, the information included in the accompanying unaudited interim condensed consolidated financial statements should be read in conjunction with the Company's audited consolidated financial statements and notes as of and for the year ended December 31, 2025, issued on March 12, 2026 in the Company's Annual Report on Form 10-K. The financial results included in this Form 10-Q are not necessarily indicative of annual year-end financial results. Principles of Consolidation The accompanying condensed consolidated financial statements include the accounts of Starling, its subsidiaries, all of which are controlled by Starling through majority voting control, and variable interest entities (“VIEs”) for which Starling is the primary beneficiary. The Company consolidates entities in which it has a controlling financial interest based on either the variable interest entity or voting interest model. All significant intercompany balances and transactions have been eliminated in consolidation. Variable Interest Entities The Company consolidates entities for which it has a variable interest and is determined to be the primary beneficiary. Revenues, expenses, and net income (loss) from these subsidiaries are included in the consolidated amounts as presented on the Condensed Consolidated Statements of Operations. The Company holds, as a result of entering into master services agreements ("MSAs"), variable interests in Starling PCs, which it cannot legally own. As of June 30, 2026, Starling held variable interests in Starling CA, Starling Oncology FL, LLC, a Professional Corporation ("Starling FL"), Starling Oncology OR, a Professional Corporation ("Starling OR"), and Starling Oncology TX, a Professional Corporation ("Starling TX"), all of which are VIEs. The Company is the primary beneficiary of the Starling PCs and thus, consolidates the Starling PCs in its financial statements. As discussed in Note 16, the noncontrolling shareholders hold nominal interests in the VIEs and do not participate in the income or loss of the VIEs. Liquidity The accompanying financial statements have been prepared on a going concern basis of accounting, which contemplates continuity of operations, realization of assets and liabilities and commitments in the normal course of business. In connection with the preparation of the condensed consolidated financial statements as of June 30, 2026, the Company conducted an evaluation as to whether there were conditions and events, considered in the aggregate, which raised substantial doubt as to its ability to continue as a going concern within one year after the date of the issuance of such financial statements. The Company had cash and cash equivalents of $41,094 and an accumulated deficit of $283,700 at June 30, 2026, and a net loss of $12,281 and net cash provided by operations of $9,725 for the six months ended June 30, 2026. The Company has concluded that it will have sufficient liquidity to fund its operations for at least one year from the date these consolidated financial statements are issued. Although the Company currently expects its sources of capital to be sufficient to meet its near-term liquidity needs, there can be no assurance that such sources will be sufficient to satisfy its liquidity requirements in the future. If the Company cannot generate or obtain needed funds, it might be forced to make substantial reductions in its operating and capital expenses or pursue restructuring plans, which could adversely affect its business operations and ability to execute its current business strategy. Segment Reporting The Company presents the financial statements by segment in accordance with ASC Topic No. 280, Segment Reporting (“ASC 280”) to provide investors with transparency into how the chief operating decision maker (“CODM”) manages the business. The Company determined the CODM is its Chief Executive Officer. The CODM reviews financial information and allocates resources across three operating segments: patient services, specialty pharmacy, and clinical trials & other. Each of the operating segments is also a reporting segment as described further in Note 19. Use of Estimates The preparation of the consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could materially differ from those estimates under different assumptions or conditions. Significant items subject to such estimates and assumptions include judgments related to fee-for-service ("FFS") revenue recognition, estimated FFS accounts receivable and the allowance for credit losses, useful lives and recoverability of long-lived assets, recoverability of goodwill, fair value of share-based compensation, fair value of liability classified instruments, and judgments related to deferred income taxes. Net Loss Per Share Basic and diluted net loss per share attributable to common stockholders is presented in conformity with the two-class method required for participating securities. The Company's Series A Convertible Preferred Stock is classified as a participating security in accordance with ASC 260. Under the two-class method, basic and diluted net loss per share attributable to common stockholders is computed by dividing the basic and diluted net loss attributable to common stockholders by the basic and diluted weighted-average number of shares of common stock outstanding during the period. Diluted net income per share attributable to common stockholders adjusts basic net income per share for the potentially dilutive impact of stock options, restricted stock units ("RSUs"), Medical RSUs (defined in Note 14), public warrants, private placement warrants, common warrants, pre-funded warrants, and Senior Secured Convertible Notes (defined in Note 11). The treasury stock method is used to calculate the potentially dilutive effect of stock options, RSUs, public warrants, and private placement warrants. The if-converted method is used to calculate the potentially dilutive effect of the Senior Secured Notes. In both methods, diluted net income (loss) attributable to common stockholders and diluted weighted-average shares outstanding are adjusted to account for the impact of the assumed issuance of potential shares of common stock that are dilutive, subject to dilution sequencing rules. For the periods presented, the public and private placement warrants are out of the money; therefore, the public and private placement warrants are anti-dilutive and excluded from diluted net loss per share. Fair Value Measurements The Company accounts for fair value measurements under ASC Topic No. 820, Fair Value Measurements (“ASC 820”). The Company uses valuation approaches that maximize the use of observable inputs and minimize the use of unobservable inputs to the extent possible. The Company determines fair value based on assumptions that market participants would use in pricing an asset or liability in the principal or most advantageous market. When considering market participant assumptions in fair value measurements, the following fair value hierarchy distinguishes between observable and unobservable inputs, which are categorized in one of the following levels (see Note 7 for further discussion): Level 1inputs: Unadjusted quoted prices in active markets for identical assets or liabilities accessible to the reporting entity at the measurement date. Level 2inputs: Other than quoted prices included in Level 1 inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the asset or liability. Level 3inputs: Unobservable inputs for the asset or liability used to measure fair value to the extent that observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at measurement date. The Company's fair value measurement for cash and cash equivalents, accounts receivable, other receivables, and accounts payable approximates fair value because of the short maturity and high liquidity of these instruments. Fair value measurement of investment securities available for sale is based upon quoted prices from active markets, if available (Level 1). If quoted prices are not available, fair values are measured using independent pricing models or other model-based valuation methodologies. Level 2 investment securities include money market securities purchased in the secondary market that use pricing inputs other than quoted prices in active markets and fair value is determined using pricing models or other valuation methodologies such as broker price indications, which are based on quoted prices for identical or similar notes, which are Level 2 input measures. Contingent considerations are valued using a present value factor using credit rating yields which are considered to be a Level 3 fair value measurement. Fair value measurements used for the goodwill and intangible assets are based on the discounted cash flow method within the income approach and guideline public company method to value the reporting units, which is considered to be a Level 3 fair value measurement. The unobservable inputs utilized in determining the fair value of goodwill based on the income approach primarily include estimated future cash flows, discounted at a rate that approximates the cost of capital of a market participant. Inputs used to calculate the fair value based on the market approach include the revenue and EBITDA multiples based on guidelines for similar publicly traded companies and recent transactions. Fair value measurements of derivative warrants liability are based on the Black-Scholes Model, which is considered to be Level 3 fair value measurements. The primary unobservable input utilized in determining the fair value of the derivative warrants is the expected volatility of the common stock. Fair value measurements of the convertible note warrant and conversion option derivative liabilities are based on the Black-Derman-Toy model implemented in the Binomial Lattice and Black-Scholes Models, which are considered to be Level 3 fair value measurements. The primary unobservable input utilized in determining the fair value of the convertible note warrant and conversion option derivative liabilities is the expected volatility of the common stock. The senior secured convertible note, which is carried at amortized cost, is considered to be a Level 2 fair value measurement due to observable inputs, such as the term matched risk-free rate and the credit spread, which is used to calculate the discount rate as of the valuation date. Cash and Cash Equivalents Cash primarily consists of deposits with banking institutions. The Company considers all highly liquid investments that are both readily convertible into cash and mature within three months from the date of purchase to be cash equivalents. Accounts Receivable and Allowance for Credit Losses The Company’s accounts receivables are recorded and stated at the amount expected to be collected determined by each payor, net of an allowance for credit losses, under ASC Topic No. 310, Receivables (“ASC 310”). In accordance with ASC Topic No. 326, Financial Instruments — Credit Losses (“ASC 326”), the Company recognizes credit losses based on a forward-looking current expected credit losses (“CECL”) model. The Company segregates accounts receivables into portfolio segments based on shared risk characteristics, such as line of business and payor type, for evaluation of expected credit losses. The Company makes estimates of expected credit losses based upon its assessment of various factors, including the age of accounts receivable balances, default-based statistics, current economic conditions, reasonable and supportable forecasts of future economic conditions, and other factors that may affect its ability to collect from customers. The allowance for credit losses is developed using a loss rate method and is recognized in the Condensed Consolidated Statement of Operations. The uncollectible accounts receivables are written off on a quarterly basis in the period when collection activities cease due to a final determination that all or a portion of the balance is no longer collectible and if there is no pending litigation activity related to the receivable. There was no allowance for credit losses recorded as of June 30, 2026 and December 31, 2025. Goodwill The Company accounts for goodwill under Accounting Standards Codification Topic No. 350, Intangibles - Goodwill and Other (“ASC 350”). Goodwill represents the excess of the aggregate purchase price paid over the fair value of the net assets acquired in the Company's business combinations. Goodwill is not amortized but is required to be evaluated for impairment at least annually or whenever events or changes in circumstances indicate that the carrying value may not be recoverable. The Company performs its annual testing of impairment for goodwill in the fourth quarter of each year. When impairment indicators are identified, the Company compares the reporting unit’s fair value to its carrying amount, including goodwill. An impairment loss is recognized as the difference, if any, between the reporting unit’s carrying amount and its fair value to the extent the difference does not exceed the total amount of goodwill allocated to the reporting unit. The Company performed a qualitative assessment as of June 30, 2026 and determined it was not necessary to perform the two-step quantitative analysis. The Company determined there was no impairment for the three months ended June 30, 2026. Debt The Company accounts for debt net of debt issuance costs and debt discount. Debt issuance costs and debt discount are capitalized, netted against the related debt for presentation purposes, and amortized to interest expense over the terms of the related debt using the effective interest method. The Company accounts for bifurcated, debt-classified embedded features separately as derivative liabilities pursuant to ASC Topic No. 815, Derivatives and Hedging ("ASC 815"). Bifurcated, debt-classified embedded features are recorded at fair value on the Company's balance sheet with subsequent changes in fair value recorded in the Condensed Consolidated Statement of Operations each reporting period. Investments in Marketable Securities The Company's investments in marketable securities are classified as available-for-sale and are carried at fair value. The Company accounts for its investment securities available for sale using the fair value election pursuant to ASC 825, Financial Instruments ("ASC 825"), where changes in fair value are recorded in unrealized gains (losses), net on the Company's Condensed Consolidated Statements of Operations. The Company determines the appropriate classification of these investments at the time of purchase and reevaluates such designation at each balance sheet date. The Company’s marketable securities are classified as current assets if the maturity date is less than one year from the balance sheet date. Interest income and accretion on marketable securities are included in interest income in the Consolidated Statements of Operations. Realized gains and losses on sales of securities, and other-than-temporary declines in the fair value of marketable securities, if any, are included as a component of other income (expense), net in the Condensed Consolidated Statements of Operations. The cost of securities sold is based on the First In, First Out method. At each reporting period, the Company evaluates available-for-sale marketable securities, to the extent the fair value option is not elected, for any credit-related impairment when the fair value of the investment is less than its amortized cost. If the Company determines that the decline in fair value is below the carrying value and this decline is other-than-temporary, credit-related impairment is recognized in the Consolidated Statement of Operations in accordance with ASC 320, Debt Securities. Comprehensive Loss Comprehensive loss includes net loss to common stockholders as well as other changes in equity that result from transactions and economic events other than those with stockholders. There was no difference between comprehensive loss and net loss to common stockholders for the periods presented. Recently Issued and Adopted Accounting Standards In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvement to Income Tax Disclosures ("ASU 2023-09"). The new standard requires a public business entity (PBE) to disclose, on an annual basis, a tabular rate reconciliation using both percentages and currency amounts, broken out into specified categories with certain reconciling items further broken out by nature and jurisdiction to the extent those items exceed a specified threshold. In addition, all entities are required to disclose income taxes paid, net of refunds received disaggregated by federal, state/local, and foreign and by jurisdiction if the amount is at least 5% of total income tax payments, net of refunds received. For PBEs, the new standard is effective for annual periods beginning after December 15, 2024, with early adoption permitted. An entity may apply the amendments in this ASU prospectively by providing the revised disclosures for the year ending December 31, 2025 and continuing to provide the pre-ASU disclosures for the prior periods, or may apply the amendments retrospectively by providing the revised disclosures for all periods presented. The Company adopted ASU 2023-09 as of December 31, 2025. The adoption did not have a material impact on the Company's financial statements. In November 2024, the FASB issued ASU 2024-03, “Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40).” ASU 2024-03 does not change the expense captions an entity presents on the face of the income statement; rather it requires disaggregation of certain expense captions into specified categories in disclosures within the footnotes to the financial statements. ASU 2024-03 requires footnote disclosure about specific expenses to disaggregate, in a tabular presentation, each relevant expense caption on the face of the income statement that includes any of the following natural expenses: (1) purchases of inventory, (2) employee compensation, (3) depreciation, (4) intangible asset amortization and (5) depreciation, depletion and amortization recognized as part of oil- and gas-production activities or other types of depletion expenses. The tabular disclosure would also include certain other expenses, when applicable. ASU 2024-03 does not change or remove existing expense disclosure requirements; however, it may affect where that information appears in the footnotes to the financial statements. ASU 2024-03 is effective for annual periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. The requirements will be applied prospectively with the option for retrospective application. Early adoption is permitted. The Company will adopt ASU 2024-03 at the beginning of fiscal year 2027. The Company is currently evaluating the disclosure requirements and its effect on the Consolidated Financial Statements

Accounts Receivable (Tables)

6 Months Ended

Jun. 30, 2026

Receivables [Abstract]

Summary of Accounts Receivable

Accounts Receivable as of June 30, 2026 and December 31, 2025 consist of the following:


(in thousands)	June 30, 2026		December 31, 2025
Oral drug accounts receivable (Specialty Pharmacy)	$	18,564	$	7,457
Capitated accounts receivable (Patient Services)	1,937		3,213
FFS accounts receivable, net (Patient Services)	29,385		35,376

Other trade receivables	16,463		12,952
Total	$	66,349	$	58,998

Accounts Receivable

6 Months Ended

Jun. 30, 2026

Receivables [Abstract]

Accounts Receivable

The Company’s accounts receivable consists primarily of amounts due from third-party payors and patients. See Note 2 for a summary of the Company’s policies relating to accounts receivable and allowance for credit losses.

Accounts Receivable as of June 30, 2026 and December 31, 2025 consist of the following:


(in thousands)	June 30, 2026		December 31, 2025
Oral drug accounts receivable (Specialty Pharmacy)	$	18,564	$	7,457
Capitated accounts receivable (Patient Services)	1,937		3,213
FFS accounts receivable, net (Patient Services)	29,385		35,376

Other trade receivables	16,463		12,952
Total	$	66,349	$	58,998

There was no allowance for credit losses as of June 30, 2026 and December 31, 2025.

As of January 1, 2025, the accounts receivable balance amounted to $48,335.

During the three and six months ended June 30, 2026 and 2025, the Company had no net bad debt recoveries and bad debt expense. Credit losses are a result of accounts receivable on completed contracts that were deemed uncollectible during the period.

Net Loss Per Share

6 Months Ended

Jun. 30, 2026

Earnings Per Share [Abstract]

Net Loss Per Share

The following table sets forth the computation of the Company's basic and diluted net loss per share to common stockholders for the three and six months ended June 30, 2026 and 2025.


(in thousands, except share data)	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Net loss attributable to Starling	$	(9,789)	$	(17,009)	$	(12,281)	$	(36,594)

Net loss attributable to Starling available for distribution	(9,789)		(17,009)		(12,281)		(36,594)
Net loss attributable to participating securities, basic and diluted	(1,548)		(3,018)		(1,951)		(6,522)
Net loss attributable to common stockholders, basic and diluted	$	(8,241)	$	(13,991)	$	(10,330)	$	(30,072)
Weighted average common shares outstanding, basic and diluted	103,031,493		93,203,665		102,419,949		85,195,734
Net loss income per share attributable to common stockholders, basic and diluted	$	(0.08)	$	(0.15)	$	(0.10)	$	(0.35)

The following potentially dilutive outstanding securities were excluded from the computation of diluted net loss per share because their effect would have been anti-dilutive for the periods presented:


	Three Months Ended June 30,		Six Months Ended June 30,
	2026	2025	2026	2025
Convertible note	10,838,000	10,842,525	10,838,000	10,842,525
Stock options	3,858,975	4,481,261	3,858,975	4,481,261
RSUs	4,219,428	3,356,847	4,219,428	3,356,847


Public Warrants	5,749,986	5,749,986	5,749,986	5,749,986
Private Warrants	2,187,283	2,187,283	2,187,283	2,187,283
Common Warrants in connection with private placement and exchange agreement	8,216,918	8,628,980	8,216,918	8,628,980

Leases - Summary of Supplemental Noncash Information Related Liabilities (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash payment for operating leases	$ 4,448	$ 4,419
Financing cash payments for finance leases	20	22
Operating leases	$ 2,090	$ 1,253

Significant Risks and Uncertainties Including Business and Credit Concentrations - Summary of Vendor Concentration Risk (Details) - Supplier Concentration	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025	Dec. 31, 2025
Direct costs \| Vendor A
Significant Risks and Uncertainties Including Business and Credit Concentrations
Concentration risk percentage	91.00%	100.00%	92.00%	100.00%
Gross payables \| Vendor A
Significant Risks and Uncertainties Including Business and Credit Concentrations
Concentration risk percentage			80.00%		77.00%
Gross payables \| Vendor B
Significant Risks and Uncertainties Including Business and Credit Concentrations
Concentration risk percentage			14.00%

- 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

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-18

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-18

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 20
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-20

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-18

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-18

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-18

Reference 7: http://www.xbrl.org/2003/role/exampleRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 18
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482836/275-10-55-18

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 20
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-20

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 954
-SubTopic 310
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478785/954-310-50-2

+ Details

- Definition

For an entity that discloses a concentration risk in relation to quantitative amount, which serves as the "benchmark" (or denominator) in the equation, this concept represents the concentration percentage derived from the division.

+ References + Details

Net Loss Per Share - Summary of Basic and Diluted Net Loss Per Share to Common Stockholders (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
Earnings Per Share [Abstract]
Net loss attributable to Starling	$ (9,789)	$ (2,492)	$ (17,009)	$ (19,585)	$ (12,281)	$ (36,594)
Net loss attributable to Starling available for distribution	(9,789)		(17,009)		(12,281)	(36,594)
Net loss attributable to participating securities, basic	(1,548)		(3,018)		(1,951)	(6,522)
Net loss attributable to participating securities, diluted	(1,548)		(3,018)		(1,951)	(6,522)
Net loss attributable to common stockholders, basic	(8,241)		(13,991)		(10,330)	(30,072)
Net loss attributable to common stockholders, diluted	$ (8,241)		$ (13,991)		$ (10,330)	$ (30,072)
Weighted average common shares outstanding, basic (in shares)	103,031,493		93,203,665		102,419,949	85,195,734
Weighted average common shares outstanding, diluted (in shares)	103,031,493		93,203,665		102,419,949	85,195,734
Net loss income per share attributable to common stockholders, basic (in dollars per share)	$ (0.08)		$ (0.15)		$ (0.10)	$ (0.35)
Net loss income per share attributable to common stockholders, diluted (in dollars per share)	$ (0.08)		$ (0.15)		$ (0.10)	$ (0.35)

Leases - Summary of Lease, Cost (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Leases [Abstract]
Operating lease costs:	$ 2,020	$ 2,172	$ 4,059	$ 4,440
Amortization of ROU asset	9	9	17	19
Interest expense	1	1	2	3
Short-term lease costs	0	3	2	6
Variable lease costs	$ 648	$ 532	$ 1,157	$ 1,014

Segment Information

6 Months Ended

Jun. 30, 2026

Segment Reporting [Abstract]

Segment Information

The Company operates its business and reports its results through three operating and reportable segments: specialty pharmacy, patient services, and clinical trials & other in accordance with ASC 280. See Note 2 for a summary of the Company’s policy on segment information.

Summarized financial information for the Company’s segments is shown in the following tables:


(in thousands)	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Revenue
Patient services	$	58,827	$	55,891	$	117,914	$	108,959
Specialty pharmacy	98,608		62,573		186,149		111,866
Clinical trials & other	3,847		1,338		4,660		3,383
Consolidated revenue	$	161,282	$	119,802	$	308,723	$	224,208

Direct costs
Intravenous (IV) drug costs	$	28,965	$	32,800	$	58,732	$	64,213
Clinician salaries and benefits	16,431		14,011		31,769		28,085
Network medical expense	9,497		1,783		16,107		1,783
Medical supplies and other	1,878		2,556		3,546		4,149
Total patient services (A)	$	56,771	$	51,150	$	110,154	$	98,230
Specialty pharmacy (B)	77,346		51,086		148,089		90,949
Clinical trials & other (C)	—		65		—		279
Total segment direct costs	$	134,117	$	102,301	$	258,243	$	189,458
Depreciation expense
Patient services	$	816	$	767	$	1,553	$	1,522
Specialty pharmacy	3		4		6		6
Clinical trials & other	—		—		—		32
Total segment depreciation expense	$	819	$	771	$	1,559	$	1,560

Amortization of intangible assets
Patient services	$	716	$	718	$	1,431	$	1,437

Clinical trials & other	—		55		—		110
Total segment amortization	$	716	$	773	$	1,431	$	1,547

Operating income
Patient services	$	524	$	3,256	$	4,776	$	7,770
Specialty pharmacy	21,259		11,483		38,054		20,911
Clinical trials & other	3,847		1,218		4,660		2,962
Total segment operating income	$	25,630	$	15,957	$	47,490	$	31,643
Other items not allocated to segments:






Selling, general and administrative expense	$	29,943	$	26,907	$	58,155	$	52,283
Non-segment depreciation and amortization	303		261		464		482
Total consolidated operating loss	$	(4,616)	$	(11,211)	$	(11,129)	$	(21,122)
Interest expense, net	1,859		1,870		3,793		7,440
Change in fair value of derivative warrant liabilities	(6)		53		(174)		96
Change in fair value of conversion option derivative liabilities	3,243		3,987		(1,753)		7,296


(in thousands)	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Other, net	77		19		(714)		771

Consolidated loss before provision for income taxes	$	(9,789)	$	(17,140)	$	(12,281)	$	(36,725)


(in thousands)	June 30, 2026		December 31, 2025
Assets
Capitated accounts receivable	$	1,937	$	3,213
FFS accounts receivable	29,385		35,376
IV drug inventory	8,984		8,079
Other assets	21,159		27,989
Patient services	61,465		74,657

Oral drug accounts receivable	18,564		7,457
Oral drug inventory	11,027		8,796
Other assets	9,493		431
Specialty pharmacy	39,084		16,684

Clinical trials & other	4,974		5,436
Non-segment assets	72,710		67,879
Total assets	$	178,233	$	164,656

The Company’s chief operating decision maker "or CODM" is the Chief Executive Officer. The CODM uses segment operating income 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 on a monthly basis when making decisions about allocating capital and personnel to the segments. The CODM also uses segment operating income for evaluating drug pricing to assess each segment’s performance by comparing the results and return on assets of each segment with one another and in the compensation of specific employees.

(A) Direct costs - patient services primarily includes chemotherapy drug costs, clinician salaries and benefits, and medical supplies. Clinicians include oncologists, advanced practice providers such as physician assistants and nurse practitioners, and registered nurses employed by the Starling PCs. These costs are regularly provided to the CODM to evaluate IV drug costs and clinician performance.

(B) Direct costs - specialty pharmacy primarily includes the cost of oral medications dispensed in the Starling PCs’ clinic locations. The CODM regularly reviews these costs evaluate drug margins, compression, and to evaluate suppliers.

(C) Direct costs - clinical trials & other primarily includes costs related to clinical trial contracts and medical supplies.

- Definition

The entire disclosure for segment reporting.

+ References

Reference 1: 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 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-42

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 34
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-34

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (ee)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 31
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-31

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 26C
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-26C

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
-Paragraph 26B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-26B

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

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

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-41

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-21

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-21

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
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+ Details

Subsequent events	6 Months Ended
Subsequent events	Jun. 30, 2026
Subsequent Events [Abstract]
Subsequent events	Subsequent events On July 1, 2026, the Company entered into a Credit Agreement (the “Term Loan Agreement”), by and among the Company, the lenders from time to time party thereto, and Orbimed Opportunities (CA) V LLC, as the initial lender and administrative agent. The Term Loan Agreement provides for a term loan facility in an aggregate principal amount of $75 million, which was drawn in full on the date of entry into the Term Loan Agreement (the “Closing Date”). Loans under the Term Loan Agreement bear interest at a monthly rate equal to the higher of (i) the forward-looking one-month term rate based on the secured overnight financing rate on the day that is two business days prior to the first day of any month and (ii) 3.00% plus, in either case, the 5.75%. Loans under the Term Loan Agreement will mature on the first to occur of (i) July 1, 2031, and (ii) the date of acceleration of such loans upon the occurrence and during the continuance of an event of default. The Term Loan Agreement contains certain customary default provisions, representations and warranties and affirmative and negative covenants, including (a) limitations on the ability to engage in unrelated lines of business; (b) limitations on the incurrence of additional indebtedness and liens; (c) limitations on investments; (d) limitations on the payment of dividends and certain other restricted payments; (e) limitations on the ability to effect mergers and consolidations; (f) limitations on the ability to sell or dispose of property or assets; (g) limitations on modifications of certain agreements; (h) limitations on the ability to enter into transactions with affiliates; (i) limitations on sale leaseback transactions; (j) limitations on benefits plans and agreements; and (k) a minimum net revenue requirement of at least $700 million for each most recently ended period of twelve consecutive months, commencing with the month ending December 31, 2027, and for each month thereafter. All indebtedness outstanding under the Term Loan Agreement is guaranteed by certain of the Company’s direct and indirect subsidiaries (the “Guarantors”). The indebtedness under the Term Loan Agreement is secured by a first-priority security interest in and lien on substantially all assets of the Company and the Guarantors pursuant to that certain Pledge and Security Agreement dated as of July 1, 2026 (the “Security Agreement”). Beginning with the first fiscal quarter ending after the 36-month anniversary of the Closing Date, the loans under the Term Loan Agreement will amortize in quarterly installments equal to 7.5% of the outstanding principal amount as of such date, together with a repayment premium and exit fee. The Company may elect to prepay loans under the Term Loan Agreement, in whole or in part, subject to a repayment premium and an exit fee. Additionally, loans under the Term Loan Agreement are subject to certain mandatory prepayment events, including by amounts equal to certain proceeds received by the Company from insurance recoveries related to casualty events and dispositions. On the Closing Date, the Company used the proceeds from the loans under the Term Loan Agreement, together with cash on hand, to repay in full the Company’s 4% senior secured convertible notes due 2027 (the “2027 Convertible Notes”), of which, as of July 1, 2026, there was approx. $86 million aggregate principal amount outstanding. As a part of the repayment of the 2027 Convertible Notes, the Company issued warrant agreements to purchase shares of common stock of the Company to Deerfield Partners, L.P. and its affiliates, with an expiration date of August 9, 2027 and an initial exercise price of $8.567 per share. The total number of shares of common stock underlying the Warrants is 10,025,535 shares. No additional consideration was paid to the Company by the warrant holders for the issuance of the Warrants.

Leases - Summary of Weighted Average Discount Rates (Details)	Jun. 30, 2026	Jun. 30, 2025
Weighted-average remaining lease term (in years)
Operating	3 years 10 months 13 days	4 years 4 months 6 days
Finance	1 year 2 months 15 days	2 years 2 months 15 days
Weighted-average discount rate
Operating	6.90%	6.70%
Finance	6.73%	6.71%

Debt - Additional Information (Details) $ / shares in Units, $ in Thousands				3 Months Ended			6 Months Ended
	Jul. 01, 2026 USD ($)	Mar. 24, 2025 USD ($) shares	Aug. 09, 2022 USD ($) $ / shares shares	Jun. 30, 2026 USD ($) shares	Jun. 30, 2025 USD ($)	Mar. 31, 2025 USD ($)	Jun. 30, 2026 USD ($) shares	Jun. 30, 2025 USD ($)	Dec. 31, 2025 USD ($) shares	Feb. 26, 2025 USD ($) offering
Debt Instrument [Line Items]
Number of equity offerings \| offering										2
Repayments of long-term debt							$ 0	$ 20,000
Exchange agreement warrants acquired in agreement (in shares) \| shares		37,232.83
Amortization of debt issuance costs and debt discount							2,467	6,003
Level 2
Debt Instrument [Line Items]
Debt instrument, estimated fair value				$ 85,889			$ 85,889		$ 73,991
Common Warrants
Debt Instrument [Line Items]
Number of warrants outstanding (in shares) \| shares				8,216,918			8,216,918
Private Placement
Debt Instrument [Line Items]
Gain (loss) on extinguishment of debt						$ (600)
Exchange agreement, principal amount of debt exchanged for securities (in shares)		$ 4,100
Exchange Agreement, units without warrants
Debt Instrument [Line Items]
Exchange agreement warrants acquired in agreement (in shares) \| shares		3,723,283
Exchange Agreement, units without warrants \| Common Warrants
Debt Instrument [Line Items]
Number of securities called by warrants or rights (in shares) \| shares		7,446,562
Exchange Agreement, units without warrants \| Certain convertible debt lenders \| Common Warrants
Debt Instrument [Line Items]
Number of securities called by warrants or rights (in shares) \| shares		1,861,642
Convertible Notes
Debt Instrument [Line Items]
Amortization period of debt discount (in years)			5 years
Remaining amortization period of debt discount (in years)			1 year 1 month 6 days
Facility Agreement
Debt Instrument [Line Items]
Debt issuance costs			$ 4,924
Facility Agreement \| Convertible Notes
Debt Instrument [Line Items]
Debt instrument, face amount			$ 110,000
Interest rate (as a percent)			4.00%
Minimum net quarterly revenues			$ 100,000
Minimum unrestricted cash and cash equivalent balance										$ 40
Repayments of long-term debt							$ 20,000
Gain (loss) on extinguishment of debt						$ (2,900)
Debt instrument, convertible, conversion price (in dollars per share) \| $ / shares			$ 8.567
Conversion cap (in shares) \| shares			14,663,019
Conversion of stock, shares issued (in shares) \| shares							0
Number of warrants outstanding (in shares) \| shares				0			0		0
Proceeds from secured lines of credit			$ 110,000
Long-term debt				$ 79,867			$ 79,867		$ 77,400
Debt issuance costs			$ 3,663	$ 796			796		1,123
Amortization period of debt issuance cost (in years)			5 years
Effective yield (as a percent)				10.64%	10.64%
Amortization of debt issuance costs and debt discount				$ 1,256	$ 1,129		2,467	6,003
Interest accrued				868	863		1,727	1,878
Accrued interest				$ 868	$ 868		$ 868	$ 868	$ 878
Facility Agreement \| Convertible Notes \| Subsequent event
Debt Instrument [Line Items]
Repayment of debt	$ 86,000
Facility Agreement \| Convertible Note Warrant
Debt Instrument [Line Items]
Long-term debt			$ 0
Debt issuance costs			0
Facility Agreement \| Optional Redemption
Debt Instrument [Line Items]
Long-term debt			0
Debt issuance costs			0
Facility Agreement \| Embedded Conversion Option Feature
Debt Instrument [Line Items]
Long-term debt			28,160
Debt issuance costs			$ 1,261

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

COVER - shares	6 Months Ended
COVER - shares	Jun. 30, 2026	Jul. 30, 2026
Document Information [Line Items]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2026
Document Transition Report	false
Entity File Number	001-39248
Entity Registrant Name	Starling Oncology, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	84-3562323
Entity Address, Address Line One	18000 Studebaker Road, Suite 800
Entity Address, City or Town	Cerritos
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	90703
City Area Code	562
Local Phone Number	735-3226
Entity Information, Former Legal or Registered Name	The Oncology Institute, Inc.
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		101,916,115
Entity Central Index Key	0001799191
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2026
Document Fiscal Period Focus	Q2
Amendment Flag	false
Common Stock
Document Information [Line Items]
Title of 12(b) Security	Common Stock, $0.0001 par value per share
Trading Symbol	STLN
Security Exchange Name	NASDAQ
Warrant
Document Information [Line Items]
Title of 12(b) Security	Redeemable warrants, each whole warrant exercisable for one share of Common stock, each at an exercise price of $11.50 per share
Trading Symbol	TOIIW
Security Exchange Name	NASDAQ

Stockholders' Equity (Deficit)	6 Months Ended
Stockholders' Equity (Deficit)	Jun. 30, 2026
Stockholders' Equity Note [Abstract]
Stockholders' Equity (Deficit)	Stockholders' Equity (Deficit) Common Stock As of June 30, 2026, there were 102,202,753 shares issued and 100,468,979 shares outstanding of common stock. As of December 31, 2025, there were 100,596,918 shares issued and 98,863,144 shares outstanding of common stock. Voting The holders of the Company’s common stock are entitled to one vote for each share of common stock held at all meetings of stockholders (and written actions in lieu of meetings), and there is no cumulative voting. Dividends Common stockholders are entitled to receive dividends whenever funds are legally available and when declared by the board of directors. No dividends have been declared as of June 30, 2026 and December 31, 2025. Preferred Stock Pursuant to the terms of the Amended and Restated Certificate of Incorporation, the Company authorized 10,000,000 shares of Series A Common Equivalent Preferred Stock (“Series A preferred stock”) with a par value and liquidation preference of $0.0001 per share. The Company’s board of directors has the authority, without further action by the stockholders to issue such shares of preferred stock in one or more series, to establish, from time to time the number of shares to be included in each such series, and to fix the dividend, voting, and other rights, preferences, and privileges of the shares. As of June 30, 2026 and December 31, 2025, there were 193,507 shares of preferred stock outstanding. Conversion Each share of Series A preferred stock is convertible, at any time on the part of the holder except with respect to the Beneficial Ownership Limitation (defined below), into 100 shares of common stock. Blocker/Beneficial Ownership Limitation The Series A preferred stock is subject to a beneficial ownership limitation such that the preferred stock may not, at any time, be convertible into more than 4.9% of the total number of shares of common stock outstanding (“Beneficial Ownership Limitation”). Voting The holders of preferred stock do not have voting rights in the Company. Dividends The holders of preferred stock are entitled to receive dividends on an as-converted basis whenever funds are legally available and when declared by the board of directors. No dividends have been declared as of June 30, 2026. Assumed Public Warrants and Private Placement Warrants from the Business Combination As a result of the Business Combination, holders of the public warrants and private placement warrants are entitled to acquire common stock of the Company. The warrants became exercisable on December 12, 2021, 30 days after the completion of the Business Combination, and will expire five years after the completion of the Business Combination or earlier upon redemption or liquidation. As of June 30, 2026, there are 5,749,986 public warrants outstanding and 2,187,283 private placement warrants outstanding from the Business Combination. Each warrant entitles the holder to purchase one share of common stock for $11.50 per share. Private warrants held by the initial purchaser or certain permitted transferees may be exercised on a cashless basis. If the reported last sale price of the common stock equals or exceeds $18.00 per share for any 20 trading days within a 30-trading day period ending three business days before the Company sends the notice of redemption to the warrant holders, the Company may redeem all the public warrants at a price of $0.01 per warrant upon not less than 30 days’ prior written notice. If the Company calls the public warrants for redemption, management will have the option to require all holders that wish to exercise the public warrants to do so on a cashless basis. The Company will not be required to net cash settle the warrants. The private warrants from the Business Combination are exercisable on a cashless basis and are non-redeemable so long as they are held by the initial purchasers or their permitted transferees. If the private warrants from the Business Combination are held by someone other than the initial purchasers or their permitted transferees, such private warrants will be redeemable by the Company and exercisable by such holders on the same basis as the public warrants. Private Placement Offering and Exchange Agreement On March 24, 2025, the Company entered into a securities purchase agreement (the “Securities Purchase Agreement”) with accredited investors for a private placement that resulted in gross proceeds of approximately $16,500 before deducting placement agent fees and offering expenses (the “PIPE”). Pursuant to the terms of the Securities Purchase Agreement, the Company issued to purchasers in the PIPE units consisting of two shares of common stock (or pre-funded warrants in lieu thereof) and common warrants to purchase one share of common stock (or pre-funded warrants) of the Company at a price of $2.2084 per unit (or $2.2082 in the case of units consisting of prefunded warrants). As a result of the PIPE the Company issued an aggregate of: (i) 12,006,510 shares of the Company’s common stock, par value $0.0001 per share (the “Common Stock”), (ii) pre-funded warrants (the “pre-funded Warrants”) to purchase up to an aggregate of 2,886,614 shares of common stock and (iii) accompanying common warrants (the “Common Warrants,”) to purchase up to an aggregate of 7,446,562 shares of common stock (collectively, the “PIPE”). In connection with the PIPE, certain Lenders under the Company’s Facility Agreement exercised their Participation Rights and entered into an exchange agreement pursuant to which such Lenders agreed to exchange approximately $4,100 aggregate principal amount of the Company’s senior secured convertible notes for 37,232.83 shares of common-equivalent preferred stock (convertible into 3,723,283 shares of common stock) and Common Warrants to purchase 1,861,642 shares of common stock. The exercise price and terms of these Common Warrants mirror the terms of the Common Warrants offered to investors in the PIPE. The pre-funded Warrants have an exercise price of $0.0001 per share, and the Common Warrants have an exercise price of $1.1980 per share. The pre-funded Warrants and Common Warrants are subject to customary anti-dilution adjustments following certain events. The pre-funded Warrants and Common Warrants are exercisable at any time by the holder on a cash or cashless basis until the respective warrants are registered, provided that the holder may not exercise the warrants if the holder would own more than 4.9% of the Company immediately following the exercise. The warrants are equity classified in accordance with ASC 815-40. As of June 30, 2026, all of the Exchange Warrants (Common Warrants) related to the lender and pre-funded Warrants issued were still outstanding. As of June 30, 2026, there were 8,216,918 Common Warrants outstanding. At-The-Market Share Issuances During the year ended December 31, 2025, the Company sold 2.8 million shares of its Common Stock through its sales agent, B. Riley Securities. The Company generated approximately $9.6 million in aggregate gross proceeds from sales under the “at-the-market” offering program and paid fees to the sales agent of approximately $384 thousand. During the year ended December 31, 2025, the Company sold 1.4 million shares of its Common Stock, through its sales agent, BTIG. The Company generated approximately $4.8 million in aggregate gross proceeds from sales under the “at-the-market” offering program and paid fees to the sales agent of approximately $192 thousand.

- Definition

The entire disclosure for equity.

+ References

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-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480237/815-40-50-6

Reference 31: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 32: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 33: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 34: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 35: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 16
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-16

+ Details

Goodwill and Intangible Assets - Summary of Intangible Assets, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Intangible Asset, Finite-Lived, after Accumulated Amortization [Abstract]
Gross carrying amount	$ 29,693	$ 29,767
Accumulated amortization	(20,108)	(18,752)
Net carrying amount	$ 9,585	$ 11,015
Payor contracts
Intangible Asset, Finite-Lived [Line Items]
Weighted average amortization period	13 years	13 years
Intangible Asset, Finite-Lived, after Accumulated Amortization [Abstract]
Gross carrying amount	$ 22,191	$ 22,191
Accumulated amortization	(15,115)	(14,095)
Net carrying amount	$ 7,076	$ 8,096
Trade names
Intangible Asset, Finite-Lived [Line Items]
Weighted average amortization period	10 years	10 years
Intangible Asset, Finite-Lived, after Accumulated Amortization [Abstract]
Gross carrying amount	$ 6,650	$ 6,650
Accumulated amortization	(4,227)	(3,900)
Net carrying amount	$ 2,423	$ 2,750
Noncompete agreements
Intangible Asset, Finite-Lived [Line Items]
Weighted average amortization period	8 years
Intangible Asset, Finite-Lived, after Accumulated Amortization [Abstract]
Gross carrying amount	$ 852
Accumulated amortization	(766)
Net carrying amount	$ 86
Clinical contracts and noncompete agreements
Intangible Asset, Finite-Lived [Line Items]
Weighted average amortization period		8 years
Intangible Asset, Finite-Lived, after Accumulated Amortization [Abstract]
Gross carrying amount		$ 926
Accumulated amortization		(757)
Net carrying amount		$ 169

Variable Interest Entities (Tables)

6 Months Ended

Jun. 30, 2026

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Summary of Consolidated Financial Statements of VIEs

The condensed consolidated financial statements include the accounts of Starling and its subsidiaries and VIEs. All inter-company profits, transactions, and balances have been eliminated upon consolidation.


(in thousands)	June 30, 2026		December 31, 2025
Assets
Current assets:
Cash	$	14,667	$	4,133
Accounts receivable, net	66,311		59,103
Other receivables	—		268
Inventories	20,006		16,874
Prepaid expenses and other current assets	541		790
Total current assets	101,525		81,168
Property and equipment, net	12		29
Other assets	605		554
Intangible assets, net	4,066		4,376
Goodwill	2,679		2,679
Total assets	$	108,887	$	88,806
Liabilities
Current liabilities:
Accounts payable	$	58,951	$	40,864

Accrued expenses and other current liabilities	23,406		14,546

Amounts due to affiliates	263,814		254,396
Total current liabilities	346,171		309,806
Other non-current liabilities	25		—

Total liabilities	$	346,196	$	309,806

- 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

Goodwill and Intangible Assets - Summary of Estimated Aggregate Amortization Expense (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Year ending December 31:
2026 (remaining six months)	$ 1,409
2027	2,713
2028	2,615
2029	453
2030	453
Thereafter	1,942
Net carrying amount	$ 9,585	$ 11,015

Commitments and Contingencies	6 Months Ended
Commitments and Contingencies	Jun. 30, 2026
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies The Company evaluates contingencies based upon available evidence. In addition, allowances for losses are provided each year for disputed items which have continuing significance. The Company believes that allowances for losses have been provided to the extent necessary, and that its assessment of contingencies is reasonable. Due to the inherent uncertainties and subjectivity involved in accounting for contingencies, there is at least a reasonable possibility that recorded estimates will change by a material amount in the near term. To the extent that the resolution of contingencies results in amounts which vary from management’s estimates, future operating results will be charged or credited. The principal commitments and contingencies are described below. Legal Matters The Company is subject to certain outside claims and litigation arising in the ordinary course of business. In the opinion of management, the outcome of such matters is not expected to have a material effect on the Company’s condensed consolidated financial statements. Loss contingencies entail uncertainty and a possibility of loss to an entity. If the loss is probable and the amount of loss can be reasonably estimated, the loss is accrued according to ASC No. 450-20, Disclosure of Certain Loss Contingencies. Indemnities The Company’s Amended and Restated Certificate of Incorporation and amended and restated bylaws require it, among other things, to indemnify any director or officer against specified expenses and liabilities, such as attorneys’ fees, judgments, fines, and settlements, paid by the individual in connection with any action, suit, or proceeding arising out of the individual’s status or service as its director or officer, other than liabilities arising from willful misconduct or conduct that is knowingly fraudulent or deliberately dishonest, and to advance expenses incurred by the individual in connection with any proceeding against the individual with respect to which the individual may be entitled to indemnification by the Company. The Company also indemnifies its lessors in connection with its facility leases for certain claims arising from the use of the facilities. These indemnities do not provide for any limitation on the maximum potential future payments it could be obligated to make. The Health Insurance Portability and Accountability Act The Health Insurance Portability and Accountability Act (“HIPAA”) assures health insurance portability, reduces healthcare fraud and abuse, guarantees security and privacy of health information, and enforces standards for health information. The Health Information Technology for Economic and Clinical Health Act (“HITECH”) imposes notification requirements in the event of certain security breaches relating to protected health information. Organizations are subject to significant fines and penalties if found not to be compliant with the provisions outlined in these regulations. The Company believes it is in compliance with these laws. Regulatory Matters Laws and regulations governing the Medicare program and healthcare generally, are complex and subject to interpretation. The Company believes that it is in compliance with all applicable laws and regulations and is not aware of any pending or threatened investigations involving allegations of potential wrongdoing. While no regulatory inquiries have been made, compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusion from the Medicare and Medi-Cal programs. Many of the Company’s payor and provider contracts are complex in nature and may be subject to differing interpretations regarding amounts due for the provision of medical services. Such differing interpretations may not come to light until a substantial period of time has passed following contract implementation. Liabilities for claims disputes are recorded when the loss is probable and can be estimated. Any adjustments to reserves are reflected in current operations. The Company does not have any reserves for regulatory matters as of June 30, 2026 and December 31, 2025. Liability Insurance The Company believes that its insurance coverage is appropriate based upon the Company’s claims experience and the nature and risks of the Company’s business. In addition to the known incidents that have resulted in the assertion of claims, the Company cannot be certain that its insurance coverage will be adequate to cover liabilities, arising out of claims asserted against the Company or the Company’s affiliated professional organizations, in the future where the outcomes of such claims are unfavorable. The Company believes that the ultimate resolution of all pending claims, including liabilities in excess of the Company’s insurance coverage, will not have a material adverse effect on the Company’s financial position, results of operations or cash flows; however, there can be no assurance that future claims will not have such a material adverse effect on the Company’s business. Contracted physicians are required to obtain their own insurance coverage. Guarantees The Company, along with certain of the Company's subsidiaries which are parties to the Facility Agreement (“Guarantors”), have pledged a first priority perfected lien on substantially all of their respective personal and real property, as collateral security for the payment of outstanding obligations, under the Facility Agreement.

Variable Interest Entities

6 Months Ended

Jun. 30, 2026

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Variable Interest Entities

The Company prepares its condensed consolidated financial statements in accordance with Accounting Standards Codification Topic No. 810, Consolidations (“ASC 810”), which provides for the consolidation of VIEs of which an entity is the primary beneficiary.

Pursuant to the MSAs established with the Starling PCs, one of the Company's wholly owned subsidiaries [Starling Management LLC ("Starling Management')], is entitled to receive a management fee, which represents a variable interest in and the right to receive the benefits of the Starling PCs. Through the terms of the MSAs, Starling Management receives the right to direct the most significant activities of the Starling PCs. Therefore, the Starling PCs are variable interest entities and Starling Management is the primary beneficiary that consolidates the Starling PCs, and their subsidiaries.


(in thousands)	June 30, 2026		December 31, 2025
Assets
Current assets:
Cash	$	14,667	$	4,133
Accounts receivable, net	66,311		59,103
Other receivables	—		268
Inventories	20,006		16,874
Prepaid expenses and other current assets	541		790
Total current assets	101,525		81,168
Property and equipment, net	12		29
Other assets	605		554
Intangible assets, net	4,066		4,376
Goodwill	2,679		2,679
Total assets	$	108,887	$	88,806
Liabilities
Current liabilities:
Accounts payable	$	58,951	$	40,864

Accrued expenses and other current liabilities	23,406		14,546

Amounts due to affiliates	263,814		254,396
Total current liabilities	346,171		309,806
Other non-current liabilities	25		—

Total liabilities	$	346,196	$	309,806

Single physician holders, who are officers of the Company, retain equity ownership in Starling CA, Starling FL, Starling TX, and Starling OR, which represents nominal noncontrolling interests. However, the noncontrolling interests do not participate in the profit or loss of Starling CA, Starling FL, Starling TX, and Starling OR.

Share-Based Compensation

6 Months Ended

Jun. 30, 2026

Share-Based Payment Arrangement [Abstract]

Share-Based Compensation

Non-Qualified Stock Option Plan

On January 2, 2019, the Company adopted the 2019 Non-Qualified Stock Option Plan (the “2019 Plan”) to incentivize directors, consultants, advisors, and other key employees of the Company and its subsidiaries to continue their association by providing opportunities to participate in the ownership and further growth of the Company. The 2019 Plan provides for the grant of options (the “Stock Options”) to purchase shares of common stock of the Company. In conjunction with the Business Combination, the Company amended and fully restated the 2019 Plan through the establishment of the 2021 Incentive Plan (“2021 Plan”).

Stock Options are granted from the pool of shares designated by the appropriate committee of the Board of Directors. The grant-date fair value of each option award is estimated on the date of grant using the Black-Scholes-Merton option-pricing model. The grant date fair value of the service vesting and the performance vesting options is recognized as an expense over the requisite service period and upon the achievement of the performance condition deemed probable of being achieved, respectively. The exercise price of each Stock Option shall be determined by the committee and may not be less than the fair market value of the shares of common stock on the date of grant. Stock Options have 10-year terms, after which they expire and are no longer exercisable.

The total number of shares of common stock for which Stock Options may be granted under the 2021 Plan shall not exceed 15,640,000.

Stock Options become vested upon fulfillment of either service vesting conditions, performance vesting conditions, or both, as determined by the award agreement entered into by the Company and optionee. The service vesting requirement states that: (i) 25% of the service vesting options shall vest on the first anniversary of the grant date and (ii) the remaining 75% shall vest on an equal monthly-basis, so long as the optionee has remained continuously employed by the Company from the date of the award through the fourth anniversary of the grant date. The performance vesting requirement states that Stock Options shall vest upon sale of the Company only if the optionee has been continuously employed by the Company or its subsidiaries from

the grant date through the date of such sale of the Company. For the awards vesting based on service conditions only and that have a graded vesting schedule, the Company recognizes compensation expense for vested awards in earnings, net of actual forfeitures in the period they occur, on a straight-line basis over the requisite service period.

As of June 30, 2026, the total number of shares of common stock remaining available for future awards (e.g., non-qualified stock options, incentive stock options, restricted stock units, restricted stock awards) under the 2021 Plan is 9,808,797. There were no Stock Options granted for the three months ended June 30, 2026 and 2025.

Stock option activity during the six months ended June 30, 2026 and 2025 is as follows:


Stock options	Number of shares	Weighted average exercise price		Weighted average remaining contractual term (years)	Aggregate intrinsic value (in thousands)
Balance at January 1, 2026	4,022,196	$	2.23
Granted	—	—
Exercised	(96,137)	1.16
Forfeited	—	—
Expired	(67,084)	1.02
Balance at June 30, 2026	3,858,975	$	2.28	5.52	$	13,386
Vested Options Exercisable at June 30, 2026	3,254,855	$	2.34	5.19	$	11,222


Stock options	Number of shares	Weighted average exercise price		Weighted average remaining contractual term (years)	Aggregate intrinsic value (in thousands)
Balance at January 1, 2025	7,488,859	$	1.67
Granted	—	—
Exercised	(2,645,017)	0.89
Forfeited	(285,112)	1.83
Expired	(77,469)	2.58
Balance at June 30, 2025	4,481,261	$	2.11	6.16	$	3,351
Vested Options Exercisable at June 30, 2025	3,374,192	$	2.10	5.50	$	2,898

Total share-based compensation expense related to stock options during the three and six months ended June 30, 2026 was $59 and $117, respectively. Total share-based compensation expense related to stock options during the three and six months ended June 30, 2025 was $107 and $213, respectively. The total intrinsic value of options exercised during three and six months ended June 30, 2026 was $93 and $429, respectively. The total intrinsic value of options exercised during three and six months ended June 30, 2025 was $7,100 and $7,277, respectively.

At June 30, 2026, there was $229 of total unrecognized compensation cost related to unvested service stock options granted under the 2021 Plan that are expected to vest. That cost is expected to be recognized over a weighted average period of 1.38 years as of June 30, 2026. During the six months ended June 30, 2026, the Company received $111 in cash and $318 tax benefit from the stock options exercised. The total fair value of shares of common stock vested during the six months ended June 30, 2026 and 2025 was $1,682 and $791, respectively.

Restricted Stock Units (“RSUs”)

The Company has 4,219,428 and 3,436,019 RSUs outstanding as of June 30, 2026 and December 31, 2025, respectively. The RSUs are service-based vesting awards and are valued based on the fair value of the Company’s common stock at the date of grant. The weighted-average grant date fair values of the RSUs granted during six months ended June 30, 2026 and 2025, were determined to be $3.01 and $1.19, respectively, based on the fair value of the Company’s common stock at the grant date.

A summary of the activity for the RSUs for the six months ended June 30, 2026 and 2025, respectively, are shown in the following table:


	Six Months Ended June 30,
	2026			2025
	Number of Shares	Weighted Average Grant Date Fair Value		Number of Shares	Weighted Average Grant Date Fair Value
Unvested at beginning of year	3,436,019	$	1.25	1,509,737	$	0.94
Granted	2,401,435	3.01		3,935,704	1.19
Vested	(1,441,843)	1.93		(1,700,884)	0.93
Forfeited	(176,183)	2.12		(387,710)	1.00
Unvested at end of year	4,219,428	$	1.98	3,356,847	$	1.23

The total share-based compensation expense related to RSUs was $1,011 and $1,568, respectively, during the three and six months ended June 30, 2026. The total share-based compensation expense related to RSUs was $644 and $860, respectively, during the three and six months ended June 30, 2025.

As of June 30, 2026, there was $7,691 of unrecognized compensation expense related to the RSUs that are expected to vest. That cost is expected to be recognized over a weighted average period of 3.43 years as of June 30, 2026.

RSUs granted to Medical Employees and Nonemployees

In 2022, the Company entered into arrangements with certain medical directors and supervisors of advanced practice providers employed by or engaged as independent contractors of the Company to grant RSUs of the Company (“Medical RSUs”). Granting of each annual Medical RSU award by the Company is dependent on the participant performing a specified minimum number of service hours during the calendar year (“One-Year Term”) and further contingent upon the participant’s continued service to, or employment by, the Company through the grant date. The Company’s regular grant date for these Medical RSU awards is in the first quarter of the calendar year following the One-Year Term. During the six months ended June 30, 2026 and 2025, 332,803 and 997,806 Medical RSU awards were granted, respectively.

The number of Medical RSUs granted to each such participant is determined by the fair market value of the Company's stock price at the grant date and are vested at the grant date. There were no unvested Medical RSU awards outstanding as of June 30, 2026 or 2025.

A summary of the activity for the equity-classified Medical RSUs for the six months ended June 30, 2026 and 2025, respectively, is shown in the following table:


	Six Months Ended June 30,
	2026	2025
Balance at beginning of period	—	—
Granted	332,803	997,806
Vested	(332,803)	(997,806)
Forfeited	—	—
Balance at end of period	—	—

Total compensation costs for Medical RSUs was $0 and $1,032 for the three and six months ended June 30, 2026, respectively. Total compensation costs for Medical RSUs was $0 and $1,137 for the three and six months ended June 30, 2025, respectively. As of June 30, 2026, all Medical RSUs had vested.

Employee Stock Purchase Plan (ESPP)

In connection with the Business Combination, the Company adopted the 2021 Employee Stock Purchase Plan ("2021 ESPP”). The 2021 ESPP has reserved 3,591,088 shares of the Company’s common stock for issuance to eligible employees, who are entitled to purchase shares of common stock equal to 85% of the lower of the closing price on the purchase date or the six month closing price average during the contribution period through accumulated payroll deductions. During the three and

six months ended June 30, 2026, the Company issued 0 and 84,392 shares of common stock under the ESPP and recognized $0 and $39, respectively, in share-based compensation expense. There was no share-based compensation for the three and six months ended June 30, 2025, related to the ESPP.

Segment Information - Additional Information (Details)	6 Months Ended
Segment Information - Additional Information (Details)	Jun. 30, 2026 segment
Segment Reporting [Abstract]
Number of operating segments	3
Number of reportable segments	3

Marketable Securities and Fair Value Measurements - Summary of Investment Securities Classified as Available-for-sale (Details) - Money Market Fund - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	$ 39,081	$ 27,230
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	39,081	27,230
Debt Securities, Available-for-Sale, Maturity, Allocated and Single Maturity Date, Amortized Cost [Abstract]
Due in One Year or Less	39,081	27,230
Due After One Year through Five Years	0	0
Due After Five Years	0	0
Total	$ 39,081	$ 27,230

Revenue - Summary of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Disaggregation of Revenue [Line Items]
Total operating revenue	$ 161,282	$ 119,802	$ 308,723	$ 224,208
Patient services
Disaggregation of Revenue [Line Items]
Total operating revenue	58,827	55,891	117,914	108,959
Capitated revenue
Disaggregation of Revenue [Line Items]
Total operating revenue	27,974	18,843	54,905	36,338
FFS revenue
Disaggregation of Revenue [Line Items]
Total operating revenue	30,853	37,048	63,009	72,621
Specialty pharmacy revenue
Disaggregation of Revenue [Line Items]
Total operating revenue	98,608	62,573	186,149	111,866
Clinical research trials and other revenue
Disaggregation of Revenue [Line Items]
Total operating revenue	$ 3,847	$ 1,338	$ 4,660	$ 3,383

- 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
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-7

Reference 2: 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 3: http://www.xbrl.org/2003/role/exampleRef
-Topic 606
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-Name Accounting Standards Codification
-Section 55
-Paragraph 91
-Subparagraph (a)
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Reference 4: http://www.xbrl.org/2003/role/exampleRef
-Topic 606
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Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 606
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Reference 6: http://www.xbrl.org/2003/role/exampleRef
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Reference 7: http://www.xbrl.org/2003/role/exampleRef
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Reference 8: http://www.xbrl.org/2003/role/exampleRef
-Topic 606
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Reference 9: http://www.xbrl.org/2003/role/exampleRef
-Topic 606
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-Section 55
-Paragraph 91
-Subparagraph (g)
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-URI https://asc.fasb.org/1943274/2147479777/606-10-55-91

+ 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

+ Details

Significant Risks and Uncertainties Including Business and Credit Concentrations - Summary of Revenue Concentration Risk (Details) - Customer concentration	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025	Dec. 31, 2025
Payor A \| Percentage of Net Revenue
Significant Risks and Uncertainties Including Business and Credit Concentrations
Concentration risk percentage	12.00%	13.00%	12.00%	14.00%
Payor C \| Percentage of Net Revenue
Significant Risks and Uncertainties Including Business and Credit Concentrations
Concentration risk percentage	13.00%		11.00%
Payor B \| Accounts Receivable
Significant Risks and Uncertainties Including Business and Credit Concentrations
Concentration risk percentage			10.00%		10.00%

- 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

- Definition

+ References + Details

Significant Risks and Uncertainties Including Business and Credit Concentrations (Tables)

6 Months Ended

Jun. 30, 2026

Risks and Uncertainties [Abstract]

Summary of Concentration Risk

The concentration of net revenue on a percentage basis for major payors for the three and six months ended June 30, 2026 and 2025 are as follows:


	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Percentage of Patient Services Net Revenue:
Payor A	12	%	13	%	12	%	14	%
Payor C	13	%	N/A		11	%	N/A

The concentration of gross receivables on a percentage basis for major payors at June 30, 2026 and December 31, 2025 are as follows:


	June 30, 2026		December 31, 2025
Percentage of Gross Receivables of Patient Services Revenue:

Payor B	10	%	10	%

The concentration of cost of sales (drug procurement) on a percentage basis for major vendors for the three and six months ended June 30, 2026 and 2025 are as follows:


	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Percentage of Direct Costs:
Vendor A	91	%	100	%	92	%	100	%

The concentration of gross payables on a percentage basis for major payors at June 30, 2026 and December 31, 2025 are as follows:


	June 30, 2026		December 31, 2025
Percentage of Gross Payables:
Vendor A	80	%	77	%
Vendor B	14	%	N/A

Net Loss Per Share (Tables)

6 Months Ended

Jun. 30, 2026

Earnings Per Share [Abstract]

Summary of Basic and Diluted Net Loss Per Share to Common Stockholders

The following table sets forth the computation of the Company's basic and diluted net loss per share to common stockholders for the three and six months ended June 30, 2026 and 2025.


(in thousands, except share data)	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Net loss attributable to Starling	$	(9,789)	$	(17,009)	$	(12,281)	$	(36,594)

Net loss attributable to Starling available for distribution	(9,789)		(17,009)		(12,281)		(36,594)
Net loss attributable to participating securities, basic and diluted	(1,548)		(3,018)		(1,951)		(6,522)
Net loss attributable to common stockholders, basic and diluted	$	(8,241)	$	(13,991)	$	(10,330)	$	(30,072)
Weighted average common shares outstanding, basic and diluted	103,031,493		93,203,665		102,419,949		85,195,734
Net loss income per share attributable to common stockholders, basic and diluted	$	(0.08)	$	(0.15)	$	(0.10)	$	(0.35)

Summary of Computation of Diluted Net Loss Per Share


	Three Months Ended June 30,		Six Months Ended June 30,
	2026	2025	2026	2025
Convertible note	10,838,000	10,842,525	10,838,000	10,842,525
Stock options	3,858,975	4,481,261	3,858,975	4,481,261
RSUs	4,219,428	3,356,847	4,219,428	3,356,847


Public Warrants	5,749,986	5,749,986	5,749,986	5,749,986
Private Warrants	2,187,283	2,187,283	2,187,283	2,187,283
Common Warrants in connection with private placement and exchange agreement	8,216,918	8,628,980	8,216,918	8,628,980

Property and Equipment, Net

6 Months Ended

Jun. 30, 2026

Property, Plant, and Equipment [Abstract]

Property and Equipment, Net

Property and equipment, net, consist of the following:


(in thousands)	Useful lives	June 30, 2026		December 31, 2025
Computers and software	60 months	$	6,317	$	5,106
Office furniture	84 months	813		812
Leasehold improvements	Shorter of lease term or estimated useful life	13,252		12,849
Medical equipment	60 months	2,339		1,497
Construction in progress		556		1,137
Finance lease ROU assets	Shorter of lease term or estimated useful life	170		209
Less: accumulated depreciation		(12,864)		(10,926)
Total property and equipment, net		$	10,583	$	10,684

Depreciation expense for the three months ended June 30, 2026 and 2025 was $1,122 and $1,032, respectively. Depreciation expense for the six months ended June 30, 2026 and 2025 was $2,023 and $2,042, respectively.

- Definition

The entire disclosure for property, plant, and equipment. Includes, but is not limited to, land and land improvement; building; machinery and equipment; furniture and fixture; and work of art, historical treasure, or similar asset classified as collection.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 360
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482099/360-10-50-3

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 360
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-Section 50
-Paragraph 3
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482099/360-10-50-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 360
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-URI https://asc.fasb.org/360/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Section 45
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-URI https://asc.fasb.org/1943274/2147482130/360-10-45-13

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 360
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 5.CC)
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-URI https://asc.fasb.org/1943274/2147480091/360-10-S99-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
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-Topic 958
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-URI https://asc.fasb.org/1943274/2147477798/958-360-50-6

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Section 50
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-SubTopic 360
-Topic 958
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477798/958-360-50-7

+ Details

Accrued Expenses and Other Current Liabilities - Additional Information (Details) $ in Thousands	1 Months Ended
	Nov. 30, 2025 USD ($) installment	Jun. 30, 2026 USD ($)	Dec. 31, 2025 USD ($)
Supplier Finance Program [Line Items]
Financing arrangement	$ 964
Interest rate	7.49%
Number of monthly installments \| installment	11
Accrued insurance reserve		$ 2,158	$ 2,282
Accrued insurance		$ 270	$ 794
Minimum
Supplier Finance Program [Line Items]
Accrued insurance reserve	$ 80
Maximum
Supplier Finance Program [Line Items]
Accrued insurance reserve	$ 90

Revenue (Tables)

6 Months Ended

Jun. 30, 2026

Revenue from Contract with Customer [Abstract]

Summary of Disaggregation of Revenue

The Company categorizes revenue based on various factors such as the nature of contracts, payors, order to billing arrangements, and cash flows received by the Company, as follows:


(in thousands)	Three Months Ended June 30,				Six Months Ended June 30,
	2026		2025		2026		2025
Patient services
Capitated revenue	$	27,974	$	18,843	$	54,905	$	36,338
FFS revenue	30,853		37,048		63,009		72,621
Subtotal	58,827		55,891		117,914		108,959
Specialty pharmacy revenue	98,608		62,573		186,149		111,866
Clinical research trials and other revenue	3,847		1,338		4,660		3,383
Total	$	161,282	$	119,802	$	308,723	$	224,208

Description of the Business (Details) $ in Thousands	6 Months Ended		12 Months Ended
Description of the Business (Details) $ in Thousands	Jun. 30, 2026 USD ($) oncologist clinic state	Jun. 30, 2025 USD ($)	Dec. 31, 2025 USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Loss on sale due to the write-off \| $	$ 0	$ 2,398	$ 2,398
Minimum number of oncologists and mid-level professionals within three states \| oncologist	125
Minimum number of clinic locations within three states \| clinic	65
Number of states in which entity operates \| state	5

Income Taxes	6 Months Ended
Income Taxes	Jun. 30, 2026
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company recorded income tax expense of $0 and $131 for the three months ended June 30, 2026 and 2025, respectively. The Company's effective tax rate was 0% for the three months ended June 30, 2026 and 2025. The Company's effective tax rate for the three months ended June 30, 2026 was different than the U.S. federal statutory tax rate of 21.00%, primarily due to the change in the valuation allowance, partially offset by non-deductible expenses.

- Definition

The entire disclosure for income tax.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 740
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-Section 50
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/740/tableOfContent

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Publisher FASB
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
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-Subparagraph (b)
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482603/740-30-50-2

+ Details

Goodwill and Intangible Assets (Tables)

6 Months Ended

Jun. 30, 2026

Intangible Asset, Goodwill and Other [Abstract]

Summary of Intangible Assets, Net

As of June 30, 2026, the Company’s intangible assets, net consists of the following:


(in thousands)	Weighted average amortization period	Gross carrying amount		Accumulated amortization		Net carrying amount
Intangible assets
Amortizing intangible assets:
Payor contracts	13 years	$	22,191	$	(15,115)	$	7,076
Trade names	10 years	6,650		(4,227)		2,423
Noncompete agreements	8 years	852		(766)		86
Total intangible assets		$	29,693	$	(20,108)	$	9,585

As of December 31, 2025, the Company’s intangible assets, net consists of the following:


(in thousands)	Weighted average amortization period	Gross carrying amount		Accumulated amortization		Net carrying amount
Intangible assets
Amortizing intangible assets:
Payor contracts	13 years	$	22,191	$	(14,095)	$	8,096
Trade names	10 years	6,650		(3,900)		2,750
Clinical contracts and noncompete agreements	8 years	926		(757)		169
Total intangible assets		$	29,767	$	(18,752)	$	11,015

Summary of Estimated Aggregate Amortization Expense

The estimated aggregate amortization expense for each of the five succeeding fiscal years as of June 30, 2026 is as follows:


(in thousands)	Amount
Year ending December 31:
2026 (remaining six months)	$	1,409
2027	2,713
2028	2,615
2029	453
2030	453

Thereafter	1,942
Total	$	9,585

Summary of Goodwill and Changes in the Carrying Amount of Goodwill

The goodwill allocated to each of the reporting units as of June 30, 2026 and December 31, 2025 is as follows:


(in thousands)	June 30, 2026		December 31, 2025
Patient services	$	2,679	$	2,679
Specialty pharmacy	4,551		4,551
Clinical trials & other	—		—
Total goodwill	$	7,230	$	7,230

- Definition

Tabular disclosure of goodwill.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482573/350-20-50-2

Reference 2: http://www.xbrl.org/2003/role/exampleRef
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-Name Accounting Standards Codification
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1A

+ Details

Goodwill and Intangible Assets - Additional Information (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025	Dec. 31, 2025	Jan. 01, 2025
Goodwill [Line Items]
Amortization expense	$ 716,000	$ 773,000	$ 1,431,000	$ 1,547,000
Patient services
Goodwill [Line Items]
Goodwill impairment charges	26,179,000		26,179,000		$ 26,179,000	$ 26,179,000
Clinical trials & other
Goodwill [Line Items]
Goodwill impairment charges	632,000		632,000		632,000
Specialty pharmacy
Goodwill [Line Items]
Goodwill impairment charges	$ 0		$ 0		$ 0	$ 0

- Definition

Amount of amortization expense for finite-lived intangible asset. Excludes goodwill and capitalized cost for software to be sold, leased, or marketed.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section 45
-Paragraph 28
-Subparagraph (b)
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-Topic 230
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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

Marketable Securities and Fair Value Measurements - Additional Information (Details) - USD ($) $ in Thousands	Jun. 30, 2026	Dec. 31, 2025
Fair Value Disclosures [Abstract]
Accrued interest receivable on cash equivalents and marketable securities	$ 82	$ 53
Debt securities, available-for-sale, accrued interest, after allowance for credit loss, current, statement of financial position [Extensible Enumeration]	Other receivables	Other receivables

Accounts Receivable - Additional Information (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025	Dec. 31, 2025	Jan. 01, 2025
Receivables [Abstract]
Service allowance for doubtful accounts	$ 0		$ 0		$ 0
Accounts receivable, remaining amount						$ 48,335,000
Accounts receivable, bad debt recovery	$ 0	$ 0	$ 0	$ 0

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025
Cash flows from operating activities:
Net loss	$ (12,281)	$ (36,594)
Adjustments to reconcile net loss to cash and cash equivalents used in operating activities:
Depreciation and amortization	3,454	3,589
Amortization of debt issuance costs and debt discount	2,467	6,003
Write-off of assets from clinical trials segment	0	2,398
Share-based compensation	2,756	2,210
Change in fair value of liability classified warrants	(174)	96
Change in fair value of liability classified conversion option derivatives	(1,753)	7,296
Deferred taxes	0	(32)
Loss on disposal of property and equipment	28	0
Changes in operating assets and liabilities:
Accounts receivable	(7,351)	(8,969)
Other receivables	(38)	(228)
Inventories	(3,136)	(5,747)
Prepaid expenses and other current assets	1,811	1,250
Other assets	(51)	3
Accounts payable	17,112	11,490
Change in operating leases	(492)	(120)
Accrued expenses and other current liabilities	7,353	2,262
Other non-current liabilities	20	(97)
Net cash and cash equivalents provided by (used in) operating activities	9,725	(15,190)
Cash flows from investing activities:
Purchases of property and equipment	(1,950)	(1,536)
Proceeds from asset disposition	0	126
Net cash and cash equivalents used in investing activities	(1,950)	(1,410)
Cash flows from financing activities:
Proceeds from private placement, net of offering costs	0	15,359
Proceeds from employee stock purchase plan	220	0
Payments made for financing of insurance payments	(560)	(456)
Principal payments on long-term debt	0	(20,000)
Principal payments on financing leases	(17)	(20)
Common stock issued for options exercised	111	2,340
Net cash and cash equivalents used in financing activities	(246)	(2,777)
Net increase (decrease) in cash and cash equivalents	7,529	(19,377)
Cash and cash equivalents at beginning of period	33,565	49,669
Cash and cash equivalents at end of period	41,094	30,292
Supplemental disclosure of noncash investing and financing activities:
Right-of-use assets in connection with operating lease modifications	0	1,253
Principal exchange of convertible note for preferred stock	0	4,111
Purchases of property and equipment included in accounts payable	0	528
Financed insurance premiums	530	540
Cash paid for:
Income taxes	0	0
Interest	$ 1,756	$ 2,158

Segment Information - Summary of Financial Information for the Company's Segments (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2026	Jun. 30, 2025	Jun. 30, 2026	Jun. 30, 2025
Segment Reporting
Consolidated revenue	$ 161,282	$ 119,802	$ 308,723	$ 224,208
Total segment depreciation expense	1,122	1,032	2,023	2,042
Total segment amortization	716	773	1,431	1,547
Selling, general and administrative expense	29,943	26,907	58,155
Non-segment depreciation and amortization	1,838	1,805	3,454	3,589
Loss from operations	(4,616)	(11,211)	(11,129)	(21,122)
Interest expense, net	1,859	1,870	3,793	7,440
Change in fair value of derivative warrant liabilities	(6)	53	(174)	96
Change in fair value of conversion option derivative liabilities	3,243	3,987	(1,753)	7,296
Other, net	77	19	(714)	771
Consolidated loss before provision for income taxes	(9,789)	(17,140)	(12,281)	(36,725)
Operating segments
Segment Reporting
Consolidated revenue	161,282	119,802	308,723	224,208
Total segment direct costs	134,117	102,301	258,243	189,458
Total segment depreciation expense	819	771	1,559	1,560
Total segment amortization	716	773	1,431	1,547
Total segment operating income	25,630	15,957	47,490	31,643
Operating segments \| Intravenous (IV) drug costs
Segment Reporting
Total segment direct costs	28,965	32,800	58,732	64,213
Operating segments \| Clinician salaries and benefits
Segment Reporting
Total segment direct costs	16,431	14,011	31,769	28,085
Operating segments \| Network medical expense
Segment Reporting
Total segment direct costs	9,497	1,783	16,107	1,783
Operating segments \| Medical supplies and other
Segment Reporting
Total segment direct costs	1,878	2,556	3,546	4,149
Items not allocated to segments
Segment Reporting
Selling, general and administrative expense	29,943	26,907	58,155	52,283
Non-segment depreciation and amortization	303	261	464	482
Patient services \| Operating segments
Segment Reporting
Consolidated revenue	58,827	55,891	117,914	108,959
Total segment direct costs	56,771	51,150	110,154	98,230
Total segment depreciation expense	816	767	1,553	1,522
Total segment amortization	716	718	1,431	1,437
Total segment operating income	524	3,256	4,776	7,770
Specialty pharmacy \| Operating segments
Segment Reporting
Consolidated revenue	98,608	62,573	186,149	111,866
Total segment direct costs	77,346	51,086	148,089	90,949
Total segment depreciation expense	3	4	6	6
Total segment operating income	21,259	11,483	38,054	20,911
Clinical trials & other \| Operating segments
Segment Reporting
Consolidated revenue	3,847	1,338	4,660	3,383
Total segment direct costs	0	65	0	279
Total segment depreciation expense	0	0	0	32
Total segment amortization	0	55	0	110
Total segment operating income	$ 3,847	$ 1,218	$ 4,660	$ 2,962

Subsequent events (Details) - USD ($) $ / shares in Units, $ in Thousands	Jul. 01, 2026	Jun. 30, 2026	Dec. 31, 2025	Aug. 09, 2022
Subsequent Event [Line Items]
Aggregate principal amount		$ 85,889
Subsequent event \| Convertible Notes
Subsequent Event [Line Items]
Warrants price per share (in usd per share)	$ 8.567
Number of shares issued in transaction (in shares)	10,025,535
Facility Agreement \| Convertible Notes
Subsequent Event [Line Items]
Aggregate principal amount				$ 110,000
Interest rate (as a percent)				4.00%
Aggregate principal amount		$ 85,889	$ 85,889
Facility Agreement \| Subsequent event \| Convertible Notes
Subsequent Event [Line Items]
Aggregate principal amount	$ 86,000
Term Loan Agreement \| Term Loan Agreement \| Subsequent event \| Line of credit
Subsequent Event [Line Items]
Aggregate principal amount	75,000
Minimum net revenue	$ 700,000
Quarterly amortization rate	7.50%
Term Loan Agreement \| Term Loan Agreement \| Subsequent event \| Line of credit \| Component one
Subsequent Event [Line Items]
Basis spread on variable rate	3.00%
Term Loan Agreement \| Term Loan Agreement \| Subsequent event \| Line of credit \| Component two
Subsequent Event [Line Items]
Basis spread on variable rate	5.75%