Spectral AI, Inc. 10-K

Item 8. Financial Statements and Supplementary Data The financial statements required to be filed pursuant to this Item 8 are appended to this Annual Report on Form 10-K. An index of those financial statements is found in Item 15, Exhibits and Financial Statement Schedules, of this Annual Report on Form 10-K. Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure None. Item 9.A. Controls and Procedures. Evaluation of Disclosure Controls and Procedures Our management, including our Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended (the “Exchange Act”) as of the end of the period covered by this Annual Report on Form 10-K. Based on management’s evaluation as of the year ended December 31, 2024, our Chief Financial Officer has concluded that we successfully remediated the material weaknesses related to (i) our lack of communication within management and internal departments regarding complex and unusual arrangements and (ii) that the Company did not maintain adequately designed controls to ensure the proper recording of operating expenses, related accruals and unbilled revenue in the correct period. However, our remediation and testing continue for the material weakness (iii) that our financial statement close process controls which relate to all financial statement accounts, did not consistently operate effectively or lacked appropriate evidence, to ensure account reconciliations, transactions, and journal entries were performed or reviewed at the appropriate level of precision and on a timely basis. As a result of the material weakness in our internal control over financial reporting as described below and in Part II, Item 1A. Risk Factors, our disclosure controls and procedures were not effective as of December 31, 2024. As a result, certain control activities in our financial statement close process controls which relate to all financial statement accounts, did not consistently operate effectively or lacked appropriate evidence, to ensure account reconciliations, transactions, and journal entries were performed or reviewed at the appropriate level of precision and on a timely basis. This control deficiency could result in a material misstatement of our accounts or disclosures that would not be prevented or detected on a timely basis, and accordingly, we determined that these control deficiencies in aggregate constitute a material weakness. 72 Notwithstanding the identified material weaknesses, our management believes the consolidated financial statements included in this Annual Report on Form 10-K fairly present, in all material respects, our financial condition, results of operations and cash flows as of and for the periods presented in accordance with U.S. GAAP. Remediation Plan for Material Weaknesses Remediation generally requires making changes to how controls are designed and implemented and then adhering to those changes for a sufficient period of time such that the effectiveness of those changes is demonstrated with an appropriate amount of consistency. In response to the material weakness, we implemented, and are continuing to implement, measures designed to improve our internal control over financial reporting. These efforts include: ● engaging a professional accounting services firm to help us assess and commence documentation of our internal controls for complying with the Sarbanes-Oxley Act of 2002; ● strengthening, formalizing, documenting and testing accounting processes and internal controls, specifically regarding accrued expenses and contract reviews and improving the information flow throughout the organization to allow for timely communication of new agreements and transactions; ● engaging consultants to provide additional technical accounting expertise; and ● enhancing functionality of our enterprise resource planning system to support certain key financial processes and controls and enforce certain segregation of duties through automation and approval workflows. The measures we are implementing are subject to continued management review supported by confirmation and testing, as well as Audit Committee oversight. Management and the Audit Committee remain committed to the implementation of remediation efforts to address the material weakness. We will continue to implement measures to remedy our internal control deficiencies, though there can be no assurance that our efforts will be successful or avoid potential future material weaknesses. In addition, until remediation steps have been completed and are operated for a sufficient period of time, and subsequent evaluation of their effectiveness is completed, the material weakness previously disclosed, and as described above, will continue to exist. Management’s Annual Report on Internal Control over Financial Reporting Our management assessed the effectiveness of our internal control over financial reporting as of December 31, 2024. In making this assessment, our management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission, or COSO, in Internal Control-Integrated 2013 Framework. Based on this assessment, our management concluded that, as of December 31, 2024, our internal control over financial reporting was not effective at the reasonable assurance level, due to the material weakness outlined above. We believe progress was made in 2024 to enhance and strengthen our internal control over financial reporting. The measures we are implementing are subject to continued management review supported by confirmation and testing, as well as Audit Committee oversight. Management remains committed to remediating this material weakness. We will continue to implement measures to remedy our internal control deficiencies, though there can be no assurance that our efforts will be successful or avoid potential future material weaknesses. This Annual Report on Form 10-K does not include an attestation report of our independent registered public accounting firm on internal control over financial reporting due to an exemption established by the JOBS Act for “emerging growth companies.” Changes in Internal Control over Financial Reporting Except for the remediation efforts in connection with the material weaknesses described above, there were no changes in our internal control over financial reporting (as defined in Rule 13a-15(f) of the Exchange Act) that occurred during the fourth quarter of the year ended December 31, 2024 that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting. Item 9.B. Other Information. None . Item 9.C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspection. Not Applicable. 73 PART III. Item 10. Directors, Executive Officers and Corporate Governance . The information required by this Item 10 is set forth under the captions “Executive Officers of the Registrant”, “Proposal No. 1 – Election of Directors” and “Board of Directors and Committees” in our Definitive Proxy Statement with respect to our 2025 Annual Meeting of Stockholders and is incorporated herein by reference. Item 11. Executive Compensation . As an “emerging growth company” as defined in the JOBS Act, we are not required to include a Compensation Discussion and Analysis section and have opted to comply with the scaled disclosure requirements applicable to emerging growth companies. The information required by this Item 11 is set forth under the caption “Executive Officer and Director Compensation” in our Definitive Proxy Statement with respect to our 2025 Annual Meeting of Stockholders and is incorporated herein by reference. Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters . The information required by this Item 12 is set forth under the captions “Share Ownership” and “Outstanding Equity Awards at Fiscal Year End 2024” in our Definitive Proxy Statement with respect to our 2025 Annual Meeting of Stockholders and is incorporated by reference. Item 13. Certain Relationships and Related Transactions, and Director Independence . The information required by this Item 13 is set forth under the captions “Certain Relationships and Related Transactions” and “Board of Directors and Committees” in our Definitive Proxy Statement with respect to our 2025 Annual Meeting of Stockholders and is incorporated herein by reference. Item 14. Principal Accountant Fees and Services . The information required by this Item 14 will be set forth under the caption “Proposal No. 3: Ratification of Independent Registered Public Accounting Firm” in our Definitive Proxy Statement with respect to our 2025 Annual Meeting of Stockholders and is incorporated herein by reference. 74 PART IV. Item 15. Exhibits, Financial Statement Schedules . (a) The following documents are filed as part of this Annual Report on Form 10-K: SPECTRAL AI, INC. INDEX TO FINANCIAL STATEMENTS Report of Independent Registered Public Accounting Firm (PCAOB ID: 185 ) F-2 Consolidated Balance Sheets F-3 Consolidated Statements of Operations and Comprehensive Loss F-4 Consolidated Statements of Changes in Stockholders’ Equity (Deficit) F-5 Consolidated Statements of Cash Flows F-6 Notes to Consolidated Financial Statements F-7 F- 1 REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM To the Stockholders and Board of Directors Spectral AI, Inc.: Opinion on the Consolidated Financial Statements We have audited the accompanying consolidated balance sheets of Spectral AI, Inc. and subsidiaries (the Company) as of December 31, 2024 and 2023, the related consolidated statements of operations and comprehensive loss, changes in stockholders’ equity (deficit), and cash flows for each of the years in the two-year period ended December 31, 2024, and the related notes (collectively, the consolidated financial statements). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2024 and 2023, and the results of its operations and its cash flows for each of the years in the two-year period ended December 31, 2024, in conformity with U.S. generally accepted accounting principles. Basis for Opinion These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these consolidated financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB. We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits, we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion. Our audits included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. We believe that our audits provide a reasonable basis for our opinion. /s/ KPMG LLP We have served as the Company’s auditor since 2021. Dallas, Texas March 31, 2025 F- 2 SPECTRAL AI, INC. CONSOLIDATED BALANCE SHEETS (in thousands, except share and per share data) December 31, December 31, 2024 2023 Assets Current assets: Cash $ 5,157 $ 4,790 Accounts receivable, net 2,505 2,346 Inventory 425 230 Deferred offering costs - 283 Prepaid expenses 1,289 1,452 Other current assets 746 801 Total current assets 10,122 9,902 Non-current assets: Property and equipment, net 2 12 Right-of-use assets 1,971 778 Total Assets $ 12,095 $ 10,692 Commitments and contingencies (Note 8) Liabilities and Stockholders’ Equity (Deficit) Current liabilities: Accounts payable $ 4,035 $ 2,683 Accrued expenses 3,210 4,300 Deferred revenue 960 2,311 Lease liabilities, short-term 201 853 Notes payable 422 436 Notes payable – at fair value 2,365 - Warrant liabilities 6,451 1,818 Total current liabilities 17,644 12,401 Lease liabilities, long-term 1,702 - Total Liabilities 19,346 12,401 Stockholders’ Deficit Preferred stock ($ 0.0001 par value); 1,000,000 shares authorized; no shares issued and outstanding as of December 31, 2024 and December 31, 2023 - - Common stock ($ 0.0001 par value); 80,000,000 shares authorized; 22,594,877 and 16,294,935 shares issued and outstanding as of December 31, 2024 and December 31, 2023, respectively 2 2 Additional paid-in capital 40,847 31,065 Accumulated other comprehensive income 3 12 Accumulated deficit ( 48,103 ) ( 32,788 ) Total Stockholders’ Deficit ( 7,251 ) ( 1,709 ) Total Liabilities and Stockholders’ Deficit $ 12,095 $ 10,692 The accompanying notes are an integral part of these consolidated financial statements F- 3 SPECTRAL AI, INC. CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS (in thousands, except share and per share data) Year Ended December 31, 2024 2023 Research and development revenue $ 29,581 $ 18,056 Cost of revenue ( 16,307 ) ( 10,176 ) Gross profit 13,274 7,880 Operating costs and expenses: General and administrative 19,856 20,864 Total operating costs and expenses 19,856 20,864 Operating loss ( 6,582 ) ( 12,984 ) Other income (expense): Net interest income 14 172 Borrowing related costs ( 2,965 ) - Change in fair value of warrant liabilities ( 4,633 ) 335 Change in fair value of notes payable ( 220 ) - Foreign exchange transaction loss, net ( 43 ) ( 24 ) Other expenses, including transaction costs ( 615 ) ( 8,342 ) Total other expense, net ( 8,462 ) ( 7,859 ) Loss before income taxes ( 15,044 ) ( 20,843 ) Income tax provision ( 271 ) ( 11 ) Net loss $ ( 15,315 ) $ ( 20,854 ) Net loss per share of common stock Basic and Diluted $ ( 0.85 ) $ ( 1.48 ) Weighted-average common shares outstanding Basic and Diluted 17,934,218 14,087,586 Other comprehensive income: Foreign currency translation adjustments $ ( 9 ) $ 12 Total comprehensive loss $ ( 15,324 ) $ ( 20,842 ) The accompanying notes are an integral part of these consolidated financial statements F- 4 SPECTRAL AI, INC. CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS’ EQUITY (DEFICIT) (In thousands, except share data) Additional Accumulated Other Total Common Stock Paid-in Comprehensive Accumulated Stockholders’ Shares Amount Capital Income Deficit Deficit Balance at December 31, 2022, after effect of Business Combination 13,170,148 $ 1 $ 23,929 $ - $ ( 11,934 ) $ 11,996 Issuance of common stock upon Business Combination 1,154,173 1 ( 2,375 ) - - ( 2,374 ) Issuance of common stock to settle accounts payable 33,333 - 150 - - 150 Issuance of shares for transaction costs 966,667 - 4,350 - - 4,350 Private placement equity issuance 744,667 - 3,351 - - 3,351 Financing equity issuance 40,000 - 101 - - 101 Stock-based compensation 30,318 - 1,243 - - 1,243 Stock option exercises 155,629 - 316 - - 316 Cumulative translation adjustment - - - 12 - 12 Net loss - - - - ( 20,854 ) ( 20,854 ) Balance at December 31, 2023 16,294,935 $ 2 $ 31,065 $ 12 $ ( 32,788 ) $ ( 1,709 ) Stock-based compensation - - 1,032 - - 1,032 Issuance of common stock under the SEPA 1,744,694 - 3,154 - - 3,154 Issuance of shares under convertible note - related party 540,996 - 1,422 - - 1,422 Sale of common stock 3,603,298 - 3,997 - - 3,997 Stock option exercises 281,857 - 177 - - 177 Vesting of restricted stock units 129,097 - - - - - Cumulative translation adjustment - - - ( 9 ) - ( 9 ) Net loss - - - - ( 15,315 ) ( 15,315 ) Balance at December 31, 2024 22,594,877 2 40,847 3 ( 48,103 ) ( 7,251 ) The accompanying notes are an integral part of these consolidated financial statements F- 5 SPECTRAL AI, INC. CONSOLIDATED STATEMENTS OF CASH FLOWS (in thousands) Year Ended December 31, 2024 2023 Cash flows from operating activities: Net loss $ ( 15,315 ) $ ( 20,854 ) Adjustments to reconcile net loss to net cash used in operating activities: Depreciation expense 10 9 Stock-based compensation 1,032 1,243 Amortization of right-of-use assets 578 713 Issuance of shares for transaction costs - 4,350 Change in fair value of warrant liabilities 4,633 ( 335 ) Change in fair value of notes payable 220 - Costs from issuance of common stock 372 - Issuance of shares for borrowing related costs 1,143 - Changes in operating assets and liabilities: Accounts receivable ( 159 ) ( 52 ) Inventory ( 195 ) ( 230 ) Unbilled revenue - 618 Prepaid expenses 163 ( 377 ) Other assets 55 ( 404 ) Accounts payable 1,426 ( 935 ) Accrued expenses ( 1,090 ) 1,359 Deferred revenue ( 1,351 ) 2,311 Lease liabilities ( 721 ) ( 656 ) Net cash used in operating activities ( 9,199 ) ( 13,240 ) Cash flows from financing activities: Proceeds from issuance of common stock 4,060 3,351 Cash received in Business Combination - 660 Proceeds from notes payable 12,096 - Proceeds from notes payable - related party 1,000 - Payments for notes payable ( 7,758 ) ( 483 ) Stock option exercises 177 316 Net cash provided by financing activities 9,575 3,844 Effect of exchange rate changes on cash ( 9 ) 12 Net increase (decrease) in cash 367 ( 9,384 ) Cash, beginning of period 4,790 14,174 Cash, end of period $ 5,157 $ 4,790 Supplemental cash flow information: Cash paid for interest $ 11 $ 29 Cash paid for taxes $ 11 $ 114 Noncash operating and financing activities disclosure: Recognition of Right-of-use assets and related lease liabilities upon lease amendment $ 1,771 $ 483 Issuance of common stock for net liabilities upon Business Combination $ - $ 3,034 Prepaid asset acquired, net of cancellation, for debt and accounts payable $ - $ 744 Issuance of common stock to settle accounts and notes payable $ 3,207 $ 150 Deferred offering costs included in accrued expenses $ - $ 182 Issuance of common stock to settle deferred offering costs $ - $ 101 The accompanying notes are an integral part of these consolidated financial statements F- 6 1. NATURE OF THE BUSINESS Business Combination Spectral AI, Inc., a Delaware corporation formerly known as Rosecliff Acquisition Corp I (“Spectral AI” or the “Company”) was formed as a blank check company on November 17, 2020. The Company was formed for the purpose of effecting a merger, capital stock exchange, asset acquisition, stock purchase, reorganization or similar business combination with one or more businesses. On September 11, 2023, the Company consummated a business combination (the “Business Combination”), pursuant to the business combination agreement dated April 11, 2023 (the “Business Combination Agreement”) by and among the Company, Ghost Merger Sub I, a Delaware Corporation, Ghost Merger Sub II, a Delaware corporation and Spectral MD Holdings, Ltd., a Delaware corporation incorporated on March 9, 2009 and headquartered in Dallas, Texas (“Legacy Spectral”). Upon closing of the Business Combination (the “Closing”), in sequential order: (a) Ghost Merger Sub I merged with and into the Legacy Spectral, with Legacy Spectral continuing as the surviving company as a wholly owned subsidiary of the Company (the “Spectral Merger”) and then, (b) Legacy Spectral merged with and into Ghost Merger Sub II (renamed Spectral MD Holdings LLC) (the “SPAC Merger”, together with the Spectral Merger (the “Business Combination”)), with Ghost Merger Sub II surviving the SPAC Merger as a direct wholly-owned subsidiary of the Company. See Note 3. Upon the Closing, the Company changed its name from Rosecliff Acquisition Corp I to Spectral AI, Inc. In conjunction with the Business Combination, the Company cancelled the redeemable warrants that it issued to Rosecliff Acquisition Sponsor I LLC, a Delaware limited liability company (the “Sponsor”), in a private placement (the “Private Warrants”) in connection with the Company’s initial public offering on February 17, 2021 (the “Initial Public Offering”) at Closing, but the 8,433,333 redeemable warrants issued to the public in the Initial Public Offering (the “Public Warrants”) remain outstanding. Prior to the Business Combination, Rosecliff Acquisition Corp I (“Rosecliff”) had 280,485 shares of Class A common stock, par value $ 0.0001 per share, issued and outstanding and held by public shareholders (the “Public Shares”) and 6,325,000 shares of Class B common stock, par value $ 0.0001 per share, issued and outstanding and held by the Sponsor (the “Sponsor Shares”). Upon the Closing, 5,445,000 of the Sponsor Shares were forfeited, in accordance with a letter agreement with the Sponsor, and the remaining 880,000 Sponsor Shares and 280,485 Public Shares, no longer designated Class A and Class B, were included in shares of the Company’s common stock, par value $ 0.0001 per share (the “Company Common Stock”). Prior to the Business Combination, Legacy Spectral’s shares of common stock, par value $ 0.001 per share (“Legacy Spectral Common Stock”) were listed on the AIM market on the London Stock Exchange (delisted on September 7, 2023). In September 2023, prior to the Closing, Legacy Spectral issued 7,679,198 shares of Legacy Spectral Common Stock to certain investors in a private placement, in exchange for $ 3.4 million (the “Equity Raise”).Upon the Closing, all of Legacy Spectral’s issued and outstanding 145,380,871 shares of Legacy Spectral Common Stock, including the shares from the Equity Raise, were exchanged for 14,094,450 shares of Company Common Stock at an exchange ratio of 10.31 (the “Exchange Ratio”), meaning that the Company issued one share of Company Common Stock in exchange for 10.31 shares of Legacy Spectral Common Stock. On September 12, 2023, the Company began trading the Company Common Stock and the Public Warrants on the NASDAQ Capital Market (“NASDAQ”) under the symbols “MDAI” and “MDAIW”, respectively. Prior to the Business Combination, the Company’s shares of Company Common Stock and Public Warrants were listed on the NASDAQ under the symbols “RCLF” and “RCLFW”, respectively. F- 7 Nature of Operations We are an artificial intelligence (“AI”) company focused on predictive medical diagnostics. Our DeepView System uses proprietary AI algorithms to distinguish between fully damaged, partially damaged and healthy human tissue characters invisible to the naked eye, at the initial time point of wound presentation. The DeepView System delivers a binary prediction on the wound’s capacity to heal by a specified time point in the future. Our DeepView System’s output is specifically engineered to assist the physician in making a more accurate, timely and informed decision regarding the treatment of the patient’s wounds. Spectral AI is devoting substantially all of its efforts towards research and development of its DeepView® Wound Imaging System, currently focused on burn wounds, specifically engineered to allow physicians to make a more accurate, timely and informed decision for treatment options. The Company has not generated any product revenue to date. The Company currently generates revenue from contract development and research services by providing such services to governmental agencies, primarily to the Biomedical Advanced Research and Development Authority (“BARDA”) and under a contract with Medical Technology Enterprise Consortium (“MTEC”). In September 2023, the Company executed its third contract with BARDA for a multi-year Project BioShield (“PBS”) contract, valued at up to approximately $ 150.0 million (the “PBS BARDA Contract”). This multi-year contract includes an initial award of nearly $ 54.9 million to support the clinical validation and FDA clearance of DeepView® for commercial development and distribution purposes. The PBS BARDA Contract also includes options, similar to our prior BARDA contracts, with an additional total value of approximately $ 95.1 million which can be exercised for additional product development, procurement and the expanded deployment of DeepView Systems at emergency rooms, trauma and burn centers. The Company completed the second contract with BARDA, referred to as BARDA Burn II, which was signed in July 2019 and completed in November 2023. Under this contract, the Company furthered the DeepView System design, developed the AI algorithm, and took steps to obtain FDA approval. As of December 31, 2024, the Company has $ 22.9 million remaining under the initial award under the PBS BARDA Contract. In April 2023, the Company received a $ 4.0 million grant from MTEC for a project that is expected to be completed by April 2025 (the “MTEC Agreement”). The MTEC Agreement is for the development of a handheld version of the DeepView System which is to be used to support military battlefield burn evaluation. The project has three phases, beginning with planning, design and testing; followed by development, design modification and buildout of the handheld device; and then the manufacturing of the handheld device. In August 2024, the MTEC award was increased to $ 4.9 million and is currently intended to run through December 2025 with funding dependent on various milestones. In March 2024, we received an additional $ 0.5 million award from the Defense Health Agency (“DHA”) to further this development. As of December 31, 2024, the Company has $ 1.9 million and $ 0.1 million remaining to receive under the MTEC and DHA awards, respectively. On March 7, 2024, the Company formed a new wholly-owned subsidiary, Spectral IP, Inc., a Delaware corporation (“Spectral IP”), to be utilized to advance artificial intelligence intellectual property with a specific emphasis on healthcare. On March 19, 2024, the Company announced that Spectral IP received a $ 1.0 million investment from an affiliate of its largest shareholder for the development of its artificial intelligence intellectual property portfolio. The investment is structured as a note payable with a one-year maturity, an interest rate of 8 %, and requiring earlier prepayment if the Company spins off Spectral IP to the Company’s shareholders or if Spectral IP is sold to a third party. On October 1, 2024, the note was amended to (i) reduce the annual interest rate from 8 % to 4 %, (ii) extend the term of the Note through the second anniversary of the issuance date, March 18, 2026, (iii) include a conversion feature at the option of either the holder or Spectral IP to convert the then outstanding principal and accrued but unpaid interest into shares of the Company at any time (into such number of shares calculated by taking a five percent ( 5.00 %) discount to the closing price of the Company’s common stock on the day prior to the date of notice to the Company of the exercise of the conversion right) and at maturity, respectively, and (iv) provide for registration rights of any shares of the Company issued in satisfaction of the outstanding obligations. On October 1, 2024, Spectral IP amended its existing $ 1,000,000 promissory note to extend the term from one to two years , reduce the interest rate from 8.00 % to 4.00 % per annum and to provide a conversion feature for shares of the Company’s common stock in satisfaction of the outstanding principal and accrued but unpaid interest. The holder of the Spectral IP Note exercised a number of conversion rights throughout the fourth quarter of 2024 for the full conversion of the Spectral IP Note in exchange for a total of 540,996 shares of the Company’s common stock, which represents a 5.00 % discount to the closing price of the Company’s shares of Common Stock on the day prior to the date of notice of the holder’s exercise of its conversion ‘right’. F- 8 Risks and Uncertainties The Company is subject to a number of risks common to development stage companies in the medical technology industry, including, but not limited to, risks of failure of preclinical studies and clinical trials, dependence on key personnel, protection of proprietary technology, reliance on third party organizations, risks of obtaining regulatory approval for any products that it may develop, development by competitors of technological innovations, compliance with government regulations and the need to obtain additional financing. Liquidity As of December 31, 2024 the Company had approximately $ 5.2 million in cash, and an accumulated deficit of $ 48.1 million. As of December 31, 2024, the Company had approximately $ 2.8 million in notes payable and no long-term debt as of either period. See Note 7. On December 26, 2023, we entered into a Common Stock Purchase Agreement and related Registration Rights Agreement with B. Riley Principal Capital II, LLC (“B. Riley”). Upon the terms and subject to the satisfaction of the conditions set forth in the Common Stock Purchase Agreement, the Company has the right, in our sole discretion, to sell to B. Riley up to $ 10.0 million in aggregate gross purchase price of newly issued shares of the Company’s Common Stock (the “ELOC”). We have previously raised $ 2.7 million from share issuances under the B. Riley transaction. The Company maintained the right to raise up to $ 3.0 million of shares of its Common Stock from the B. Riley transaction upon execution of the SEPA with Yorkville, which is described in more detail below. On March 20, 2024, the Company entered into a Standby Equity Purchase Agreement (“SEPA”) with YA II PN, LTD, a Cayman Islands exempt limited partnership (“Yorkville”) pursuant to which the Company has the right to sell to Yorkville up to $ 30.0 million of its shares of Common Stock, subject to certain limitations and conditions set forth in the SEPA. In connection with the SEPA, and subject to the conditions set forth therein, Yorkville has agreed to advance to the Company in the form of convertible promissory notes an aggregate principal amount of up to $ 12.5 million (the “Pre-Paid Advance”), which will be paid in three tranches. The first Pre-Paid Advance was disbursed on March 20, 2024 in the amount of $ 5.0 million with a fixed conversion price of $ 3.16 . The Company received $ 4.6 million in cash, net of the 8 % original issue discount. On May 14, 2024, the shareholders voted to approve the reservation and issuance of shares to Yorkville to exceed the 19.99 % of the shares of Common stock outstanding immediately prior to the execution of the SEPA (the “Exchange Cap”) and the second Pre-Paid Advance was disbursed on May 16, 2024 in the amount of $ 4.6 million, which is the $ 5.0 million second Pre-Paid Advance net of $ 0.4 million of the 8 % original issue discount, with a fixed conversion price of $ 2.03 . The third Pre-Paid Advance was disbursed on July 17, 2024 in the principal amount of $ 2.3 million, which is the $ 2.5 million third Pre-Paid Advance net of the $ 0.2 million of the 8 % original issue discount. As of December 31, 2024, $ 7.8 million of the outstanding balance of the Pre-Paid Advances was paid in cash and $ 2.4 million was paid in shares of the Company issued under the SEPA. The Company still has access to the remaining funds under the SEPA. The sales of the shares of Common Stock to Yorkville under the SEPA, and the timing of any such sales, are at the Company’s option. In March 2024, the Company received an additional $ 0.5 million award from the Defense Health Agency to further the development related to the DHA Agreement. On June 3, 2024, the Company received a letter from the Listing Qualifications Staff of the Nasdaq Stock Market, LLC (“Nasdaq”) that the Company was not in compliance with the listing requirement relating to a minimum market value of its listed securities of $ 35.0 million. On December 20, 2024, the Company received a “moot” letter from Nasdaq confirming that the Company has regained compliance with all applicable listing standards for its continued listing on the Nasdaq Capital Market. We cannot assure you that our securities will continue to be listed on Nasdaq. If any of our securities are delisted from trading on its exchange and we are not able to list our securities on another national securities exchange, we expect such securities could be quoted on an over-the-counter market. If our securities are delisted, we may face limitations in utilizing the SEPA and the ELOC. F- 9 As of December 31, 2024, based on our current operating plan, we believe that our cash and cash equivalents, together with the PBS BARDA Contract, the MTEC Agreement, the B. Riley ELOC, and the Yorkville Transaction, and certain research and development cost-saving measures, will be sufficient to fund operations for at least one year beyond the release date of these consolidated financial statements. We have based this determination on assumptions that may prove to be wrong, and we could utilize our available capital resources sooner than we currently expect. Changing circumstances could also cause us to consume capital significantly faster than we currently anticipate, and we may need to raise capital sooner or in greater amounts than currently expected because of circumstances beyond our control. Changes in the current equity markets may also limit our ability to utilize the B. Riley ELOC and Yorkville Transaction as currently structured, including if the Company is no longer listed on Nasdaq or another securities exchange. On March 24, 2025, the Company completed an equity financing and entered into a long-term debt financing agreement with Avenue Venture Opportunities Fund II, L.P., a fund of Avenue Capital Group, with an initial draw-down of $ 8.5 million. In connection with the debt financing, the Company also raised $ 2.7 million of equity financing from institutional investors as well as existing UK investors. The financing includes the potential for up to almost $ 25.0 million after the completion of certain development and financing milestones for the second tranche of debt financing. To the extent additional capital is necessary, there are no assurances that we will be able to raise additional capital on favorable terms or at all, and therefore we may not be able to execute our business plans and the continued work on indications beyond expanding our burn indication. 2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation The Company’s consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“GAAP”) as determined by the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) or an Accounting Standards Update (“ASU”). The Business Combination was accounted for as a reverse recapitalization in accordance with GAAP. Legacy Spectral was determined as the accounting acquirer and the Company as the acquired company for financial reporting purposes. Accordingly, for accounting purposes, the Business Combination is treated as the equivalent of a capital transaction in which Legacy Spectral issued stock for the net assets of the Company. Upon the Closing, the net assets of the Company are stated at fair value, with no goodwill or other intangible assets recorded. See Note 3 – Recapitalization . Legacy Spectral was determined to be the accounting acquiror based on evaluation of the following facts and circumstances: (i) Legacy Spectral’s former shareholders have a majority of the voting power of Spectral AI; (ii) Legacy Spectral’s senior management comprises all of the senior management of Spectral AI; (iii) Legacy Spectral selected five of the six directors for the Board of Directors of Spectral AI; (iv) Legacy Spectral’s relative size of assets and operations compared to Rosecliff; and (v) Legacy Spectral’s operations comprise the ongoing operations of Spectral AI. All historical financial information presented in the consolidated financial statements represents the accounts of Legacy Spectral at their historical values as if Legacy Spectral is the predecessor to the Company. The consolidated financial statements following the Closing reflect the results of the combined entity’s operations. All issued and outstanding shares of Legacy Spectral Common Stock and warrants, stock options, restricted stock units (“RSUs”) and restricted stock awards (“RSAs”) of Legacy Spectral and the per share amounts contained in the consolidated financial statements for the periods presented prior to the Closing have been retroactively restated to reflect the Exchange Ratio (as defined in Note 1). F- 10 Principles of Consolidation The consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries, Spectral MD Holdings LLC, Spectral MD Inc., Spectral MD UK Limited (“Spectral MD UK”), Spectral IP, Inc. and Spectral DeepView Limited. Significant inter-company transactions and balances have been eliminated in consolidation. Use of Estimates The preparation of the consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. The Company bases its estimates and judgments on historical experience and on various other assumptions that it believes are reasonable under the circumstances. The amounts of assets and liabilities reported in the Company’s balance sheets and the amounts of expenses reported for each of the periods presented are affected by estimates and assumptions, which are used for, but not limited to, revenue recognition, warrant liabilities, the fair value of short term notes payable, fair value of the B. Riley and Yorkville derivative instruments, stock-based compensation expense, stock issued for transaction costs, the net realizable value of inventory, right-of-use assets, and income tax valuation allowances. Actual results could differ from these estimates. Segments Operating segments are defined as components of an enterprise for which separate and discrete information is available for evaluation by the chief operating decision-maker in deciding how to allocate resources and assess performance. The Chairman of the Board in conjunction with the Company’s executive management team manages the Company’s operations on an aggregate basis for the purpose of allocating resources. The Company has one operating segment. The accounting policies of the Company’s single operating and reportable segment are the same as those described in the summary of significant accounting policies. The Company’s method for measuring profitability includes net income (loss), which the chief operating decision-maker uses to assess performance and make decisions for resource allocation, consistent with the measurement principals for net income(loss) as reported on the Company’s consolidated statement of operations. The significant expenses regularly reviewed by the chief operating decision-maker are consistent with those reported on the Company’s consolidated statement of operations as well as research and development expenses which are disclosed in the footnotes to these financial statements. Certain expenses are reviewed for purposes of assessing operating activities and resource allocation for the Company. The measure of segment assets is reported on the consolidated balance sheets as total assets. Cash The Company considers all highly liquid investments with an original maturity of three months or less when purchased to be cash equivalents. All cash is held in US, UK, and Ireland financial institutions. Accounts Receivable, Net and Unbilled Revenue Accounts receivable represent amounts due from US government agencies pursuant to research and development contracts associated with the Company’s DeepView ® System. The Company evaluates the collectability of its receivables based on a variety of factors, including the length of time the receivables are past due, the financial health of its customers and historical experience. Based upon the review of these factors, the Company recorded no allowance for doubtful accounts as of December 31, 2024 and December 31, 2023. Certain third-party costs that are prepaid per the terms of the contract are billable to customers prior to recognition of related expenses. The Company records deferred revenue when the customers have been billed prior to recognizing revenue. The Company records unbilled revenue when revenue is recognized prior to billing customers. F- 11 Comprehensive Loss Comprehensive loss includes net loss, as well as other changes in stockholders’ equity (deficit) that result from transactions and economic events other than those with stockholders. Concentrations of Credit Risk Financial instruments which potentially subject the Company to credit risk consist principally of cash and accounts receivable. Primarily all cash is held in US financial institutions which, at times, exceed federally insured limits. The Company has not recognized any losses from credit risks on such accounts. The Company believes it is not exposed to significant credit risk on cash. Additional credit risk is related to the Company’s concentration of receivables. As of December 31, 2024 and December 31, 2023, receivables were concentrated from one customer (which is a US. government agency) representing 85 % and 92 % of total net receivables, respectively. One customer (which is a U.S. government agency) accounted for 94 % for the year ended December 31, 2024 and 95 % for the year ended December 31, 2023 of the recognized research and development revenue. Inventory Inventory is comprised of finished goods, purchased from a third-party manufacturer, and is stated at the lower of cost (average cost) or net realizable value. For the year ended December 31, 2024, the Company did not have write-downs for obsolete inventory. Fair Value Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. Assets and liabilities that are measured at fair value are reported using a three-level fair value hierarchy that prioritizes the inputs used to measure fair value. This hierarchy maximizes the use of observable inputs and minimizes the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: Level 1 Unadjusted quoted prices in active markets that are assessable at the measurement date for identical, unrestricted assets or liabilities. Level 2 Quoted prices in markets that are not active, or inputs that are observable, either directly or indirectly, for substantially the full term of the asset or liability; and Level 3 Prices or valuation techniques that require inputs that are both significant to the fair value measurement and unobservable (supported by little or no market activity). Foreign Currency The reporting currency for the consolidated financial statements of the Company is the US dollar. The functional currency of the Company and its wholly-owned subsidiaries Spectral MD Holdings LLC, Spectral MD, Inc., and Spectral IP is the US dollar. The functional currency of Spectral MD UK is its local currency, the British pound. The functional currency of Spectral DeepView Limited, an Irish private limited company, is its local currency, the Euro. The assets and liabilities of Spectral MD UK and Spectral DeepView Limited, are translated into US. Dollars at exchange rates in effect at the end of each reporting period, and the revenues and expenses are translated at average exchange rates in effect during the applicable reporting period. Translation adjustments are included in accumulated other comprehensive income as a component of stockholders’ equity. As of December 31, 2024 and December 31, 2023, the Company’s translation adjustments are not material. Monetary assets and liabilities denominated in currencies other than the US dollar are translated at exchange rates in effect as of the balance sheet date. Resulting unrealized gains and losses are included in other income (expense), net in the consolidated statements of operations. For the year ended December 31, 2024, the Company recorded approximately $ 43,000 of net foreign exchange transaction losses. For the year ended December 31, 2023, the Company recorded approximately $ 24,000 of net foreign exchange transaction losses. These amounts primarily relate to one of the Company’s bank accounts being denominated in British Pounds and certain accounts payable denominated in British Pounds. F- 12 Property and Equipment, Net Property and equipment, net is recorded at cost less accumulated depreciation. Depreciation expense is recorded using the straight-line method over the estimated useful lives of the related assets, which are as follows: Estimated Useful Life Computer equipment 3 years Manufacturing equipment 5 years Furniture and equipment 5 years Laboratory equipment 5 years Leasehold improvements Shorter of remaining lease term or useful life Purchased assets that are not yet in service are recorded to construction-in-process and no depreciation expense is recorded. Once they are placed in service, they are reclassified to the appropriate asset class. When assets are retired or otherwise disposed of, the assets and related accumulated depreciation are eliminated from the accounts and any resulting gain or loss is reflected in the Company’s consolidated statements of operation and comprehensive loss. Expenditures for maintenance and repairs are expensed as incurred. Impairment of Long-Lived Assets Long-lived assets consist of property and equipment. The Company continually evaluates whether events or circumstances have occurred that indicate that the estimated remaining useful life of its long-lived assets may warrant revision or that the carrying value of these assets may not be recoverable. If circumstances require that a long-lived asset or asset group be tested for impairment, the Company first compares the estimated undiscounted future cash flows expected to result from the use or disposition of that asset or asset group to its carrying amount. If the carrying amount of the long-lived asset or asset group is not recoverable on an undiscounted cash flow basis, an impairment loss would be recognized to the extent the carrying value exceeds its fair value. Fair value is determined through various valuation techniques including discounted cash flow models, quoted market prices and third-party independent appraisals, as considered necessary. Leases Under lease guidance, arrangements meeting the definition of a lease are classified as operating or financing leases. Operating leases are recorded in the consolidated balance sheets as both a right-of-use asset and a lease liability, calculated by discounting fixed lease payments at the rate implicit in the lease or the Company’s incremental borrowing rate factoring the term of the lease. The incremental borrowing rate used by the Company is an estimate of the interest rate the Company would incur to borrow an amount equal to the lease payments on a collateralized basis over the term of the lease. Because the Company does not generally borrow on a collateralized basis, it uses the interest rate it pays on its noncollateralized borrowings as an input to deriving an appropriate incremental borrowing rate, adjusted for the amount of lease payments, the lease term and the effect on that rate of designating specific collateral with a value equal to the unpaid lease payments for that lease. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred. In calculating the right-of-use assets and lease liabilities, the Company has elected to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the requirement to capitalize right-of-use assets and liabilities as an accounting policy election. During the years ended December 31, 2024 and 2023, the Company did not have any financing leases. F- 13 Warrant Liabilities On September 11, 2023, in conjunction with the Business Combination, the Company assumed the Public Warrants which had an exercise price of $ 11.50 per share, are exercisable 30 days after the Business Combination and expire five years after the Business Combination or upon redemption. The Company may redeem the Public Warrants if the Company’s common stock equals or exceeds $ 18.00 per share for 20 trading days within a 30-trading day period ending on the third trading day prior to the date on which the Company sends the notice of redemption to the holders of Public Warrants. In November 2024, the Company amended the Public Warrants to have an exercise price of $ 2.75 per share. As of December 31, 2024, there are 8,433,333 Public Warrants Outstanding. Each warrant entitles the registered holder to purchase one share of Company Common Stock at an exercise price of $ 2.75 per full share. Pursuant to the Warrant Agreement, a holder of Public Warrants may exercise its Public Warrants only for a whole number of shares of Company Common Stock. This means that only a whole warrant may be exercised at any given time by a holder of Public Warrants. The Company maintains a redemption right with respect to the Public Warrants in that the Company can redeem some or all of the Public Warrants for $ 0.10 per Public Warrant based on certain market conditions and the market price of the Company Common Stock. In September 2021, Legacy Spectral issued 73,978 warrants, with a strike price of $ 7.75 and a five-year life, to SP Angel Corporate Finance LLP (“SP Angel”), who acted as nominated adviser and broker to the Company for the purposes of the AIM Rules (“Angel Warrants”). In conjunction with the Business Combination, the Angel Warrants were converted into warrants to purchase Company Common Stock based on the Exchange Ratio. As of December 31, 2024, there are 73,978 Angel Warrants to purchase Company Common Stock outstanding. The Company accounts for its Public Warrants and the Angel Warrants as derivative liabilities. Accordingly, the Company recognizes the instruments as liabilities at fair value, determined using the closing price of the observable market quote in an active market (the NASDAQ) for the Public Warrants and the Black-Scholes option-pricing model for the Angel Warrants, and adjusts the instruments to fair value at the end of each reporting period. The liabilities are subject to re-measurement at each balance sheet date until exercised, redeemed or expired, and any change in fair value is recognized in the Company’s consolidated statements of operations within other income (expense). Research and Development Revenue The Company recognizes revenue when the Company’s customers obtain control of promised goods or services, in an amount that reflects the consideration which the Company expects to receive in exchange for those goods or services by analyzing the following five steps: (1) identify the contract with a customer(s); (2) identify the performance obligations in the contract; (3) determine the transaction price; (4) allocate the transaction price to the performance obligations in the contract; and (5) recognize revenue when (or as) the Company satisfies a performance obligation. The Company generates research and development revenue, primarily from the contracts with BARDA and MTEC. Each contract for BARDA and MTEC has a single performance obligation. The contracts with BARDA are cost-plus-fee contracts associated with development of certain product candidates. BARDA reimburses the Company based on allowable costs plus any recognizable earned fee. Revenues from these reimbursable costs are recognized as the costs are incurred. We receive funding from a contract by the DHA within the U.S. Department of Defense, which enables us to research and develop a fully portable, handheld version of our DeepView System and has been extended through the second quarter of 2025. We were previously awarded a $ 1.1 million Sequential Phase II STTR contract by the DHA within the U.S. Department of Defense, which is paid to us monthly, as well as a STTR Phase I and initial Phase II contract from the DHA. The MTEC Agreement provides for installment payments after the completion of milestone events. The installment payments are considered variable consideration as the entitlement depends on successful completion of research. However, the payments are not constrained from inclusion in the transaction price as it not probable that a significant reversal of cumulative revenue will be reversed when the underlying uncertainty is resolved. Revenue for the MTEC Agreement is recognized over time based upon the cost-to-cost measure of progress, using this input method to measure progress as the customer has the benefit of access to the development research under these projects and therefore benefits from the Company’s performance incrementally as research and development activities occur under each project. The Company measures progress of performance by comparing the actual costs incurred to-date to the total estimated cost of the project. The Company will adjust the measure of progress at the end of each reporting period and reflect any changes to the estimated cost of the project on a prospective basis. F- 14 The Company elected the practical expedient not to adjust the transaction price for the effects of a significant financing component as the period between performance (satisfaction of a performance obligation) and payment is one year or less. Payments from customers are generally received within 30 days of when the invoice is sent. Research and Development Expense The Company expenses research and development costs as incurred. These expenses include salaries for research and development personnel, consulting fees, product development, pre-clinical studies, clinical trial costs, and other fees and costs related to the development of the technology. For the years ended December 31, 2024 and 2023, research and development expense was $ 19.3 million and $ 15.1 million, respectively, of which $ 16.3 million and $ 10.2 million, respectively, is related to the combined BARDA and MTEC contracts and included in cost of revenue and $ 3.0 million and $ 4.9 million, respectively, is included in general and administrative expenses. Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options and RSUs based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSUs are valued based on the fair value of the Company’s common stock on the date of grant. The fair value of RSUs with market based vesting conditions were determined using a Monte-Carlo Simulation to reflect the effects of the market conditions. The assumptions used in calculating the fair value of the Company’s stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options and RSUs over the requisite service period. Forfeitures are recorded as they occur. Compensation previously recorded for unvested equity awards that are forfeited is reversed upon forfeiture. The Company expenses stock-based compensation to employees over the requisite service period, on a straight-line basis, based on the estimated grant-date fair value of the awards. For RSUs with market-based conditions, compensation is not reversed if these awards are forfeited based solely on failing to meet such market-based conditions. Income Taxes The Company records its deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Valuation allowances are provided, if based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. The Company has no uncertain tax positions as of December 31, 2024 and December 31, 2023 that qualify for either recognition or disclosure in the consolidated financial statements under this guidance. The Company’s policy is to classify assessments, if any, for tax related interest as interest expense and penalties as general and administrative expenses in the consolidated statements of operations. The Company did not have any interest or penalties during the years ended December 31, 2024 and 2023 and did not have any interest or penalties accrued as of December 31, 2024. F- 15 Net Loss per Share of Common Stock Basic net loss per share of common stock is computed by dividing the net loss attributable to common stockholders by the weighted-average number of shares of common stock outstanding during the period. Diluted net loss per share of common stock adjusts basic earnings per share for the potentially dilutive impact of unvested restricted stock, stock options and warrants. Securities having an anti-dilutive effect on diluted net earnings per share are excluded from the calculation. The dilutive effect of the unvested restricted stock and stock options is calculated using the treasury stock method. For warrants that are liability-classified, during periods when the impact is dilutive, the Company assumes share settlement of the instruments as of the beginning of the reporting period and adjusts the numerator to remove the change in fair value of the warrant liability and adjusts the denominator to include the dilutive shares calculated using the treasury stock method. Comprehensive Income (Loss) Comprehensive income (loss) consists of net income (loss) and other comprehensive income (loss), which includes foreign currency translation adjustments. For the purposes of comprehensive income (loss) disclosures, the Company does not record deferred taxes for the net changes in the foreign currency translation adjustment, as it intends to indefinitely reinvest undistributed earnings of its foreign subsidiaries. Accumulated other comprehensive income (loss) is reported as a component of stockholders' equity. Recently Adopted Accounting Standards In September 2016, the FASB issued ASU No. 2016-13, Financial Instruments — Credit Losses, which was subsequently amended by ASU No. 2018-19, ASU No. 2019-04, ASU No. 2019-05, ASU 2019-10, ASU No. 2019-11, ASU No. 2020-03, and ASU No. 2022-02. These ASUs have provided for various minor technical corrections and improvements to the codification as well as other transition matters. Smaller reporting companies who file with the SEC are required to apply the guidance for fiscal years, and interim periods within those years, beginning after December 15, 2022. This standard requires the measurement of expected credit losses for financial instruments carried at amortized cost held at the reporting date based on historical experience, current conditions and reasonable forecasts. The updated guidance also amends the current other-than-temporary impairment model for available-for-sale debt securities by requiring the recognition of impairments relating to credit losses through an allowance account and limits the amount of credit loss to the difference between a security’s amortized cost basis and its fair value. In addition, the length of time a security has been in an unrealized loss position will no longer impact the determination of whether a credit loss exists. The main objective of this ASU is to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. The Company adopted this standard on January 1, 2023, with no impact on its consolidated financial statements and related disclosures. In August 2020, the FASB issued ASU No. 2020-06, Debt — Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging — Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity, which simplifies accounting for convertible instruments by removing major separation models required under current GAAP. The ASU removes certain settlement conditions that are required for equity contracts to qualify for the derivative scope exception, and it also simplifies the diluted earnings per share calculation in certain areas. The Company adopted this standard on January 1, 2024, with no impact on its consolidated financial statements and related disclosures. In June 2022, the FASB issued ASU 2022-03, ASC Subtopic 820 Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions (“ASU 2022-03”). The FASB issued this update (1) to clarify the guidance in Topic 820, Fair Value Measurement, when measuring the fair value of an equity security subject to contractual restrictions that prohibit the sale of an equity security, (2) to amend a related illustrative example, and (3) to introduce new disclosure requirements for equity securities subject to contractual sale restrictions that are measured at fair value in accordance with Topic 820. For public business entities, the amendments in this update are effective for fiscal years beginning after December 15, 2023, and interim periods within those fiscal years. The Company adopted this standard on January 1, 2024, with no impact on its consolidated financial statements and related disclosures. F- 16 In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”). ASU 2023-07 updates reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses and information used to assess segment performance. The Company adopted this guidance in the year ended December 31, 2024 with no material impact on the consolidated financial statements and disclosures. See Segment policy above for additional information. Recently Issued Accounting Standards In October 2023, the FASB issued ASU 2023-06 Disclosure Improvements: Codification Amendments in Response to the SEC’s Disclosure Update and Simplification Initiative (“ASU 2023-06”), which modifies certain disclosure and presentation requirements of a variety of Topics in the Codification and is intended to both clarify or improve such requirements and align the requirements with the SEC’s regulations. The effective date for each amendment is the effective date of the removal of the related disclosure from Regulation S-X or Regulation S-K, with early adoption prohibited. The Company will apply the provisions prospectively as such provisions become effective and does not expect ASU 2023-06 to have a material impact on the consolidated financial statements. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures (“ASU 2023-09”). ASU 2023-09 requires more detailed income tax disclosures, requiring entities to disclose disaggregated information about their effective tax rate reconciliation as well as expanded information on income taxes paid by jurisdiction. The disclosure requirements will be applied on a prospective basis, with the option to apply them retrospectively. This update will be effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact that the adoption of this standard will have on its consolidated financial statements and disclosures. In November 2024, the FASB issued ASU No. 2024-03, Income Statement- Reporting Comprehensive Income- Expense Disaggregation Disclosures (Subtopic 220-40), requiring public business entities to disclose additional information about specific expense categories in the notes to financial statements at interim and annual reporting periods. ASU 2024-03 is effective for fiscal years beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027, with early adoption permitted. The disclosures required under the guidance can be applied either prospectively to financial statements issued for reporting periods after the effective date or retrospectively to any or all periods presented in the financial statements. The Company is currently evaluating the impact of adopting this guidance on its consolidated financial statements and disclosures. 3. RECAPITALIZATION As discussed in Note 1, on September 11, 2023, the Company consummated the Business Combination, with Legacy Spectral surviving the merger as a wholly-owned subsidiary of the Company. On the date of the Business Combination, the Company recorded net liabilities of $ 2.4 million, with an offsetting decrease to additional paid-in capital. The following table provides the elements of the Business Combination: Cash $ 660 Other current assets 127 Accounts payable ( 860 ) Accrued expenses ( 277 ) Warrant liabilities ( 2,024 ) Net liabilities assumed in exchange for common stock ( 2,374 ) Less: Cash ( 660 ) Non-cash net liabilities assumed in exchange for common stock $ ( 3,034 ) Upon the Closing, the Company issued 33,333 shares of Company Common Stock, with a fair value of $ 0.2 million, to settle an assumed liability to the Sponsor as a payment for an administrative fee. The Company recorded transaction costs, consisting of legal, accounting and other professional services incurred by Legacy Spectral related to the Business Combination, of $ 7.6 million (the “Transaction Costs”), in other income (expense) in the consolidated statement of operations for the year ended December 31, 2023 and no costs were capitalized. During the year ended December 31, 2023, the Company paid $ 1.9 million of Transaction Costs in cash and issued 966,667 shares of Company Common Stock with a fair value of $ 4.4 million. F- 17 Prior to the Business Combination the Company incurred $ 0.7 million of transaction costs, included in other income (expense) in the consolidated statement of operations for the year ended December 31, 2023, for professional services incurred by Legacy Spectral that were related to potential business combinations that did not occur. 4. FAIR VALUE MEASUREMENTS The following table presents information about the Company’s financial liabilities that are measured at fair value on a recurring basis as of December 31, 2024 and December 31, 2023, by level within the fair value hierarchy (in thousands): Fair value measured as of December 31, 2024 Fair value at December 31, 2024 Quoted prices in active markets (Level 1) Significant other observable inputs (Level 2) Significant unobservable inputs (Level 3) Warrant liabilities $ 6,451 $ 6,409 $ - $ 41 Short-term notes payable- Yorkville 2,365 - - 2,365 $ 8,816 $ 6,409 $ - $ 2,406 Fair value measured as of December 31, 2023 Fair value at December 31, 2023 Quoted prices in active markets (Level 1) Significant other observable inputs (Level 2) Significant unobservable inputs (Level 3) Warrant liabilities $ 1,818 $ 1,771 $ - $ 47 There were no transfers between Level 1, 2 or 3 during the years ended December 31, 2024 and 2023. Fair values of cash, accounts receivable, accounts payable, accrued expenses, and short-term debt (other than the notes payable with Yorkville) are carried at cost, which management believes approximates fair value due to the short-term nature of these instruments. The fair value of the Public Warrants, which trade in active markets, is based on quoted market prices and classified in Level 1 of the fair value hierarchy. The SP Angel Warrants are classified within Level 3 of the fair value hierarchy because their fair values are based on significant inputs that are unobservable in the market. The following table presents changes in Level 3 warrant liabilities measured at fair value for the years ended December 31, 2024 and 2023 (in thousands): Balance - January 1, 2023 $ 129 Change in fair value ( 82 ) Balance - January 1, 2024 $ 47 Change in fair value ( 6 ) Balance - December 31, 2024 $ 41 Both observable and unobservable inputs were used to determine the fair value of warrants that the Company has classified within the Level 3 category. Unrealized gains and losses associated with warrant liabilities within the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long- dated volatilities) inputs. F- 18 The following table provides quantitative information regarding Level 3 warrant liability fair value measurements inputs at their measurement: December 31, December 31, 2024 2023 Strike price (per share) $ 7.32 $ 7.32 Contractual term (years) 2.5 3.5 Volatility (annual) 70.6 % 71.2 % Risk-free rate 4.3 % 4.0 % Dividend yield (per share) 0.0 % 0.0 % Valuation of short-term notes payable – Yorkville The Company elected the fair value option to account for the financial instrument with Yorkville signed on March 20, 2024 (see Note 7). The estimate of the fair value as of December 31, 2024 was determined using a binomial lattice model. The fair value measurement of the debt is determined using Level 3 inputs and assumptions unobservable in the market. Changes in the fair value of debt that is accounted for at fair value, inclusive of related accrued interest expense, are presented as gains or losses as a component of other income (expense) in the accompanying consolidated statements of operations and comprehensive loss under change in fair value of debt. The actual settlement of the short-term debt could differ from current estimates based on the timing of when and if Yorkville elects to convert amounts into common shares, potential cash repayment by the Company prior to maturity, and movements in the Company’s common stock price. The following table provides a rollforward of the aggregate fair values of the Company’s Yorkville debt for which fair values are determined using Level 3 inputs (in thousands): Balance as of January 1, 2024 $ - Addition of short-term notes payable 11,500 Principal repayments ( 9,355 ) Fair value adjustment 220 Balance as of December 31, 2024 2,365 The following table provides quantitative information regarding Level 3 fair value measurements inputs at their measurement: December 31, 2024 Expected term (years) 0.05 – 0.13 Volatility (annual) 100 % Risk-free rate 4.34 – 4.35 % F- 19 Valuation of forward options in B. Riley ELOC and Yorkville SEPA The B. Riley ELOC and Yorkville SEPA are accounted for as derivatives and will be recognized at fair value. The Company has determined the fair value of the purchase put option in the Company’s shares to be immaterial. Any changes in fair value between the carrying amount of the forward issuance contracts and the settlement amounts will be recognized in other income (expense) in the consolidated statement of operations and comprehensive loss. For the year ended December 31, 2024, the Company determined there were immaterial changes in derivative liability fair value related to the B. Riley ELOC the Yorkville SEPA. The Company recorded no liability for the forward issuance contract, as there are no such contracts outstanding at December 31, 2024. 5. RESEARCH AND DEVELOPMENT REVENUE For the years ended December 31, 2024 and 2023, the Company’s revenues disaggregated by the major sources was as follows (in thousands): Year Ended December 31, 2024 2023 BARDA $ 27,903 $ 17,027 Other U.S governmental authorities 1,678 1,029 Total revenue $ 29,581 $ 18,056 The following table presents the activity in the Company’s contract liabilities during the year ended December 31, 2024 (in thousands): December 31, 2023 Balance Additions Reductions December 31, 2024 Balance Contract liabilities: Deferred revenue $ 2,311 $ 6,396 $ ( 7,747 ) $ 960 Total contract liabilities $ 2,311 $ 6,396 $ ( 7,747 ) $ 960 6. ACCRUED EXPENSES Accrued expenses consist of the following as of December 31, 2024 and December 31, 2023 (in thousands): December 31, December 31, 2024 2023 Salary and wages $ 2,196 $ 1,910 Operating expenses 355 1,563 Benefits 410 720 Taxes 188 107 Non-operating expenses 60 - Total accrued expenses $ 3,210 $ 4,300 7. NOTES PAYABLE The Company entered into the Yorkville Convertible Notes, the Related Party Note, and financing arrangements for a portion of its Directors and Officers insurance premiums, as follows (in thousands): Principal Repayments Outstanding Balance Year Ended December 31, December 31, December 31, Amount Financed Interest Rate 2024 2023 2024 2023 Yorkville Convertible Notes $ 12,500 0.0 % $ 9,355 $ - $ 2,365 $ - Related Party Note 1,000 8.0 % 1,000 - - - 2024 Insurance Note 596 8.4 % 174 - 422 - New 2023 Insurance Note 631 8.6 % 436 195 - 436 2023 Insurance Note 151 9.7 % - 113 - - 2022 Insurance Note 376 6.7 % - 175 - - $ 10,965 $ 483 $ 2,787 $ 436 F- 20 Yorkville Convertible Notes On March 20, 2024, the Company entered into the SEPA with Yorkville pursuant to which the Company has the right to sell to Yorkville up to $ 30.0 million of its shares of Company Common Stock, subject to certain limitations and conditions set forth in the SEPA, from time to time during the term of the SEPA (such transaction, the “Yorkville Transaction”). In connection with the SEPA, and subject to the conditions set forth therein, Yorkville has agreed to advance to the Company in the form of convertible promissory notes (the “Convertible Notes”) an aggregate principal amount of up to $ 12.5 million (the “Pre-Paid Advance”), which will be paid in three tranches. The first Pre-Paid Advance was disbursed on March 20, 2024 in the amount of $ 5.0 million with a fixed conversion price of $ 3.16 . The Company received $ 4.6 million in cash, net of the 8 % original issue discount. On May 14, 2024, the shareholders voted to approve the reservation and issuance of shares to Yorkville to exceed the Exchange Cap and the second Pre-Paid Advance was disbursed on May 16, 2024 in the amount of $ 4.6 million, which is the $ 5.0 million second Pre-Paid Advance net of $ 0.4 million of the 8 % original issue discount, with a fixed conversion price of $ 2.03 . The third Pre-Paid Advance was disbursed on July 17, 2024 in the principal amount of $ 2.3 million, which is the $ 2.5 million third Pre-Paid Advance net of the $ 0.2 million of the 8 % original issue discount, with a fixed conversion price equal to 120 % of the average VWAP during the three trading days immediately prior to the issuance of the note. The purchase price for the Pre-Paid Advance is 92.0 % of the principal amount of the Pre-Paid Advance. Interest shall accrue on the outstanding balance of any Pre-Paid Advance at an annual rate equal to 0 %, subject to an increase to 18 % upon an event of default as described in the Convertible Notes. The Company paid no interest relating to the Convertible Notes. Beginning on the forty-fifth (45th) day following the issuance date of the Convertible Note issued in connection with the first Pre-Paid Advance, and continuing on the same day of each successive month thereafter, (each, an “Installment Date”), the Company shall repay a portion of the outstanding balance of the Pre-Paid Advance in an amount equal to (i) $ 1,750,000 , provided however, in respect of any Installment Date prior to the closing of the second Pre-Paid Advance, $ 750,000 (the “Installment Principal Amount”), plus (ii) the a payment premium of 7 % of such Installment Principal Amount, and (iii) accrued and unpaid interest hereunder as of each Installment Date. The maturity date of the Convertible Notes issued in connection with each Pre-Paid Advance will be 12 months after the issuance date of such Convertible Notes. In October 2024, the Company and Yorkville agreed to amend the dates and the allocation of installment amounts to be paid pursuant to the Pre-Paid Advances, such that the outstanding balance of the Pre-Paid Advances is to be paid by February 2025. As of December 31, 2024, the Company has made aggregate installment payments on the Pre-Paid Advances in the amount of $ 10.2 million, of which $ 7.8 million was settled in cash and $ 2.4 million was settled in shares. Of the aggregate installment payments, $ 9.4 million relates to the repayment of the principal, $ 0.8 million relates to the 8 % original issue discount and $ 0.6 million relates to the 7 % payment premium. As of December 31, 2024, the aggregate outstanding principal balance of the Yorkville Convertible Notes is $ 2.1 million. As of December 31, 2024, $ 7.8 million of the outstanding balance of the Pre-Paid Advances has been paid in cash and $ 2.4 million was paid in shares of the Company issued under the SEPA. The Company still has access to the remaining funds under the SEPA. The sales of the shares of Common Stock to Yorkville under the SEPA, and the timing of any such sales, are at the Company’s option. As the SEPA is an equity-linked contract that does not qualify for equity classification, any expenses incurred will be recognized in the consolidated statements of operations and comprehensive loss within borrowing related costs. For the year ended December 31, 2024, the Company recognized $ 1.1 million in issuance costs related to the 8 % original issue discount for the SEPA. F- 21 Related Party Note On March 19, 2024, the Company announced that Spectral IP received a $ 1.0 million investment from an affiliate of its largest shareholder for the acquisition and development of a health care related artificial intelligence intellectual property portfolio. The investment is structured as a note payable with a one-year maturity, at an interest rate of 8 %, and requiring earlier prepayment if the Company spins off Spectral IP to the Company’s shareholders or if Spectral IP is sold to a third party. The holder of the Spectral IP Note exercised a number of conversion rights throughout the fourth quarter of 2024 for the full conversion of the Spectral IP Note in exchange for a total of 540,996 shares of the Company’s common stock, which represents a 5.00 % discount to the closing price of the Company’s shares of Common Stock on the day prior to the date of notice of the holder’s exercise of its conversion right. Insurance Notes The Company finances its director and officer liability insurance premiums over a term of less than one year. The Company has determined that the carrying amounts of all of the insurance notes approximate fair value due to the short-term nature of borrowings and current market rates of interest. 8. COMMITMENTS AND CONTINGENCIES Legal Matters The Company is not a party to any material legal proceedings or pending claims. The Company is aware of a material threatened claim that it believes is without merit. From time to time, the Company may be subject to various legal proceedings and claims that arise in the ordinary course of its business activities, none of which we believe are material or would be expected to have, individually or in the aggregate, a material adverse effect on our business, financial condition, cash flows or results of operations. 9. LEASES The Company leases office space for its principal office in Dallas, Texas, which was amended in April 2024 to extend the lease term to expire in February 2028. The lease amendment also included a landlord-provided tenant improvement allowance of up to $ 0.3 million to be applied to the costs of the construction of leasehold improvements. The Company determined that it owns the leasehold improvements under the lease and, as such, reflected the $ 0.3 million lease incentive as a reduction in lease liabilities and right-of-use assets. As of December 31, 2024, the Company has not yet incurred any leasehold improvement costs that were paid for by the lessor. During 2023, the Company entered into a lease for office space in the United Kingdom for annual payments of $ 0.1 million under a lease that expired in March 2024. The lease was renewed in March 2024, however the Company has excluded this lease from the tables below as the term is twelve months . The following table summarizes quantitative information about the Company’s operating leases for the years ended December 31, 2024 and 2023 (in thousands): Year Ended December 31, 2024 2023 Operating cash flows used in operating leases $ 894 $ 744 Right-of-use assets exchanged for operating lease liabilities $ 1,771 $ 483 Weighted average remaining lease term (in years) 3.2 1.0 Weighted average discount rate 8.5 % 8.5 % The following table provides the components of the Company’s lease cost included in general and administrative expense in the consolidated statement of operations (in thousands): Year Ended December 31, 2024 2023 Operating leases Operating lease cost $ 751 $ 802 Variable lease cost 407 357 Operating lease expense 1,158 1,159 Short-term lease rent expense 149 110 Total rent expense $ 1,307 $ 1,269 F- 22 Variable lease cost is primarily attributable to amounts paid to lessors for utility charges, parking, and property taxes under an office space lease. As of December 31, 2024, future minimum payments under the non-cancelable operating leases were as follows (in thousands): Year ended December 31, 2025 $ 527 Year ended December 31, 2026 850 Year ended December 31, 2027 871 Year ended December 31, 2028 149 Total 2,397 Less: imputed interest ( 167 ) Less: tenant improvement allowance ( 327 ) Operating lease liabilities $ 1,903 10. STOCKHOLDERS’ EQUITY In conjunction with the Closing, the Company’s certificate of incorporation was amended and restated to authorize the issuance of 80,000,000 shares of Company Common Stock, $ 0.0001 par value and 1,000,000 shares of preferred stock, $ 0.0001 par value (the “Company Preferred Stock”). In November and December 2024, the Company issued 2,415,900 shares for aggregate net proceeds of approximately $ 3.1 million to certain institutional investors through at-the market equity issuances. 11. STOCK-BASED COMPENSATION Each option and warrant to purchase common stock of Legacy Spectral was converted into an option and warrant, respectively, to purchase Spectral AI’s common stock based on the Exchange Ratio, with corresponding adjustments to the exercise price. Accordingly, the options and warrants to purchase 46,592,862 and 762,712 , respectively, shares of the common stock of Legacy Spectral were converted into options and warrants to purchase 4,519,191 and 73,978 , respectively, shares of Spectral AI’s common stock. Legacy Spectral’s 600,000 RSUs were converted into 58,197 Spectral AI RSUs, based on the Exchange Ratio. 2018 Long Term Incentive Plan On July 24, 2018, Legacy Spectral’s Board of Directors adopted the 2018 Long Term Incentive Plan (the “2018 Plan”) which permitted granting of incentive stock options (which must meet all statutory requirements), non-qualified stock options, stock appreciation rights, restricted stock, stock units, performance shares, performance units, incentive bonus awards, and other cash-based or stock-based awards. In May 2024, all awards outstanding under the 2018 Plan were replaced with corresponding awards to be issued pursuant to the 2023 Plan, as discussed below, and no new grants will be made under the 2018 Plan. F- 23 2022 Long Term Incentive Plan On September 27, 2022, Legacy Spectral’s stockholders approved the adoption of the 2022 Long Term Incentive Plan (the “2022 Plan”) which permitted granting of incentive stock options (they must meet all statutory requirements), non-qualified stock options, stock appreciation rights, restricted stock, stock units, performance shares, performance units, incentive bonus awards, and other cash-based or stock-based awards. In May 2024, all awards outstanding under the 2022 Plan were replaced with corresponding awards to be issued pursuant to the 2023 Plan, as discussed below, and no new grants will be made under the 2022 Plan. 2023 Long Term Incentive Plan On May 14, 2024, the Company’s shareholders approved the adoption of the 2023 Long Term Incentive Plan (the “2023 Plan”) which permits granting of incentive stock options (they must meet all statutory requirements), non-qualified stock options, stock appreciation rights, restricted stock, stock units, performance shares, performance units, incentive bonus awards, and other cash-based or stock-based awards. The options, restricted stock units and other securities issued pursuant to the 2018 Plan and 2022 Plan have been replaced with a corresponding award issued pursuant to the 2023 Plan. No new grants will be made under the 2022 Plan and the 2018 Plan and all outstanding grants under the 2018 Plan and 2022 Plan will be assumed by the 2023 Plan. The maximum aggregate number of shares that may be issued under the Plan shall not exceed 8,000,000 , plus the number of shares that are automatically added on January 1st of each year for a period of up to ten years, commencing on January 1, 2024 and ending on (and including) January 1, 2033, in an amount equal to the lesser of (i) five percent ( 5 %) of the total number of shares of stock outstanding on December 31st of the preceding calendar year, and (ii) an amount determined by the Board of Directors. Pursuant to the 2023 Plan, stock options must expire within 10 years and must be granted with exercise prices of no less than the fair value of the common stock on the grant date, as determined by the Board of Directors. As of December 31, 2024, under the 2023 Plan, 3,594,488 shares of common stock were issuable upon exercise of outstanding options and 169,400 restricted stock units (“RSUs”) were issuable. Under the 2023 Plan, 4,236,112 shares remain available for issuance through grants of future options. The 2023 Plan provides that the Compensation Committee shall determine the vesting conditions of awards granted under the 2023 Plan, and the Compensation Committee has from time-to-time approved vesting schedules for certain awards that deviate from the vesting conditions described in the previous sentence. Restricted Stock Units On January 3, 2024, pursuant to the 2022 Plan, the Company granted its then-CFO a market condition RSU of up to 150,000 shares of the Company’s common stock. The award had a grant date fair value of approximately $0.4 million using a Monte Carlo simulation model. The RSUs under this market-based award will vest partially based on achievement of stock price targets of the Company’s common stock. 50,000 RSUs vest when the 180-day VWAP meets or exceeds $ 8.00 per share, 50,000 RSUs vest when the 180-day VWAP meets or exceeds $ 12.00 per share, and 50,000 RSUs are not market-based and will vest over the continued service period of three years. These market-based conditions must be met in order for portions of the RSU award to vest, and it is therefore possible that certain awards ultimately would not vest. The grant date fair value of each RSU grant is expensed over the requisite service period. Compensation expense relating to share-based awards with market-based conditions is not reversed if these awards are forfeited based solely on failing to meet such market-based conditions. On February 29, 2024, pursuant to the 2022 Plan, the Company granted both its CFO and CEO awards of RSUs up to 150,000 shares of the Company’s common stock. The two awards together had a grant date fair value of approximately $ 0.6 million using a Monte Carlo simulation model. The portion of RSUs that are market-based awards will vest partially based on achievement of stock price targets of the Company’s common stock. 37,500 RSUs vest when the 180-day VWAP meets or exceeds $ 8.00 per share, 37,500 RSUs vest when the 180-day VWAP meets or exceeds $ 10.00 per share. The market-based conditions must be met in order for the market-based portion of the RSU awards to vest, and it is therefore possible that certain awards ultimately would not vest. 75,000 RSUs are not market-based and will vest over the continued service period of three years. The grant date fair value of each RSU grant is expensed over the requisite service period. Compensation expense relating to share-based awards with market-based conditions is not reversed if these awards are forfeited based solely on failing to meet such market-based conditions. On February 29, 2024, the Company amended the terms of the January 3, 2024 RSU grant to its then-CFO to provide for identical vesting terms to those provided in the February 29, 2024 RSU grant. The Company determined the amended RSU grant represents a modification of the original award, however, the incremental compensation cost of the amendment was not material. F- 24 In October 2024, in connection with the resignation of the then-CEO, 300,000 unvested RSUs were forfeited and the Company granted 100,000 RSUs that immediately vested to the then-CEO. The previously recognized compensation cost related to the forfeited RSUs was reversed upon forfeiture, and the fair value of the awards granted in October 2024 was expensed as of the grant date. A summary of RSU activities for the year ended December 31, 2024 are presented below: Number of Shares Weighted Average Grant Date Fair Value per Share Nonvested as of January 1, 2024 58,197 $ 4.65 Granted 550,000 $ 1.98 Vested ( 129,097 ) $ 0.99 Forfeited ( 309,699 ) $ 2.24 Nonvested as of December 31, 2024 169,401 $ 1.73 During the year ended December 31, 2024 and 2023, the Company granted 550,000 and 58,197 restricted stock units, respectively, with a weighted-average grant date fair value of $ 1.98 per share and $ 4.65 per share, respectively. As of December 31, 2024, total unrecognized compensation expense related to restricted stock units was $ 0.3 million, which is expected to be recognized over a weighted-average period of 1.5 years. Stock Options The fair value of each employee and non-employee stock option grant is estimated on the date of grant using the Black-Scholes option-pricing model. Legacy Spectral’s stock became publicly traded on June 22, 2021 on the AIM Market of the London Stock Exchange, and lacks company-specific historical and implied volatility information. On September 11, 2023 the Company completed the Business Combination and was listed on NASDAQ under the symbol MDAI. Legacy Spectral estimated its expected stock volatility based on the historical volatility of a publicly traded set of peer companies. Spectral AI continues to estimate its expected stock volatility based on the historical volatility of a publicly traded set of peer companies. Due to the lack of historical exercise history, the expected term of Legacy Spectral’s and Spectral AI’s stock options for employees has been determined utilizing the simplified method by taking an average of the vesting periods and the original contractual terms for each award. The expected term of stock options granted to non-employees is equal to the contractual term of the option award. The risk-free interest rate is determined by reference to the US. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is zero based on the fact that Legacy Spectral and Spectral AI have never paid cash dividends and Spectral AI does not expect to pay any cash dividends in the foreseeable future. The Company’s stock options generally vest ratably annually over 3 years and have a contractual term of 10 years. In applying the Black Scholes option pricing model, the Company used the following assumptions for stock options granted during the years ended December 31, 2024 and 2023: Year ended December 31, 2024 Year ended December 31, 2023 Fair value of common stock $ 1.51 $ 4.57 Expected term (years) 4.8 6.0 Volatility (annual) 66 % 72 % Risk-free rate 4.2 % 3.6 % Dividend yield (per share) 0 % 0 % F- 25 A summary of stock options activity for the year ended December 31, 2024 is presented below: Stock Options Weighted Average Exercise Price Weighted Average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at January 1, 2024 3,598,944 $ 2.20 6.5 $ 8,087 Options granted 643,437 $ 1.55 Options forfeited 156,156 ) $ 3.88 Options cancelled ( 209,880 ) $ 3.56 Options exercised ( 281,857 ) $ 1.07 Outstanding as of December 31, 2024 3,594,488 $ 2.01 6.0 3,825 Options vested and exercisable as of December 31, 2024 2,941,842 $ 1.87 5.5 3,285 The aggregate intrinsic value of options is calculated as the difference between the exercise price of the stock options and the fair value of the Company’s common stock for those stock options that had exercise prices lower than the fair value of the common stock as of the respective date. The weighted-average grant date fair value of stock options granted during the years ended December 31, 2024 and 2023 was $ 0.90 and $ 3.20 per share, respectively. As of December 31, 2024, there was approximately $ 0.7 million of unrecognized stock-based compensation related to stock option grants that will be amortized over a weighted average period of 0.8 years. The Company recorded stock-based compensation expense for stock options, RSUs, and restricted stock awards of $ 1.03 million for the year ended December 31, 2024 and $ 1.2 million for the year ended December 31, 2023 in general and administrative expenses in the consolidated statements of operations. During the year ended December 31, 2018, the Company granted 973,803 stock options to investors (the “Investor Options”) that were approved by the Board of Directors outside of the 2018 Plan. During the year ended December 31, 2023, 34,779 of the Investor Options were exercised and the remaining 904,245 Investor Options expired in November 2023. The Investor Options had an exercise price of $ 2.06 per share. As of December 31, 2024, there is no unrecognized stock-based compensation expense related to the Investor Options. 12. INCOME TAXES Effective Tax Rate The overall effective tax rate (“ETR”) for the Company, as calculated under ASC 740 guidance for the years ended December 31, 2024, and 2023 is ( 1.78 %) and ( 0.10 %), respectively. The following table reconciles the federal statutory income rate to the Company’s effective income tax rate: 2024 2023 Federal income tax rate 21.00 % 21.00 % State income tax benefit ( 0.65 )% ( 0.10 )% Impact of non-U.S. Earnings ( 0.63 )% 0.10 % Permanent items ( 7.34 )% ( 8.20 )% Return to provision adjustments ( 0.05 )% 0.00 % Non-deductible stock compensation ( 1.03 )% ( 1.10 )% Non-deductible executive compensation ( 1.35 )% 0.00 % Tax Credits 0.16 % 0.00 % Difference and changes in tax rates 0.06 % 0.00 % Other 0.01 % 0.00 % Change in valuation allowance ( 11.95 )% ( 11.82 )% Effective income tax rate ( 1.78 )% ( 0.10 )% The above schedule beaks out the key components of the ETR. The main drivers between the federal statutory rate of 21 % and ETR of ( 1.78 %) are permanent adjustments and change in valuation allowance. F- 26 Components of Income Tax Expense/(Benefit) The components of income tax expense/(benefit) for the years ended December 31, 2024 and 2023 are as follows (in thousands): 2024 2023 Current US Federal $ 157 $ ( 5 ) US State 114 15 Total current provision 271 10 Total provision for income taxes $ 271 $ 10 The Company is in a taxable loss position for the year ending December 31, 2024. The current tax expense of $ 271,000 is resulting from a reversal of a federal income tax refund and the gross margin tax for the Company’s state filing in Texas. Deferred Income Taxes The main components of deferred tax assets/(liabilities) for the periods ended December 31, 2024 and 2023, are as follows (in thousands): 2024 2023 Deferred income tax assets: Net operating loss carryforwards $ 4,518 $ 2,419 Capitalized research expenses 870 717 Stock-based compensation 337 278 Lease liabilities - 179 Tax credits 118 44 Other 81 875 Total deferred income tax assets 6,661 4,512 Deferred income tax liabilities: Right-of-use assets ( 412 ) ( 163 ) Lease liabilities ( 75 ) - Other - - Total deferred income tax liabilities $ ( 487 ) $ ( 163 ) Net deferred income tax assets $ 6,174 $ 4,349 Valuation allowance ( 6,174 ) ( 4,349 ) Deferred income tax assets, net of valuation allowance - - Valuation Allowance Considerations ASC 740, “Income Taxes” requires that a valuation allowance be established when it is “more likely than not” that all, or a portion of, deferred tax assets will not be realized. A review of all available positive and negative evidence needs to be considered, including the scheduled reversal of deferred tax liabilities, projected future taxable income, and tax planning strategies. After consideration of all the information available, management believes that uncertainty exists with respect to future realization of its deferred tax assets and has, therefore, established a full valuation allowance as of December 31, 2024, and 2023. The net change in valuation allowance for the years ended December 31, 2024 and 2023 was an increase of $ 1.8 million and $ 3.0 million, respectively. Section 174 Capitalization The Tax Cuts and Jobs Act of 2017 (TCJA) made a significant change to Section 174 that went into effect for taxable years beginning after December 31, 2021. The change eliminated the ability to currently deduct R&D expenses. Instead, taxpayers must now capitalize and amortize these costs. Capitalized Section 174 costs must be amortized over five years ( 15 years for expenditures attributable to foreign research) beginning with the midpoint of the tax year in which the expenditures are paid or incurred. The Company had an estimated $ 1.7 million of domestic R&D expenses for the tax year ending December 31, 2024. The domestic R&D expenses will be capitalized and amortized over a five-year period. F- 27 Net Operating Losses As of December 31, 2024 and 2023, the Company had available federal net operating loss carryforwards (“NOLs”) of $ 19.2 million and $ 11.0 million, respectively, which are available to offset future federal taxable income. Under the Tax Cuts and Jobs Act (“TCJA”), all NOLs incurred after December 31, 2017 are carried forward indefinitely for federal tax purposes. Utilization of net operating losses and credits may be subject to substantial annual limitations due to the “change in ownership” provisions of the Internal Revenue Code of 1986 and similar state provisions. The annual limitations may result in the expiration of net operating losses before utilization. Section 382 of the Internal Revenue Code limits the utilization of U.S. net operating loss (“NOL”) carryforwards following a change of control. We have not performed an analysis of whether a change of control defined under Section 382 may have occurred. Upon performing an analysis of whether an ownership change has occurred, any future NOL deductions may be limited. However, our NOL carryforward as discussed above does not expire. The Company is subject to taxation in the U.S and in various state, local and foreign jurisdictions. The Company’s tax returns for years 2021 through present are open to tax examinations by U.S. Federal, state, local and foreign tax authorities; however, carryforward attributes that were generated prior to January 1, 2018, remain subject to adjustment upon examination if they either have been utilized or will be utilized in a future period. 13. NET LOSS PER COMMON SHARE Basic and diluted net loss per common share attributable to common stockholders are the same for the years ended December 31, 2024 and 2023, since the inclusion of all potential shares of common stock outstanding would have been anti-dilutive due to the Company’s net loss. The table below summarizes potentially dilutive securities that were excluded from the computation of net loss per common share as of the periods presented because including them would be anti-dilutive. 2024 2023 Common stock options 3,594,484 3,578,579 Common stock warrants 8,507,311 8,507,311 Unvested restricted stock units 169,399 58,197 Unvested restricted stock - - Potentially dilutive securities 12,271,194 12,144,087 14. RELATED PARTY TRANSACTIONS On March 7, 2024, the Company formed a new wholly-owned subsidiary, Spectral IP, to be utilized to advance artificial intelligent intellectual property with a specific emphasis on healthcare. On March 19, 2024, the Company announced that Spectral IP received a $ 1.0 million investment from an affiliate of its largest shareholder for the development of its artificial intelligence intellectual property portfolio. The investment is structured as a note payable with a one-year maturity, an interest rate of 8 %, and requiring earlier prepayment if the Company spins off Spectral IP to the Company’s shareholders or if Spectral IP is sold to a third party (the “Note”). On October 1, 2024, the Note was amended to (i) reduce the annual interest rate from 8 % to 4 %, (ii) extend the term of the Note through the second anniversary of the issuance date, March 18, 2026, (iii) include a conversion feature at the option of either IP Protocol or Spectral IP to convert the then outstanding principal and accrued but unpaid interest into shares of the Company at any time (into such number of shares calculated by taking a five percent ( 5.00 %) discount to the closing price of the Company’s common stock on the day prior to the date of notice to the Company of the exercise of the conversion right) and at maturity, respectively, and (iv) provide for registration rights of any shares of the Company issued in satisfaction of the outstanding obligations. In December 2024, the Company issued 540,996 shares of common stock to settle its outstanding obligations under the Note. For the year ended December 31, 2023, the Company did not have any transactions with related parties. 15. SUBSEQUENT EVENTS On March 24, 2025, the Company completed an equity financing and entered into a long-term debt financing agreement with Avenue Venture Opportunities Fund II, L.P., a fund of Avenue Capital Group, with an initial draw-down of $ 8.5 million. In connection with the debt financing, the Company also raised approximately $ 2.7 million of equity financing from institutional investors, as well as existing UK investors. The financing includes the potential for up to almost $ 25.0 million with the completion of the milestones for the second tranche of debt financing. The term of the financing agreement is for three years , with an interest-only payment period of no less than 15 months, which can be extended to 24 months upon achieving the milestones for the second financing tranche. The second financing tranche, which includes an additional $ 6.5 million in debt financing from Avenue Capital Group is contingent upon; (i) FDA clearance of the DeepView System and (ii) the Company completing a $ 7.0 million equity raise. The Company also issued 768,072 warrants to Avenue Capital Group which was equal to 8.5 % of the total funding commitment, with an exercise price of $ 1.66 per share as part of the debt financing. F- 28 (b) Exhibits: The exhibits listed in the accompanying index to exhibits are filed or incorporated by reference as part of this Annual Report on Form 10-K. Exhibit Index Exhibit Number Description 2.1†** Business Combination Agreement, by and among Rosecliff Acquisition Corp I, Merger Sub I, Merger Sub II and Spectral MD Holdings, Ltd., dated as of April 11, 2023 (incorporated by reference to Annex A of the Registration Statement on Form S-4 (File No. 333-271566)). 3.1** Second Amended and Restated Certificate of Incorporation of Spectral AI, Inc. (incorporated by reference to the Registrant’s Current Report on Form 8-K filed with the SEC on September 15, 2023). 3.2** Amended and Restated Bylaws of Spectral AI, Inc. (incorporated by reference to the Registrant’s Current Report on Form 8-K filed with the SEC on September 15, 2023). 4.1** Warrant Agreement, dated February 11, 2021, between Rosecliff Acquisition Corp I and Continental Stock Transfer & Trust Company, as warrant agent (incorporated by reference to the Registrant’s Current Report on Form 8-K filed with the SEC on February 17, 2021) 4.2** Description of the Registrant’s Securities (incorporated by reference to the Registrant’s Annual Report on Form 10-K filed on March 31, 2022) 4.3** Amended and Restated Registration Rights & Lock-up Agreement (incorporated by reference to the Registrant’s Current Report on Form 8-K filed with the SEC on September 15, 2023). 4.4** Registration Rights Agreement, dated December 26, 2023, between the Registrant and B. Riley Principal Capital II, LLC (incorporated by reference to Exhibit 10.2 of the Registrant’s Current Report on Form 8-K filed with the SEC on December 27, 2023). 10.1** Form of Indemnification Agreement (incorporated by reference to the Registrant’s Current Report on Form 8-K filed with the SEC on September 15, 2023). 10.2** Sponsor Warrants Purchase Agreement, dated February 11, 2021, between the Registrant and the Sponsor (incorporated by reference to the Registrant’s Current Report on Form 8-K filed with the SEC on February 17, 2021) 10.3** BARDA Award/Contract, July 1, 2019, by and between Spectral MD, Inc. and ASPR-BARDA (incorporated by reference to Exhibit 10.14 of the Registration Statement on Form S-4 (File No. 333-271566)). 10.4** Amendment of the Solicitation/Modification of the BARDA Contract, dated August 26, 2022, by and between Spectral MD, Inc. and ASPR-BARDA (incorporated by reference to Exhibit 10.15 of the Registration Statement on Form S-4 (File No. 333-271566)). 10.5** Award/Contract for DHA, dated July 1, 2021, by and between Spectral MD, Inc. and U.S. Army Medical Materiel Development Activity (incorporated by reference to Exhibit 10.16 of the Registration Statement on Form S-4 (File No. 333-271566)). 10.6** Amendment of the Solicitation/Modification of the DHA Contract, dated July 1, 2021, by and between Spectral MD, Inc. and U.S. Army medical Materiel Development Activity (incorporated by reference to Exhibit 10.17 of the Registration Statement on Form S-4 (File No. 333-271566)). 10.7** MTEC Research Project Award, dated April 12, 2023, by and between Spectral. MD, Inc. and Advanced Technology International MTEC Consortium Manager (incorporated by reference to Exhibit 10.18 of the Registration Statement on Form S-4 (File No. 333-271566)). 10.8** Sponsor Letter Agreement, dated April 11, 2023, by and among Rosecliff Acquisition I Sponsor LLC, Spectral MD Holdings, Ltd., and Rosecliff Acquisition Corp I (incorporated by reference to Annex F of the Registration Statement on Form S-4 (File No. 333-271566)). 10.9†** Common Stock Purchase Agreement, dated December 26, 2023, between the Registrant and B. Riley Principal Capital II, LLC (incorporated by reference to Exhibit 10.1 of the Registrant’s Current Report on Form 8-K filed with the SEC on December 27, 2023). 10.10** Spectral MD, Inc. 2018 Long Term Incentive Plan (incorporated by referenced to Exhibit 99.1 of Registrant’s Registration Statement on Form S-8, filed with the SEC on February 9, 2024) 75 10.10.1** Form of Stock Option Award Agreement under Spectral MD, Inc. 2018 Long-Term Incentive Plan (incorporated by referenced to Exhibit 99.3 of Registrant’s Registration Statement on Form S-8, filed with the SEC on February 9, 2024) 10.10.2** Form of RSU Award Agreement under Spectral MD, Inc. 2018 Long-Term Incentive Plan (incorporated by referenced to Exhibit 99.4 of Registrant’s Registration Statement on Form S-8, filed with the SEC on February 9, 2024) 10.11** Spectral MD Holdings, Ltd. 2022 Long Term Incentive Plan (incorporated by referenced to Exhibit 99.2 of Registrant’s Registration Statement on Form S-8, filed with the SEC on February 9, 2024) 10.11.1** Form of Stock Option Award Agreement under Spectral MD Holdings, Ltd. 2022 Long-Term Incentive Plan (incorporated by referenced to Exhibit 99.5 of Registrant’s Registration Statement on Form S-8, filed with the SEC on February 9, 2024) 10.11.2** Form of RSU Award Agreement under Spectral MD Holdings, Ltd. 2022 Long-Term Incentive Plan (incorporated by referenced to Exhibit 99.6 of Registrant’s Registration Statement on Form S-8, filed with the SEC on February 9, 2024) 10.12** Spectral AI, Inc. 2023 Long Term Incentive Plan (Incorporated by reference to Exhibit 10.12 of Registrants Form 10-K, filed with the SEC on March 29, 2024) 14** Code of Business Conduct and Ethics (Incorporated by reference to Exhibit 14 of Registrants Form 10-K, filed with the SEC on March 29, 2024) 19** Insider Trading Policy (Incorporated by reference to Exhibit 19 of Registrants Form 10-K, filed with the SEC on March 29, 2024) 21 List of Subsidiaries of the Registrant as of December 31, 2024. 23.1 Consent of KPMG LLP. 31.1 Certification of the Principal Executive Officer pursuant to Rule 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934, as adopted pursuant to §302 of the Sarbanes-Oxley Act of 2002 31.2 Certification of the Chief Financial Officer pursuant to Rule 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934, as adopted pursuant to §302 of the Sarbanes-Oxley Act of 2002 32.1 18 U.S.C. Section 1350 Certifications of the Principal Executive Officer and the Chief Financial Officer 97** Policy relating to recovery of erroneously awarded compensation (Incorporated by reference to Exhibit 97 of Registrants Form 10-K, filed with the SEC on March 29, 2024) 101.INS Inline XBRL Instance Document 101.SCH Inline XBRL Taxonomy Extension Schema Document 101.CAL Inline XBRL Taxonomy Extension Calculation Linkbase Document 101.DEF Inline XBRL Taxonomy Extension Definition Linkbase Document 101.LAB Inline XBRL Taxonomy Extension Label Linkbase Document 101.PRE Inline XBRL Taxonomy Extension Presentation Linkbase Document 104 Cover Page Interactive Data File ** Previously filed. † Certain portions of this Exhibit have been omitted pursuant to Regulation S-K Item 601(a)(5), Item 601(a)(6) or Item 601(b)(10), as applicable, promulgated under the Exchange Act. The Registrant agrees to furnish supplementally a copy of any omitted schedule to the SEC upon request. Item 16. Form 10-K Summary. None. 76 SIGNATURES Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized. Signature Title Date /s/ J. Michael DiMaio Chairman of the Board of Directors March 31, 2025 J. Michael DiMaio ( Principal Executive Officer ) /s/ Vincent Capone Chief Financial Officer March 31, 2025 Vincent Capone ( Principal Financial Officer, General Counsel And Principal Accounting Officer ) /s/ Richard Cotton Director March 31, 2025 Richard Cotton /s/ Martin Mellish Director March 31, 2025 Martin Mellish /s/ Deepak Sadagopan Director March 31, 2025 Deepak Sadagopan /s/ Erich Spangenberg Director March 31, 2025 Erich Spangenberg /s/ Marion Snyder Director March 31, 2025 Marion Snyder 77