Section 2

Monthly Volume

The 2026 operating trend strengthened sharply in the second quarter. June established the highest monthly count, while partial July volume sustained the highest exams-per-active-day rate of the period.

The growth rate that drives the model

Examinations per active service day is the operating rate the scenario model projects forward. Raw monthly counts mix true demand growth with the number of days the scanner was open, so the model compounds the daily rate and applies active days separately.

Section 3

Daily Volume and Operating Pattern

Daily capacity increased materially from the first quarter into June and July. The moving-average view separates the underlying rise from day-to-day patient mix.

Operating pattern by day of week

Tuesday carried the highest average exam load at 5.52 examinations per active day. Thursday carried the highest average patient load at 4.52 patients per active day. The spread across weekdays is narrow, which means there is no single weak day to fill; incremental volume has to come from added slots or added days rather than from redistributing the existing week.

Appendix A. Daily volume by date of service

Active service dates carrying at least one net diagnostic imaging examination after professional component exclusion. Unique patients are counted within each date.

Section 4

Patient Utilization and Multiple Procedures

Most patients had one examination, but more than one-quarter had multiple procedures. This distinction matters for scheduling because exam load grows faster than patient arrivals when multi-exam visits increase.

Multiple-procedure structure

Section 5. Patient identification quality

The composite key identifies every reportable exam row, but account fallback is less durable than a facility MRN. If a patient receives a new account number on a future visit and still lacks an MRN, that patient may be counted twice across periods. This affects the unique-patient count and the exams-per-patient ratio, not the examination count itself, so projected volume and projected revenue are unaffected.

Section 6

Interactive Scenario Model

The model projects examinations forward from the observed operating rate and converts that volume into revenue, contribution, EBITDA, and debt service coverage. Change any input below and every figure, table, and readout on this page recalculates.

Selected scenario at a glance

Monthly projection

Annual summary

Scenario comparison

Section 7

Lender Package

This section restates the model in the terms a credit committee works in: what is assumed, what the debt costs, how many examinations cover it, and what happens when the assumptions move against the borrower.

Assumptions register

Every input the model uses, with its current value and its basis. Inputs marked as an assumption are not observed in the source data and are the borrower’s representations.

Debt service

The monthly payment is the standard level-payment amortization: the principal multiplied by the monthly periodic rate, divided by one minus the compounding factor raised to the negative number of payments.

Breakeven expressed in examinations

Coverage tests are usually written in dollars, but the operation manages examinations. These rows translate each threshold into the operating unit the schedule actually controls.

Sensitivity: year one coverage

Downside stress tests

Sections 8 to 10

Definitions, Controls, Limitations, and Exports

Metric definitions

Patient matching logic

• Facility MRN is the preferred patient identifier when it contains a valid value.
• The export value 37 is treated as a missing MRN. When MRN is unavailable, the Account field provides the patient-level fallback.
• If one account is associated with multiple real MRNs, the records remain separate at the MRN level. Two account-to-MRN conflicts were handled this way.
• All 635 signed imaging-exam rows received a patient key.

Recommended controls and operating actions

• Make modifier 26 exclusion a permanent refresh rule. Retain a visible reconciliation showing rows removed and net units removed so billing corrections remain auditable.
• Maintain separate measures for charge-line procedures and diagnostic imaging exams. Exclude contrast supply CPT A9577 and zero-unit administrative or miscellaneous lines from the exam KPI.
• Improve Facility MRN capture for the 108 account-fallback patients. A stable MRN will reduce the risk of overstating unique patients when repeat visits create new accounts.
• Use June and July operating levels for near-term capacity planning. Recent demand is approximately 7.4 exams per active day, with observed peaks of 11 exams.
• Monitor multi-exam blocks separately from simple patient arrivals. Approximately 23.2% of patients had multiple same-day exams, which can create longer table utilization and protocol complexity.

Limitations

• The source does not contain patient names or dates of birth. Identification relies on Facility MRN and Account only.
• The September 2025 record is isolated from the main 2026 operating period and should not be interpreted as a full historical month.
• July 2026 is incomplete through July 24. Monthly totals should be compared using active-day rates as well as raw counts.
• Signed procedure units are used so reversals reduce volume. A different operational definition, such as one exam per accession, would produce a different count and should be separately specified.
• The scenario model projects a single blended examination. It does not model modality mix, payer mix, or the timing difference between service date and cash collection. A model presented for credit should be paired with an accounts receivable and collection-lag schedule.
• Every financial input is an assumption entered into this model, not a figure observed in the source report.

Exports

Each table carries its own CSV button and each figure carries its own PNG button. The buttons below export the whole model.