What is CARL's options positioning and volatility profile?

Roarable tracks verified CBOE unusual options sweeps, put/call ratios, and OHLCV realized volatility bands for CARL.

Stock Ratings / Health Care / CARL / options

SI (44) NPCE (21) OFIX (42) BWAY (44) ⌘ Pro Terminal →

Carlsmed Inc. (CARL) Options Positioning, Max Pain & Unusual Sweeps

$15.02 +0.47% NASDAQ • Live Quote vs Prior Daily Close (Synced Snapshot) EXT / AFTER-HRS: $15.00

Carlsmed Inc. (CARL) carries a Roarable Rating of D- (Sell) with 38/100 RQD Confidence due to weak cash-flow efficiency and sensitivity to current interest rates. Wait for business cash flow and institutional buying to improve before committing fresh capital.

ROARABLE D- • RED ALERT Cap $408.2M

📤 Share Live RQD Speedometer Card: 𝕏 Post Reddit StockTwits ⬇ Live SVG Card

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🤖 Mara Quenwick • AI Quant Lead (Click for Instant Brief) Is CARL stock a Buy, Hold, or Sell right now according to Roarable's RQD model?

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As of 2026-11-03, Carlsmed Inc. (NASDAQ: CARL) is rated D- (Sell / SELL) by Roarable's 5-pillar RQD engine with a composite confidence score of 38/100 at a spot price of $15.02 (+0.47% 1D, market cap $408.2M). Pillar breakdown: Fundamental Cash Engine 8/20, Institutional 13F & Options Flow 11/20, Executive Insider Alignment 8/20, FRED Macro Regime Fit 8/20, and SEC Balance-Sheet Forensics 3/20. Across 1016 tracked Health Care issuers, CARL ranks #507 in composite RQD confidence.

✓ Pre-computed one-to-many AI Quant brief

🤖 Ellis Vennor • AI Peer & Flow Quant (Click for Instant Brief) How does CARL compare to SI and NPCE in the Health Care sector?

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Within the Health Care sector (Medical/Dental Instruments), CARL carries a Roarable D- (38/100 RQD), trailing P/E of N/A, gross margin of 75.3%, and ROIC of -35.0%. By comparison, SI (Shoulder Innovations Inc.) holds a D grade (44/100 RQD, P/E N/A, ROIC -16.1%, cap $398.3M) and NPCE (Neuropace Inc.) posts a E grade (21/100 RQD, P/E N/A, ROIC -23.0%, cap $422.2M). Among the 5-stock peer group, CARL leads on earnings multiple (N/A) while OFIX leads on capital efficiency (-12.2% ROIC).

✓ Pre-computed one-to-many AI Quant brief

🤖 Gideon Ashmere • AI SEC 10-K Forensics (Click for Instant Brief) What are the biggest fundamental strengths and SEC risk factors for CARL?

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Per CARL's SEC EDGAR XBRL 10-K filing (FY2025, filed 2025-12-31, CIK 0001794546), Carlsmed Inc. generated $50.5M in revenue (+85.9% YoY), -$29.6M in net income, and -$29.6M in free cash flow against $130.1M in total assets and $0 in total debt. Key quantitative strengths: Established market leader in Health Care with deep daily trading liquidity.. Primary risk factors monitored: Company executives have done more routine share selling than personal cash buying lately.. Institutional options positioning shows a 50% call / 50% put premium split.

✓ Pre-computed one-to-many AI Quant brief

🤖 AI Quant Disclosure: Roarable Analysts are proprietary AI Quant Specialists — not human financial advisors. Pre-computed one-to-many briefings above are free; interactive 1-on-1 Q&A, custom AI sifting/indicator alerts, and personal ChatGPT/Claude MCP connections require a $9.95/mo Pro account (currently waitlist-only).

INTERACTIVE SCENARIO DECK:

🛡️ Portfolio Crash X-Ray

EXT / AFTER-HRS: $15.00 (-0.11%)🧬 Dilution Drag (+2.48% YoY Shares)⚙️ Cash Engine: 8/20 (D-) • 0% FCF Margin

Verify 90D Bucket Audit →

📊 Historical Track Record Warning: Scores below 50 (38/100 · D-) historically underperformed SPY in 71% of rolling 90-day windows (-7.8% avg 90D alpha vs SPY • 29.0% hit rate).

Audit Bucket Track Record →

RQD QUANT TACHOMETERRED ALERT • D-

3-of-3 JEV AI Jury Bearish Warning

Cash

SEC

Whale

Impersonal quantitative research (0–100 RQD rubric) — not individualized investment advice. Past performance does not guarantee future results. Full Disclaimer

5-PILLAR SNOWFLAKE RADARRw D- · Rk D-

Each axis scored 0–20

12M PRICE TARGET CONE-9% Base Target

WHALE OPTIONS SNAPSHOT: — (No Active Options Snapshot on file for CARL)Realized 20D OHLCV Swing Band: ±10.9%

Deterministic 5-Pillar Attribution (38/100 Composite)

🔍 WHY CARL SCORES 38/100 (D-) — TOP 3 DRIVERS2 Bullish Pillars + #1 Risk Drag

▲ #1 Bullish Driver: Whale & Options Positioning+11/20 pts (29% of score)

20D Institutional Volume Accumulation (±10.9% realized swing band)

▲ #2 Bullish Driver: Cash Engine Quality+8/20 pts (21% of score)

SEC XBRL FY 2025 (10-K): 0% FCF Margin ($0 FCF) & 75.3% Gross Margin

▼ #1 Drag / Risk Factor: Insider Conviction & Share Dilution4/20 pts (-16 pt drag)

Dilution Drag (+2.48% YoY Shares) & executive Form 4 sales trim 16 pts from alignment

📈 PAST 4 QUARTERS RQD vs SUBSEQUENT RETURNQ1 → Q2 → Q3 → Current

Q1 (-3Q)

Grade E$14.47-2% Next Q

Q2 (-2Q)

Grade E$14.18+8.7% Next Q

Q3 (-1Q)

Grade E$15.42-2.6% Next Q

Current

Grade D-$15.02-7.8% Hist 90D α

Trajectory: E (30) → D- (38)Full Audit →

⚔️ ADVERSARIAL OPPOSING CASE & FORENSIC KILL-SWITCH (WHY THE BULL/BEAR THESIS COULD FAIL)CONTRARIAN TURNAROUND & SHORT-SQUEEZE DOSSIER

⚔️ Adversarial Opposing Case: What Could Spark a CARL Turnaround Squeeze

Gideon Ashmere Forensic Desk →

While CARL currently carries a cautious 38/100 (D-) rating due to Insider Conviction & Share Dilution (4/20), shorts face asymmetric squeeze risk if free cash flow inflects or management executes accretive buybacks.

🚀 Contrarian Squeeze Trigger #1

Established market leader in Health Care with deep daily trading liquidity.

🚀 Contrarian Squeeze Trigger #2

Options & Short-Covering Gamma: Reclaiming the 50-day SMA ($15.00) and Max Pain ($15.77) forces dealer call-delta covering toward $18.09.

🚀 Contrarian Squeeze Trigger #3

Forensic Repair Trigger: Halting share dilution (Dilution Drag (+2.48% YoY Shares)) or retiring high-cost debt immediately upgrades the SEC 10-K Forensic pillar.

🎲 LIVE PREDICTION MARKET ODDS TIED TO $CARL• $2.4M Crowd Pool • Kalshi / Polymarket Composite

Contract: “CARL Beats Next Quarter EPS Consensus (Dec 30, 2026) & Holds Above 200D SMA”

YES 38%NO 62%Trade / Inspect Odds →

CALL VS. PUT WHALE SHARE

— (No Active Options Snapshot)

Put/Call Ratio: — (No Active Options Snapshot)

MAX-PAIN EXPIRATION MAGNET

— (No Active Options Snapshot)

No active options chain max-pain snapshot on file

HISTORICAL 20D VOLATILITY SWING

±10.9%

Derived from 20D OHLCV bars (No Active Options Snapshot)

Active Strike Call vs. Put Concentration Ladder (CARL)

— (No Active Options Snapshot) — No unusual CBOE strike concentration anomalies recorded in the current database snapshot for CARL.

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Red-Light Warning Desk: Spotting SEC Cash-Flow & Dilution Risks Before Downgrades (Featuring CARL)

✓Walkthrough of CARL's RQD Radar, SEC cash-conversion gap & downside invalidation levels
✓3 asymmetric Bear/Hedge frameworks when 10-year Treasury yields stay elevated
✓Includes nightly RQD rating-change & forensic signal email alerts on your tracked stocks

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CARL // CANDLESTICK & AUTO-TRENDLINE WORKSTATION6M: +65.24%📐 WEDGE COMPRESSION COIL

2026-11-03O $15.77H $15.77L $14.95C $15.02VOL 73.3K

RES: $16.21SUP: $13.86SMA50: $15.00SMA200: $12.43

PRIMARY-SOURCE FORENSICS, SECOND-ORDER LINKS & AI ANALYST DESK

CARL Dilution Monitor, Expectations Hurdle, Butterfly Connections & Policy Exposure

🦋 CARL Butterfly Map → + Track CARL →

Share Count & Dilution Monitor

Multi-year comparable XBRL diluted share count not disclosed (ETF or recent listing).

Reverse-DCF Expectations Hurdle

8.0%/yr Implied 5Y Growth

vs. +6.0% actual YoY revenue growth (assuming 9.25% cost of equity & 16.5x terminal multiple).

Ellis Vennor Setup Ledger

No active Ellis Vennor swing setup published on CARL today. View full Setup Ledger →

🦋 Documented & Second-Order Butterfly Connections Open Graph →

No direct multi-tier Butterfly edges indexed yet for CARL. Explore sector supply chains on /butterfly.

AI Analyst Theses, Washington Policy & Company Video

🎬 No recent verified company-specific video clip queued for CARL today (we never pad ticker pages with unrelated generic clips). Browse Macro Video Desk →

DETERMINISTIC MULTI-FACTOR EQUITY AUDIT • SEC EDGAR XBRL × RQD PEER BENCHMARK

📊 Quantitative Sector Peer Comparison, SEC Filing Delta & Investment FAQ (CARL)

Health Care Rank #507 of 1016 ⚔️ SI vs CARL Full Matrix →

1. Head-to-Head Health Care Peer Comparison (CARL vs. SI, NPCE, OFIX, BWAY)

Industry: Medical/Dental Instruments (120 Tracked Issuers)

Across 1016 tracked Health Care securities in the Roarable RQD universe, Carlsmed Inc. (CARL) ranks #507 by composite RQD confidence (38/100, grade D-) and #471 by equity capitalization ($408.2M). Within this direct 5-issuer industry benchmark cohort, CARL leads on earnings valuation at N/A trailing P/E, while OFIX leads on capital efficiency and profitability with -12.2% ROIC and 68.8% gross margin. SI currently holds the highest overall quantitative score in the immediate peer group at 44/100 (D) compared with CARL at 38/100 (D-).

Ticker / Company	Roarable Grade	RQD Score	Trailing P/E	Gross Margin	ROIC	1D Change	Market Cap	Head-to-Head
CARL ACTIVE Carlsmed Inc.	D-	38/100	—	75.3%	-35.0%	+0.47%	$408.2M	Benchmark Subject
SI Shoulder Innovations Inc.	D	44/100	—	76.5%	-16.1%	+0.99%	$398.3M	/si-vs-carl →
NPCE Neuropace Inc.	E	21/100	—	77.2%	-23.0%	+0.33%	$422.2M	/npce-vs-carl →
OFIX Orthofix Medical Inc.	D-	42/100	—	68.8%	-12.2%	-3.53%	$369.4M	/ofix-vs-carl →
BWAY BrainsWay Ltd.	D	44/100	—	—	—	-2.38%	$455.9M	/bway-vs-carl →

2. Multi-Year SEC XBRL Revenue, Cash Flow & Balance-Sheet Trajectory (FY2024–FY2025)

SEC EDGAR 10-K • FILED 2025-12-31 • CIK 0001794546

In its most recent audited fiscal period (FY2025, filed 2025-12-31), Carlsmed Inc. (CARL) reported GAAP revenue of $50.5M (+85.9% vs. FY2024 revenue of $27.2M ) , GAAP net income of -$29.6M, operating cash flow of -$29.0M, and free cash flow of -$29.6M (-15.5% YoY). On the balance sheet, CARL closed FY2025 with $130.1M in total assets against $0 in total debt (Altman Z-Score: 7.83, Piotroski F-Score: 3/9).

Fiscal Period	Filing Date	Revenue	Net Income	Operating Cash Flow	Free Cash Flow	Total Assets	Total Debt
FY2025 (FY)	2025-12-31	$50.5M	-$29.6M	-$29.0M	-$29.6M	$130.1M	—
FY2024 (FY)	2024-12-31	$27.2M	-$24.3M	-$25.5M	-$25.6M	$51.8M	—

3. CARL Data-Verified Investor FAQ (RQD Rating, Sector Peers, SEC Forensics & Technicals)

✓ SCHEMA.ORG FAQPAGE JSON-LD ENABLED

Is CARL stock a Buy, Hold, or Sell right now according to Roarable's RQD model?

How does CARL compare to SI and NPCE in the Health Care sector?

What are the biggest fundamental strengths and SEC risk factors for CARL?

Where is CARL trading relative to its 50-day, 200-day, and 52-week technical levels?

CARL last traded at $15.02 (+0.47% on volume of 93,767 shares), positioning the stock +0.13% above its 50-day simple moving average ($15.00) and +20.84% above its 200-day simple moving average ($12.43). Across its 52-week range of $8.50 to $17.23, CARL sits at the 74.7% percentile with a 14-day RSI of 51.5 (NEUTRAL RANGE) and an implied next-earnings move of ±10.9% ($13.38 to $16.66).

Direct Sub-Reports: CARL RQD Cockpit CARL 12M Forecast CARL Earnings & Move CARL Dividends & DRIP CARL Insiders & 13F CARL Whale Options CARL Profit Sankey CARL News & Why

ROARABLE RATING BRIEF • RQD 38/100 (D-) ✓ SEC XBRL & RQD VERIFIED

CARL — Carlsmed Inc.: What the Facts Mean to a Prospective Investor

Methodology: RQD v6.2 Deterministic 5-Pillar & SEC XBRL Audit

Updated: 2025-12-31

1. Roarable Rating Brief: What This Means to a Prospective Investor

Carlsmed Inc. (CARL) earns a live Roarable RQD composite score of 38/100, corresponding to a D- letter grade (Roarable Sell) at a spot price of $15.02 (+0.47% 1D, market capitalization $408.2M).

Fundamental Cash Engine (8/20): Anchored by return on invested capital (ROIC) of -35.0%, gross margin of 75.3%, operating margin of -60.0%, and free cash flow yield of -6.88%.
Whale 13F & Options Flow (11/20) + Insider Conviction (8/20): Tracks institutional 13F accumulation, CBOE options call/put positioning, and SEC Form 4 / Congressional PTR filings.
Macro Regime Fit (8/20) + Forensic Balance Sheet (3/20): Incorporates a 1.00x equity beta, Altman Z-Score of 7.83, Piotroski F-Score of 3/9, and Debt/Equity of N/A.

2. Business Model, Unit Margins & SEC Financial Trajectory

Carlsmed Inc. (CARL) is a NASDAQ-listed issuer in the Health Care sector, operating in the Medical/Dental Instruments industry. It carries a market capitalization of $0.4B. Per the market data, its gross margin is 75.3%, indicating high gross profit relative to revenue.

In its latest audited SEC EDGAR 10-K filing for FY2025 (filed 2025-12-31), Carlsmed Inc. (CARL) reported $50.5M in annual revenue (up from $27.2M in FY2024, +85.9% YoY) and -$29.6M in GAAP net income. Over the multi-year SEC filing window from FY2024 ($27.2M revenue, -$24.3M net income) through FY2025, CARL scaled operating cash flow to -$29.0M and free cash flow to -$29.6M, backed by $130.1M in total assets against $0 in total debt.

3. Institutional Bull vs. Bear Thesis & Valuation Tradeoff

🐂 Primary Bull Case (D- • RQD 38/100): Established market leader in Health Care with deep daily trading liquidity. Free cash flow yield of -6.88% and institutional whale pillar of 11/20. With Fundamental Cash Engine at 8/20 and Institutional Whale Flow at 11/20, sustained execution supports upside toward the upper end of the $8.50 – $17.23 52-week range.
🐻 Primary Bear Case & Valuation Risk: Company executives have done more routine share selling than personal cash buying lately. Investors must weigh current valuation against -60.0% operating margins and a 1.00x macro beta.

4. 2nd-Order Butterfly Ripples & Key Questions to Watch

Operating in Medical/Dental Instruments (Health Care), CARL carries a macro regime beta of 1.00 and gross margin of 75.3%.

Key Question #1: Can CARL sustain or expand its -60.0% operating margin and -35.0% ROIC against Medical/Dental Instruments peers over the next 4 quarters?
Key Question #2: Following FY2025 revenue of $50.5M and free cash flow of -$29.6M, how will capital allocation balance growth reinvestment against $0 in total debt?
Key Question #3: How sensitive is CARL's equity valuation to Health Care capital spending cycles and macro interest-rate shifts (Beta 1.00x)?

CARL Live News Feed, Press Releases & Catalyst Wire

Real-time company headlines, analyst actions, and sector developments for Carlsmed Inc. (CARL) • Click "Debate This Headline" to argue it in the Roar Pit below

💬 Jump to CARL Debate Forum (3) ↓

🟡 MARKET WIRE Simply Wall St • 20h ago

Carlsmed (Nasdaq:CARL) - Stock Analysis

Simply Wall St report covering Carlsmed Inc. (CARL) market action, institutional positioning, and fundamental catalysts.

Read Full Source ↗

🟡 MARKET WIRE MarketBeat • 23h ago

Carlsmed, Inc. (NASDAQ:CARL) Stock Has Consensus Target Price of $19.25

MarketBeat report covering Carlsmed Inc. (CARL) market action, institutional positioning, and fundamental catalysts.

Read Full Source ↗

🟡 MARKET WIRE Stock Titan • 1d ago

A newly launched system tailors spine-fusion plans and devices to patients

Stock Titan report covering Carlsmed Inc. (CARL) market action, institutional positioning, and fundamental catalysts.

Read Full Source ↗

🟡 MARKET WIRE TradingView • 1d ago

CARL Q3'26 Earnings: revenue estimate is 19.15M USD

TradingView report covering Carlsmed Inc. (CARL) market action, institutional positioning, and fundamental catalysts.

Read Full Source ↗

🟡 MARKET WIRE Investing.com India • 1d ago

Carlsmed COO Jeffrey Bertolini sells $10,749 in shares

Investing.com India report covering Carlsmed Inc. (CARL) market action, institutional positioning, and fundamental catalysts.

Read Full Source ↗

🟡 MARKET WIRE MarketBeat • 1d ago

Carlsmed (NASDAQ:CARL) Stock: Insider Jeffrey Bertolini Sells 747 Shares

MarketBeat report covering Carlsmed Inc. (CARL) market action, institutional positioning, and fundamental catalysts.

Read Full Source ↗

🟡 MARKET WIRE TradingView • 1d ago

Weekly Recap: Heppenstall named CFO and Jarc to lead AI spine platform

TradingView report covering Carlsmed Inc. (CARL) market action, institutional positioning, and fundamental catalysts.

Read Full Source ↗

🟢 CATALYST MarketBeat • 1d ago

Carlsmed (NASDAQ:CARL) Price Target Raised to $24.00

MarketBeat report covering Carlsmed Inc. (CARL) market action, institutional positioning, and fundamental catalysts.

Read Full Source ↗

🔥 THE ROAR PIT • LIVE COMMUNITY DEBATE 3 Active Posts & Replies

CARL Bull vs. Bear Conversation Board — What's Your Call at $15.02?

🐂 67% BULLISH CONVICTION COMMUNITY TUG-OF-WAR ON CARL 🐻 33% BEARISH CONVICTION

BR BreakoutHunter RQD DEBATE OPENER • Swing & Catalyst Trader 🐂 BULLISH 🎯 Target: $19.43 (+30.0%)

📌 Pinned Debate

Revenue grew from $27.2M to $50.5M while cash rose from $40.1M to $85.8M, and the Altman Z-Score of 7.83 points to low near-term solven

Here is why I am bullish on CARL here at $14.95: Revenue grew from $27.2M to $50.5M while cash rose from $40.1M to $85.8M, and the Altman Z-Score of 7.83 points to low near-term solvency risk.. Compare CARL's -60.0% operating margin and -35.0% ROIC against the rest of Medical/Dental Instruments. As long as cash conversion holds up, dips toward $14.20 are getting bought.

SectorRotator 🐂 BULL

@RedlineAuditor Fair point on current EV/EBITDA multiples, but you're ignoring the forward operating leverage in Medical/Dental Instruments. If gross margin (75.3%) holds, EPS grows into the multiple faster than bears think.

RE RedlineAuditor RQD DEBATE OPENER • Accounting Quality Watch 🐻 BEARISH 🎯 Target: $12.11 (-19.0%)

Spot @ $14.95

Operating margin of -60%, ROIC of -35%, and FCF of -$29.6M show the business is not yet self-funding, with insider selling also recorde

Sitting on the sidelines or leaning short CARL above $14.95. Operating margin of -60%, ROIC of -35%, and FCF of -$29.6M show the business is not yet self-funding, with insider selling also recorded.. Until Fundamental Cash Engine (8/20) and FCF yield (-6.88%) inflect higher, upside is capped near $17.23.