Revelation Alpine, LLC - 09 Jun 2025 Form 4 Insider Report for Omada Health, Inc. (OMDA)

Role
10%+ Owner
Signature
REVELATION ALPINE, LLC, By: /s/ Michael Boggs, Managing Member of Manager
Issuer symbol
OMDA
Transactions as of
09 Jun 2025
Net transactions value
$0
Form type
4
Filing time
09 Jun 2025, 17:22:16 UTC
Previous filing
05 Jun 2025
SEC
View on sec.gov

Reporting Owners (3)

Name Relationship Address Signature Signature date CIK
Revelation Alpine, LLC 10%+ Owner 300 TURNEY STREET, 2ND FLOOR, SAUSALITO REVELATION ALPINE, LLC, By: /s/ Michael Boggs, Managing Member of Manager 09 Jun 2025 0001910436
Boggs Michael Huff 10%+ Owner 300 TURNEY STREET, 2ND FLOOR, SAUSALITO /s/ Michael Boggs 09 Jun 2025 0002070450
HALSTED SCOTT S 10%+ Owner 300 TURNEY STREET, 2ND FLOOR, SAUSALITO /s/ Scott S. Halsted 09 Jun 2025 0001204322

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction OMDA Common Stock Conversion of derivative security +469,222 +1983% 492,886 09 Jun 2025 See footnotes F1, F2, F6, F7
transaction OMDA Common Stock Conversion of derivative security +456,184 +132% 802,849 09 Jun 2025 See footnotes F1, F3, F6, F7
transaction OMDA Common Stock Conversion of derivative security +2,439,265 +372% 3,095,306 09 Jun 2025 See footnotes F1, F4, F6, F7
transaction OMDA Common Stock Conversion of derivative security +816,993 816,993 09 Jun 2025 See footnotes F1, F5, F6, F7

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction OMDA Series C Preferred Stock Conversion of derivative security -158,072 -100% 0 09 Jun 2025 Common Stock 158,072 See footnotes F1, F2, F6, F7
transaction OMDA Series C-1 Preferred Stock Conversion of derivative security -44,535 -100% 0 09 Jun 2025 Common Stock 44,535 See footnotes F1, F2, F6, F7
transaction OMDA Series E Preferred Stock Conversion of derivative security -266,615 -100% 0 09 Jun 2025 Common Stock 266,615 See footnotes F1, F2, F6, F7
transaction OMDA Series E Preferred Stock Conversion of derivative security -456,184 -100% 0 09 Jun 2025 Common Stock 456,184 See footnotes F1, F3, F6, F7
transaction OMDA Series D Preferred Stock Conversion of derivative security -2,161,265 -100% 0 09 Jun 2025 Common Stock 2,161,265 See footnotes F1, F4, F6, F7
transaction OMDA Series E Preferred Stock Conversion of derivative security -278,000 -100% 0 09 Jun 2025 Common Stock 278,000 See footnotes F1, F4, F6, F7
transaction OMDA Series D Preferred Stock Conversion of derivative security -816,993 -100% 0 09 Jun 2025 Common Stock 816,993 See footnotes F1, F5, F6, F7
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Revelation Alpine, LLC is no longer subject to Section 16 filing requirements. Form 4 or Form 5 obligations may continue.

Explanation of Responses:

Id Content
F1 Each share of Series C Preferred Stock, Series C-1 Preferred Stock, Series D Preferred Stock and Series E Preferred Stock automatically converted into approximately 0.33333 shares of the Issuer's common stock immediately prior to the closing of the Issuer's initial public offering. These shares are reported in Table II above on an as-converted basis and have no expiration date.
F2 Shares held by Revelation Alpine, LLC.
F3 Shares held by Revelation Healthcare Fund II, L.P.
F4 Shares held by Revelation Healthcare Fund IV, L.P.
F5 Shares held by Revelation Alpine, L.P.
F6 Revelation Healthcare Fund II GP, LLC is the general partner of Revelation Healthcare Fund II GP, L.P., which is the general partner of Revelation Healthcare Fund II, L.P. Revelation Alpine GP, LLC is the general partner of Revelation Alpine, L.P. and the manager of Revelation Alpine, LLC. Revelation Healthcare Fund IV GP, LLC is the general partner of Revelation Healthcare Fund IV GP, L.P., which is the general partner of Revelation Healthcare Fund IV, L.P. Scott Halsted and Michael Boggs are the managing members of Revelation Healthcare Fund II GP, LLC, Revelation Alpine GP, LLC, and Revelation Healthcare Fund IV GP, LLC and in such capacity make investment and voting decisions on behalf of Revelation Alpine, LLC, Revelation Healthcare Fund II, L.P., Revelation Healthcare Fund IV, L.P. and Revelation Alpine, L.P.
F7 Each of the Reporting Persons disclaims beneficial ownership of the securities reported herein for purposes of Section 16 of the Exchange Act except to the extent of its or his pecuniary interest therein, if any. This report shall not be deemed an admission that any of the Reporting Persons is a beneficial owner of such securities for the purpose of Section 16 of the Exchange Act or for any other purpose.

Remarks:

Form 2 of 2: This Form 4 is the second of two Forms 4 being filed relating to the same event. The Form 4 has been split into two filings because there are more than 10 Reporting Persons in total, and the SEC's EDGAR filing system limits a single Form 4 to a maximum of 10 Reporting Persons. Each Form 4 will be filed by Designated Filer Revelation Alpine, LLC.