Sacra estimates that Nitra hit $34M in annualized revenue in 2025, representing 11x year-over-year growth from approximately $3M at the end of 2024.

That growth is largely a function of how quickly Nitra has turned medical practice spend into a revenue stream. As of Q4 2025, the company is processing over $1 billion in annualized purchase volume, with daily throughput around $2.5 million to $3 million and peak days reaching roughly $7 million.

Economically, Nitra is an interchange business wrapped in a workflow product. The Nitra Visa Business Card generates interchange on every swipe, and after the issuing bank, the network, and rewards, that typically translates into roughly a 1 percent net take rate on volume.

The software layer matters because it pushes more spend onto the card and keeps it there. Subscription fees exist, but Nitra often waives them indefinitely when a practice commits to using the card as its primary payment method, which makes the product feel free while still compounding transaction volume.

Nitra raised $62 million in August 2022 through a combination of equity and debt financing. The round included $17 million in equity funding and a $45 million debt facility to support the company's charge card operations and working capital requirements.

The equity portion was led by Andreessen Horowitz and New Enterprise Associates, with participation from Pantera Capital, KB Financial Group, Jerry Yang's AME Cloud Ventures, and Will Smith's Dreamers VC. Additional investors included Primer Sazze Partners, SparkLabs Taipei & Global, Dunamu, Expa, Soma Capital, Slope Capital, K50 Ventures, 8090 Partners, Comma Capital, Gaingels, Gold House Ventures, and CoVenture.

The debt facility increases balance sheet capacity for Nitra to extend short-term credit through its charge card product, where the company fronts payment to merchants before collecting from customers. This structure creates working capital needs common to card issuers.

Nitra is building what it describes as a financial operating system for medical practices. The simplest way to describe it is a corporate card and payments product that comes bundled with automation for the messy back office work that clinics still run on, like purchasing, expense coding, invoice approvals, and reconciliation.

The center of gravity is the Nitra Visa Business Card, issued by Cross River Bank with payment rails running through Stripe.

Practices can spin up unlimited physical and virtual cards, then layer on controls that actually map to how clinics operate, like role-based limits for front desk staff versus clinical managers, merchant and category rules, and real time alerts when spend drifts outside policy.

Where Nitra tries to feel different is in the way the software behaves once the card is in motion. The AI Finance Manager is positioned as the always-on reconciler. When a staff member buys supplies, the transaction gets categorized automatically, receipts are captured and matched, and data is synced into accounting systems like QuickBooks, Sage, and NetSuite with minimal human follow up.

Bill Pay extends the same logic to invoices. Incoming bills get captured, parsed, and routed through approval workflows based on rules the practice sets up, then paid via ACH, check, or virtual card. The point is not that clinics have never had AP software, it is that Nitra is bundling AP into the same surface where card spend already lives, so the audit trail, permissions, and accounting sync all stay consistent.

Procurement is the longer-term wedge that could make the platform much stickier than a card plus expense management bundle. Nitra’s planned AI Procurement Manager is designed to forecast supply needs, generate purchase orders, and route orders through a marketplace that can compare vendors, suggest substitutes, and consolidate orders to reduce cost. If that works, Nitra becomes the place where clinics decide what to buy and from whom, not just how to pay for it.

Underneath all of this is integration. Nitra connects into accounting software, and it also plugs into practice management and EHR systems like AdvancedMD. That clinical adjacency is what enables workflows a generic spend tool struggles to replicate, like anticipating supply demand based on scheduled procedures and then pairing that forecast with automated purchasing and payment execution.

Nitra sells like software, but it monetizes like a payments company. The card is the engine, and the product suite is built to make the engine harder to replace and easier to expand inside each practice.

Most revenue is driven by interchange on card transactions. In the US, gross interchange can look like a few percentage points depending on merchant category and card program structure, but Nitra’s economic reality is what it nets after the bank, network costs, fraud and chargeback mechanics, and a deliberately aggressive rewards program.

That net take rate is closer to something like 1 percent on volume, which is why the company obsesses over adoption, primary-card behavior, and vendor marketplace pull-through.

Software fees exist, but Nitra frequently waives them indefinitely for customers that commit to the card. That is a classic vertical fintech trade. Nitra is effectively saying, do not debate a $30 a month tool, just run your spend through us and we will automate the workflow around it.

The outcome is that the practice’s switching costs come less from contracts and more from operational dependency, since the card, expense rules, bill pay workflows, approvals, and accounting sync all become intertwined.

Rewards are also product strategy. By offering richer cash back on healthcare relevant categories and the marketplace, Nitra is trying to buy share of wallet early, then let workflow automation and procurement convenience keep it.

The marketplace adds a second lever, since procurement volume can generate vendor rebates and pricing advantages that do not rely purely on interchange economics.

The $45 million debt facility supports the charge card model by providing working capital capacity. Nitra fronts merchant payments and collects from customers on cycle, which creates float and underwriting exposure.

Done well, float economics and credit discipline become incremental contributors to margin. Done poorly, they become the risk center of the business.

Over time, the cleanest expansion path is consumption-led. As a practice routes more of its supplies, vendor payments, and operating expenses through Nitra, volume rises and the economics scale.

The obvious next layer is selective monetization of premium automation, deeper procurement functionality, and eventually credit products that are priced off the platform’s visibility into practice cash flows.

Nitra sits in an awkward but promising competitive position. It is taking the corporate card plus spend management playbook that worked in tech and trying to repackage it for a regulated, operationally messy vertical where the real pain is not expense reports, it is procurement, approvals, and reconciliation across dozens of medical vendors.

That means competition shows up from every direction. Horizontal fintechs can outspend Nitra on rewards and distribution. Legacy healthcare supply and group purchasing players own vendor relationships. AP and procurement incumbents have deep workflows but usually lack a unified payments layer.

Nitra’s bet is that bundling card, AP, and procurement into one healthcare-specific workflow surface creates a wedge that none of the single category competitors can match.

Ramp and Brex are the most direct analogs. They have proven that card plus software can scale quickly, and they have the balance sheet, network relationships, and product velocity to move into verticals when it matters.

If they decide healthcare is worth it, they can compete aggressively on rewards, underwriting, and price, and they can use their broader customer bases to learn category patterns fast.

Nitra’s counterposition is depth. A generic spend platform can add healthcare flavored controls, but it typically cannot match tight integrations into practice management systems or build procurement workflows that reflect how clinics actually order supplies.

Nitra’s advantage is not just templates, it is the ability to connect clinical context to purchasing and financial operations in a way that feels native rather than bolted on.

On the payables side, Bill.com and similar AP automation tools compete on invoice capture, approvals, and accounting sync. They are often best in class at the narrow workflow, and they already live in the finance stack for many SMBs.

The tradeoff is that these tools are usually one component in a larger patchwork, which can leave practices stitching together a card program, AP, and procurement with brittle integrations.

Nitra’s pitch is consolidation. If the unified system is good enough, it becomes the default place where payments are initiated, categorized, and reconciled, which reduces the number of tools a practice needs to maintain.

The risk is that AP specialists can keep pushing downmarket with better UX and more features, while also partnering with card issuers, which would blunt Nitra’s bundling advantage.

Procurement is where the competitive landscape gets strange. In the enterprise, platforms like Coupa define what modern procurement looks like, but they are typically overbuilt for independent practices and small groups.

In healthcare, group purchasing organizations like Vizient and Premier, along with distributors like McKesson and Cardinal Health, own pricing power and entrenched relationships.

Nitra is attacking from a different angle. It is not trying to replace distributor logistics, it is trying to become the decision layer that chooses vendors, routes orders, and captures the financial trail, then uses aggregated demand to negotiate better terms.

If Nitra’s marketplace and procurement automation become central to how practices buy supplies, distributors can be relegated to fulfillment. If not, incumbents can respond by bundling better payment terms, financing, and software into their existing supply relationships.

There are also vertical finance companies that own parts of the physician financial lifecycle through loans, deposits, and practice financing.

These players can compete on trust and regulatory comfort, but they generally do not own daily spend workflows. That leaves Nitra room to win the operational layer even if it does not win every financial product category.

The more Nitra expands into lending, banking, or revenue cycle adjacent products, the more it will invite direct competition from these incumbents, and the more it will need to prove that its underwriting and compliance muscles match its product ambition.

Nitra’s long-term opportunity is tied to how broadly it can define healthcare financial operations. Today, the wedge is spend flowing through a card, wrapped in automation that saves time for office managers and administrators. T

hat is already a large market, but the real upside comes if Nitra becomes the system that governs purchasing decisions, vendor relationships, and eventually the full money movement cycle for a clinic.

The company’s product roadmap points toward expansion in three directions. First, going deeper into procurement and supply chain where the dollars are concentrated and where aggregation can create pricing power. Second, moving from payables to receivables so Nitra touches both money out and money in. Third, pushing closer to the front office and clinical workflows, which increases switching costs and widens the budget owner set beyond finance.

If Nitra becomes the default way practices buy supplies, the card becomes a distribution channel rather than the core product.

Procurement software that can forecast demand, compare vendors, generate purchase orders, and enforce approvals turns the platform into a daily operating surface rather than a month-end finance tool.

That also expands TAM through economics, not just customer count. Aggregated purchasing creates a path to vendor rebates, preferred pricing, and marketplace take rates that can scale independently of interchange.

In a world where interchange is pressured and rewards are expensive, procurement driven margin can be the difference between a nice product and a durable business.

Healthcare is unusual in that payables are painful, but receivables are existential. Insurance collections, denials, patient balances, and cash flow timing are the financial reality for many practices.

Moving into revenue cycle management would be a major expansion of TAM, since it taps into much larger pools of spend and more mission critical workflows.

Nitra already has a financial data layer, payment rails, and integrations into practice systems. If it extends those into patient payments, claims workflow support, or automation around collections and posting, it can start to compete for budgets that currently sit with RCM vendors and billing services.

Even partial expansion, like better visibility into cash flow and automated routing for patient payments, would increase platform stickiness.

Planned features like AI patient management and smart triage suggest a move from back office finance toward front office coordination.

That shifts Nitra from being a finance tool bought by administrators to a workflow platform that touches scheduling, communications, and operational throughput.

The strategic value here is not just new features, it is data. When a system can see appointments and procedure mix, it can forecast supplies, anticipate staffing needs, and predict cash flow timing.

That creates a compounding advantage where clinical context improves financial automation, which improves procurement, which increases payment volume and marketplace usage.

With a charge card and a debt facility already in place, embedded lending is a natural adjacency. Nitra has visibility into spend patterns, vendor obligations, and operating cadence, which are useful signals for underwriting working capital, equipment financing, or short-term liquidity products.

If executed carefully, credit can become a meaningful revenue stream that is less sensitive to interchange compression. It also deepens customer dependency, since financing tied directly to procurement and payables workflows becomes operational, not just financial.

International expansion is plausible if Nitra can replicate its playbook in markets with similar private practice structures and fragmented procurement. The harder constraint is not payments infrastructure, it is building local vendor ecosystems and integration partnerships.

Adjacent verticals like dentistry, veterinary, ambulatory surgery centers, and specialty clinics are likely nearer-term and lower friction.

They share the same back office pain, similar purchasing behavior, and a willingness to adopt tools that reduce admin overhead. If Nitra’s product is truly verticalized around healthcare supply and compliance posture, these categories are a logical next step without diluting the core thesis.

Interchange compression: Nitra’s core revenue stream depends on card economics that are continuously competed away. If interchange rates fall, partner terms tighten, or rewards become table stakes, Nitra’s net take on volume can shrink quickly unless procurement rebates, software monetization, or credit products expand to offset it.

Rewards driven unit economics: Aggressive cash back can be an effective growth lever, but it can also attract price sensitive customers with low loyalty. If the marketplace and workflow automation do not create enough lock-in, Nitra risks subsidizing volume that can migrate to the next best rewards program.

Healthcare consolidation: As more physicians move into hospital employment and independent practices consolidate, the addressable base of small buyers can shrink. Larger health systems also bring longer sales cycles, heavier compliance demands, and incumbents that are already embedded.