# EDGAR Filing Document

**Accession Number:** 0000790526
**File Stem:** 0001683168-23-001214
**Filing Date:** 2023-3
**Character Count:** 97088
**Document Hash:** 7f452e7fe6b57dc222df13ecd9012e36
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001683168-23-001214.hdr.sgml**: 20230301

**ACCESSION NUMBER**: 0001683168-23-001214

**CONFORMED SUBMISSION TYPE**: 8-K

**PUBLIC DOCUMENT COUNT**: 17

**CONFORMED PERIOD OF REPORT**: 20230228

**ITEM INFORMATION**: Results of Operations and Financial Condition

**ITEM INFORMATION**: Financial Statements and Exhibits

**FILED AS OF DATE**: 20230301

**DATE AS OF CHANGE**: 20230301

**FILER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** RadNet, Inc.
- **CENTRAL INDEX KEY:** 0000790526
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-MEDICAL LABORATORIES [8071]
- **IRS NUMBER:** 133326724
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 8-K
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-33307
- **FILM NUMBER:** 23692662

**BUSINESS ADDRESS:**
- **STREET 1:** 1510 COTNER AVE
- **CITY:** LOS ANGELES
- **STATE:** CA
- **ZIP:** 90025
- **BUSINESS PHONE:** 3104787808

**MAIL ADDRESS:**
- **STREET 1:** 1510 COTNER AVE
- **CITY:** LOS ANGELES
- **STATE:** CA
- **ZIP:** 90025

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** PRIMEDEX HEALTH SYSTEMS INC
- **DATE OF NAME CHANGE:** 19930518

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** CCC FRANCHISING CORP
- **DATE OF NAME CHANGE:** 19920703

?xml version="1.0" encoding="utf-8"?

**UNITED STATES**

**SECURITIES AND EXCHANGE COMMISSION**

**Washington, D.C. 20549**

**FORM 8-K**

**CURRENT REPORT**

**Pursuant to Section 13 OR 15(d) of The Securities Exchange Act of 1934**

Date of Report (Date of earliest event reported February 28, 2023)

_______________________________________________

**RadNet, Inc.**

(Exact name of registrant as specified in its charter)

---

| | | |
|:---|:---|:---|
| &nbsp;&nbsp;&nbsp;**Delaware** | &nbsp;&nbsp;&nbsp;**001-33307** | **13-3326724** |
| &nbsp;&nbsp;&nbsp;(State or other jurisdiction<br> of incorporation) | &nbsp;&nbsp;&nbsp;(Commission File Number) | (IRS Employer Identification No.) |

---

**1510 Cotner Avenue**

**Los Angeles, California 90025**

(Address of Principal Executive Offices) (Zip Code)

**(310) 478-7808**

(Registrant's Telephone Number, Including Area Code)

_______________________________________________

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

☐ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

☐ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

☐ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

☐ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

---

| | | |
|:---|:---|:---|
| **Title of each class** | **Trading Symbol(s)** | **Name of each exchange on which registered** |
| Common Stock, $0.0001 par value | RDNT | NASDAQ Global Market |

---

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

---

| | |
|:---|:---|
| **Item 2.02** | **RESULTS OF OPERATIONS AND FINANCIAL CONDITION** |

---

On February 28, 2023 RadNet, Inc. ("RadNet") issued a press release and held a conference call regarding our 2022 financial results for the fourth quarter and full fiscal year ended December 31, 2022. A copy of the press release is furnished as Exhibit 99.1 and a copy of the transcript of the conference call is furnished as Exhibit 99.2 to this Current Report.

The information in this Current Report, including Exhibit 99.1 and Exhibit 99.2 is being furnished and shall not be deemed "filed" for purposes of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that Section. The information in this Current Report, including Exhibit 99.1 and Exhibit 99.2 shall not be incorporated by reference into any registration statement or other document filed with the Commission.

---

| | |
|:---|:---|
| **Item 9.01.** | **Financial Statements and Exhibits.** |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(d) Exhibits

---

| | |
|:---|:---|
| <u>**Exhibit Number**</u> | <u>**Description of Exhibit**</u> |
| 99.1 | [Press Release dated February 28, 2023 relating to RadNet, Inc.'s financial results for the quarter and full fiscal year ended December 31, 2022](radnet_ex9901.htm) |
| 99.2 | [Transcript of conference call](radnet_ex9902.htm) |
| 104 | Cover Page Interactive Data File (embedded within the inline XBRL document) |

---

**SIGNATURES**

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

---

| | | |
|:---|:---|:---|
|  | **RADNET, INC.** | **RADNET, INC.** |
| Date: March 1, 2023 | By: | /s/ Mark D. Stolper |
|  | Name: | Mark D. Stolper |
|  | Title: | Chief Financial Officer |

---

**EXHIBIT INDEX**

---

| | |
|:---|:---|
| <u>**Exhibit Number**</u> | <u>**Description**</u> |
| 99.1 | [Press Release dated February 28, 2023.](radnet_ex9901.htm) |
| 99.2 | Transcript of conference call. |
| 104 | Cover Page Interactive Data File (embedded within the inline XBRL document) |

---

## Exhibit 99.1

**Exhibit 99.1**

FOR IMMEDIATE RELEASE

**RadNet Reports Fourth Quarter 2022 Results, Including Record Revenue and Adjusted EBITDA<sup>(1)</sup>, and Releases 2023 Financial Guidance**

&nbsp;&nbsp;&nbsp;&nbsp;· *Revenue increased 15.2% to a record of $383.9 million in the fourth quarter of 2022 from $333.1 million in the fourth quarter of 2021; Excluding Revenue from the Artificial Intelligence ("AI") reporting segment, Revenue from the Imaging Centers reporting segment in the fourth quarter of 2022 was $382.5 million, an increase of 15.1% from last year's fourth quarter* 

&nbsp;&nbsp;&nbsp;&nbsp;· *Excluding losses from our AI reporting segment and adjusting for Provider Relieve Funding Received in the fourth quarter of 2021, Adjusted EBITDA<sup>(1)</sup> from the Imaging Centers reporting segment was a record $61.6 million as compared with $52.0 million in the fourth quarter of 2021, an increase of 18.4%* 

&nbsp;&nbsp;&nbsp;&nbsp;· *Adjusting for unusual or one-time items impacting Net Income in the quarter, Adjusted Earnings Per Share<sup>(3)</sup> was $0.11 for the fourth quarter of 2022; This compares with Adjusted Earnings Per Share<sup>(3)</sup> of $0.10 for the fourth quarter of 2021* 

&nbsp;&nbsp;&nbsp;&nbsp;· *Aggregate procedural volumes increased 8.0% and same-center procedural volumes increased 3.6% compared to the fourth quarter of 2021* 

&nbsp;&nbsp;&nbsp;&nbsp;· *After a successful pilot in Delaware, RadNet is implementing its Enhanced Breast Cancer Detection (EBCD) AI-powered mammography offering across all of its markets* 

&nbsp;&nbsp;&nbsp;&nbsp;· *RadNet announces 2023 guidance ranges, anticipating increases in Revenue, Adjusted EBITDA<sup>(1)</sup> and Free Cash Flow<sup>(2)</sup> for 2023 over 2022* 

 

**LOS ANGELES, California, February 28, 2023 – RadNet, Inc. (NASDAQ: RDNT),** a national leader in providing high-quality, cost-effective, fixed-site outpatient diagnostic imaging services through a network of 357 owned and/or operated outpatient imaging centers, today reported financial results for its fourth quarter and full year ended December 31, 2022.

**<u>Financial Results</u>**

 

*Fourth Quarter Report:*

 

Dr. Howard Berger, President and Chief Executive Officer of RadNet, commented, "I am very pleased with our strong performance in the fourth quarter, which enabled us to exceed our 2022 full-year revised guidance ranges for Revenue and Adjusted EBITDA<sup>(1)</sup>. Contributing to our record Revenue and Adjusted EBITDA<sup>(1)</sup> in the quarter was a combination of high procedural demand for our services and improving conditions in our labor markets. Since September, we have been more successful in filling open positions and staffing our locations, enabling us to better meet the increasing demand we are experiencing for our services in virtually all markets in which we operate."

"Throughout 2022, we carefully managed our liquidity and financial leverage. At year-end 2022, we had a cash balance of over $127 million and our net debt leverage ratio remained under 3.5 times Adjusted EBITDA<sup>(1)</sup>. Our Days Sales Outstanding (DSOs) remained low at 39 days as of December 31, 2022, helping to contribute to our strong cash flow in the quarter and throughout 2022," Dr. Berger noted.

"Moving into 2023, the demand for diagnostic imaging remains robust and is growing. Our solid financial position and operating model have presented us with targeted opportunities to expand our business, particularly through the construction of new centers to meet the growing demand and utilization in strategic markets. Currently, we have over a dozen centers in various stages of construction and development, and we believe these sites should be positive contributors to our performance in 2023. As the imaging center market further consolidates, we continue to see opportunities for tuck-in acquisitions in virtually all of RadNet markets at prices consistent with our historical discipline. Furthermore, throughout 2023, we expect to expand existing health system joint ventures and partnerships and establish new ones," added Dr. Berger.

Dr. Berger concluded, "We are also making significant strides in commercializing and monetizing our AI investments. Specifically, in November 2022, we began an implementation of our Enhanced Breast Cancer Diagnostic (EBCD) mammography program, where we are offering novel AI-enhanced mammography services to women in conjunction with their annual breast cancer screening exams for an additional fee. We expect that this offering will be available in all RadNet mammography centers by the end of the summer of 2023. Based upon early adoption data from several of our east coast markets, we are anticipating our losses from AI in 2023 to significantly narrow as a result of EBCD revenue, and we project our AI segment to be profitable in 2024."

For the fourth quarter of 2022, RadNet reported Revenue from its Imaging Center reporting segment of $382.5 million and Adjusted EBITDA<sup>(1)</sup> of $61.6 million, which excludes Revenue and Losses from the AI reporting segment. As compared with last year's fourth quarter, Revenue increased $50.3 million (or 15.1%) and Adjusted EBITDA<sup>(1)</sup> increased $9.6 million (or 18.4%), also excluding $2.9 million of Provider Relief Funding received in the fourth quarter of 2021.

Including our AI reporting segment, Revenue was $383.9 million in the fourth quarter of 2022, an increase of 15.2% from $333.1 million in last year's fourth quarter. Including the Adjusted EBITDA<sup>(1)</sup> losses of the AI reporting segment, Adjusted EBITDA<sup>(1)</sup> was $57.2 million in the fourth quarter of 2022 and $51.7 million in the fourth quarter of 2021 (also excluding the Provider Relief Funding received in the fourth quarter of 2021).

For the fourth quarter of 2022, RadNet reported a Net Loss of $934,000 as compared with a net loss of $3.8 million for the fourth quarter of 2021. Net Loss Per Share for the fourth quarter of 2022 was $(0.02), compared with a Net Loss per share of $(0.07) in the fourth quarter of 2021, based upon a weighted average number of diluted shares outstanding of 57.0 million shares in 2022 and 54.0 million shares in 2021.

There were a number of unusual or one-time items impacting the fourth quarter of 2022 including: $45,000 of non-cash gain from interest rate swaps (excluding the amortization of the accumulation of the changes in fair value out of Other Comprehensive Income); $450,000 of severance paid in connection with headcount reductions related to cost savings initiatives; $1.2 million expense related to leases for our de novo facilities under construction that have yet to open their operations; $927,000 acquisition transaction costs primarily related to the purchase of Heart and Lung Imaging Limited; $47,000 of valuation adjustment for contingent consideration related to acquisitions; $731,000 expenses related to debt restructuring and loss on extinguishment related to the refinancing of New Jersey Imaging Network's credit facilities; and $6.1 million of pre-tax losses related to our AI reporting segment. Adjusting for the above items, Adjusted Earnings<sup>(3)</sup> from the Imaging Centers reporting segment was $6.4 million and diluted Adjusted Earnings Per Share<sup>(3)</sup> was $0.11 during the fourth quarter of 2022.

Also, affecting Net Income in the fourth quarter of 2022 were certain non-cash expenses and unusual items including: $4.7 million of non-cash employee stock compensation expense resulting from the vesting of certain options and restricted stock; $1.6 million loss on the disposal of certain capital equipment; and $750,000 of non-cash amortization of deferred financing costs and loan discounts related to financing fees paid as part of our existing credit facilities.

For the fourth quarter of 2022, as compared with the prior year's fourth quarter, MRI volume increased 11.9%, CT volume increased 11.8% and PET/CT volume increased 20.7%. Overall volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 8.0% over the prior year's fourth quarter. On a same-center basis, including only those centers which were part of RadNet for both the fourth quarters of 2022 and 2021, MRI volume increased 7.5%, CT volume increased 6.0% and PET/CT volume increased 16.9%. Overall same-center volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 3.6% over the prior year's same quarter.

*Annual Report:*

For full-year 2022, RadNet reported Revenue from its Imaging Centers reporting segment of $1,426 million and Adjusted EBITDA<sup>(1)</sup> Excluding Losses from the AI reporting segment of $209.0 million. Revenue increased $112.0 million (or 8.5%) and Adjusted EBITDA<sup>(1)</sup> decreased $2.9 million (or 1.4%), excluding $9.1 million of Provider Relief Funding received in 2021.

Including our AI reporting segment Revenue of $4.4 million, Revenue was $1,430 million for full-year 2022, an increase of 8.7% from $1,315 million in 2021. Including Adjusted EBITDA<sup>(1)</sup> losses from the AI segment, Adjusted EBITDA<sup>(1)</sup> for 2022 was $192.5 million as compared with $209.8 million in 2021 (which includes a one-time $7.7 million benefit from the employee retention credit and excludes $9.1 million of Provider Relief Funding received in 2021).

For 2022, RadNet reported Net Income of $10.7 million, a decrease of approximately $14.1 million over 2021. Per share diluted Net Income for the full year of 2022 was $0.17, compared to a diluted Net Income per share of $0.46 in 2021 (based upon a weighted average number of diluted shares outstanding of 57.3 million in 2022 and 53.4 million in 2021).

Affecting Net Income in 2022 were certain non-cash expenses and unusual items including: $39.6 million of non-cash gain from interest rate swaps; $946,000 of severance paid in connection with headcount reductions related to cost savings initiatives; $4.3 million expense related to leases for our de novo facilities under construction that have yet to open their operations; $24.9 million of pre-tax losses related to our AI reporting segment; $23.8 million of non-cash employee stock compensation expense resulting from the vesting of certain options and restricted stock; $731,000 expenses related to debt restructuring and loss on extinguishment related to the refinancing of New Jersey Imaging Network's credit facilities; $2.2 million in legal settlements; $2.5 million loss on the disposal of certain capital equipment; $8.1 million change in estimate related to refund liability; and $2.7 million of non-cash amortization of deferred financing costs and loan discounts related to financing fees paid as part of our existing credit facilities.

*Actual 2022 Results vs. 2022 Guidance:*

The following compares the Company's 2022 performance with previously announced revised guidance levels.

---

| | | | |
|:---|:---|:---|:---|
|  | Original Guidance Range | Revised Guidance Range After Q3 Results | 2022 Actual Results |
| Revenue – Imaging Center Ops. | $1,350 - $1,400 million | $1,360 - $1,410 million | $1,426 million |
| Adjusted EBITDA<sup>(1)</sup> Excluding Losses from AI Segment | $205 - $215 million | $203 - $208 million | $209 million |
| Capital Expenditures<sup>(a)</sup> | $85 - $90 million | $100 - $105 million | $109 million |
| Cash Paid for Interest<sup>(c)</sup> | $27 - $32 million | $35 - $40 million | $39 million |
| Free Cash Flow <sup>(b)(2)</sup> | $80 - $90 million | $60 - $70 million | $61 million |

---

______________________

&nbsp;&nbsp;&nbsp;&nbsp;(a) Net of proceeds from the sale of equipment, imaging centers and joint venture interests, and excludes
New Jersey Imaging Network capital expenditures (net of disposition proceeds) of $6.3 million.

&nbsp;&nbsp;&nbsp;&nbsp;(b) Defined by the Company as Adjusted EBITDA <sup>(1)</sup> less
Capital Expenditures and Cash Paid for Interest.

&nbsp;&nbsp;&nbsp;&nbsp;(c) Excludes payments to and from counterparties of interest rate swaps.

Dr. Berger commented, "Our strong operating performance in the fourth quarter drove us to meet or exceed most all of our projected guidance ranges. Our 2022 results were above the high end of our revised Revenue and Adjusted EBITDA<sup>(1)</sup> guidance ranges. Additionally, our Free Cash Flow<sup>(2)</sup> results fell within our revised guidance range, despite our higher than originally projected capital expenditures as a result of the construction of certain de novo locations. We are very pleased with these results in light of the difficult labor market we faced throughout most of 2022, impacting the availability and cost of staffing."

**<u>2023 Fiscal Year Guidance</u>**

For its 2023 fiscal year, RadNet announces its guidance ranges as follows:

---

| | |
|:---|:---|
| <u>Imaging Center Segment</u> | <u>Imaging Center Segment</u> |
| Revenue | $1,525 million - $1,575 million |
| Adjusted EBITDA<sup>(1)</sup> | $220 million - $230 million |
| Capital Expenditures <sup>(a)</sup> | $105 million - $115 million |
| Cash Paid for Interest <sup>(c)</sup> | $35 million - $40 million |
| Free Cash Flow Generation <sup>(b)(2)</sup> | $70 million - $80 million |
| <u>Artificial Intelligence Segment</u> | <u>Artificial Intelligence Segment</u> |
| Revenue | $16 million - $18 million |
| Adjusted EBITDA<sup>(1)</sup> (Loss) | $(9) million - $(11) million |

---

________________

&nbsp;&nbsp;&nbsp;&nbsp;(a) Net of proceeds from the sale of equipment, imaging centers and joint venture interests, and excludes
New Jersey Imaging Network capital expenditures.

&nbsp;&nbsp;&nbsp;&nbsp;(b) Defined by the Company as Adjusted EBITDA <sup>(1)</sup> from
Imaging Center Segment less Capital Expenditures and Cash Paid for Interest.

&nbsp;&nbsp;&nbsp;&nbsp;(c) Net of payments to and from counterparties on interest rate swaps.

Dr. Berger noted, "We are anticipating strong results in 2023, demonstrating improvement in all financial and operating metrics. We are projecting Revenue growth from imaging center operations of between 7% and 10% and Adjusted EBITDA<sup>(1)</sup> growth from imaging center operations of between 5% and 10%. The anticipated growth implicit in our guidance in 2023 is projected to result from same-center growth, the contribution of various de novo locations opened in the second half of 2022 and scheduled to open throughout 2023, reimbursement increases from private and capitated payers, new and expanded health system joint ventures and the further contribution from acquisitions completed at various times during 2022."

Dr. Berger continued, "Our Adjusted EBITDA<sup>(1)</sup> guidance for 2023 excludes anticipated Adjusted EBITDA<sup>(1)</sup> losses of approximately $10 million from our AI division (DeepHealth, Aidence and Quantib). We estimate that these losses will be net of approximately $16 million to $18 million of anticipated Revenue from both the Enhanced Breast Cancer Detection (EBCD) mammography program currently being implemented and additional growth from Aidence and Quantib AI operations. We anticipate the AI operating segment to be profitable in 2024, and will continue to report the financial results of our AI and imaging center operating segments separately each quarter throughout 2023, providing transparency for our stakeholders to track our progress," concluded Dr. Berger.

**<u>Conference Call for Today</u>**

Dr. Howard Berger, President and Chief Executive Officer, and Mark Stolper, Executive Vice President and Chief Financial Officer, will host a conference call today, at 10:30 a.m. Eastern Time. During the call, management will discuss the Company's 2022 fourth quarter and year-end results.

*Conference Call Details:*

Date: Tuesday, February 28, 2023

Time: 10:30 a.m. ET

Dial In-Number: 877-407-0789

International Dial-In Number: 201-689-8562

There will also be simultaneous and archived webcasts available at https://viavid.webcasts.com/starthere.jsp?ei=1598450&tp_key=1aa3f92537 or http://www.radnet.com under the "About RadNet" menu section and "News & Press Releases" sub-menu of the website. An archived replay of the call will also be available and can be accessed by dialing 844-512-2921 from the U.S., or 412-317-6671 for international callers, and using the passcode 13736399.

***About RadNet, Inc.***

RadNet, Inc. is the leading national provider of freestanding, fixed-site diagnostic imaging services and related information technology solutions (including artificial intelligence) in the United States based on the number of locations and annual imaging revenue. RadNet has a network of 357 owned and/or operated outpatient imaging centers. RadNet's markets include California, Maryland, Delaware, New Jersey, New York, Florida and Arizona. Together with affiliated radiologists, and inclusive of full-time and per diem employees and technologists, RadNet has a total of approximately 9,000 employees. For more information, visit http://www.radnet.com.

 ****

***Forward Looking Statements***

This press release contains "forward-looking statements" within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements are expressions of our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, and anticipated future conditions, events and trends. Forward-looking statements can generally be identified by words such as: "anticipate," "intend," "plan," "goal," "seek," "believe," "project," "estimate," "expect," "strategy," "future," "likely," "may," "should," "will" and similar references to future periods. Forward-looking statements in this press release include, among others, statements we make regarding response to and the expected future impacts of COVID-19, including statements about our anticipated business results, balance sheet and liquidity and our future liquidity, burn rate and our continuing ability to service or refinance our current indebtedness.

Forward-looking statements are neither historical facts nor assurances of future performance. Because forward-looking statements relate to the future, they are inherently subject to uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Therefore, you should not place undue reliance on any of these forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following:

&nbsp;&nbsp;&nbsp;&nbsp;· the ongoing impact of the COVID-19 pandemic on
our business, suppliers, payors, customers, referral sources, partners, patients and employees, including (i) government's unprecedented
action regarding existing and potential restrictions and/or obligations related to citizen and business activity to contain the virus;
(ii) the consequences of an economic downturn resulting from the impacts of COVID-19 and the possibility of a global economic recession;
(iii) the impact of the volume of canceled or rescheduled procedures, whether as a result of government action or patient choice; (iv)
measures we are taking to respond to the COVID-19 pandemic, including changes to business practices; (v) the impact of government and
administrative regulation, guidance and appropriations; (vi) changes in our revenues due to declining patient procedure volumes, changes
in payor mix; (vii) potential increased expenses or workforce disruptions related to our employees that could lead to unavailability of
key personnel; (viii) workforce disruptions related to our key partners, suppliers, vendors and others we do business with; (ix) the impact
of return to work orders in certain states in which we operate; and (x) increased credit and collectability risks;

· the availability and terms of capital to fund
our business;

· our ability to service our indebtedness, make
principal and interest payments as those payments become due and remain in compliance with applicable debt covenants, in addition to our
ability to refinance such indebtedness on acceptable terms;

· changes in general economic conditions nationally
and regionally in the markets in which we operate, including their effects on the cost and availability of labor;

· the availability and terms of capital to fund
the expansion of our business and improvements to our existing facilities;

· our ability to maintain our current credit rating
and the impact on our funding costs and competitive position if we do not do so;

· volatility in interest and exchange rates, or
credit markets;

· the adequacy of our cash flow and earnings to
fund our current and future operations;

· changes in service mix, revenue mix and procedure
volumes;

· delays in receiving payments for services provided;

&nbsp;&nbsp;&nbsp;&nbsp;· increased bankruptcies among our partner physicians
or joint venture partners;

· the impact of the political environment and related
developments on the current healthcare marketplace and on our business, including with respect to the future of the Affordable Care Act;

· the extent to which the ongoing implementation
of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof by federal and state regulators or
related litigation result in a reduction in coverage or reimbursement rates for our services, or other material impacts to our business;

· closures or slowdowns and changes in labor costs
and labor difficulties, including stoppages affecting either our operations or our suppliers' abilities to deliver supplies needed in
our facilities;

· the occurrence of hostilities, political instability
or catastrophic events;

· the emergence or reemergence of and effects related
to future pandemics, epidemics and infectious diseases; and

· noncompliance by us with any privacy or security
laws or any cybersecurity incident or other security breach by us or a third party involving the misappropriation, loss or other unauthorized
use or disclosure of confidential information.

Any forward-looking statement contained in this current report is based on information currently available to us and speaks only as of the date on which it is made. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that we may make from time to time, whether as a result of changed circumstances, new information, future developments or otherwise, except as required by applicable law.

***Regulation G: GAAP and Non-GAAP Financial Information***

This release contains certain financial information not reported in accordance with GAAP. The Company uses both GAAP and non-GAAP metrics to measure its financial results. The Company believes that, in addition to GAAP metrics, these non-GAAP metrics assist the Company in measuring its cash-based performance. The Company believes this information is useful to investors and other interested parties because it removes unusual and nonrecurring charges that occur in the affected period and provides a basis for measuring the Company's financial condition against other quarters. Such information should not be considered as a substitute for any measures calculated in accordance with GAAP, and may not be comparable to other similarly titled measures of other companies. Non-GAAP financial measures should not be considered in isolation from, or as a substitute for, financial information prepared in accordance with GAAP. Reconciliation of this information to the most comparable GAAP measures is included in this release in the tables which follow.

 

 ****

***CONTACTS:***

***RadNet, Inc.***

***Mark Stolper, 310-445-2800***

***Executive Vice President and Chief Financial Officer***

**RADNET, INC. AND SUBSIDIARIES**

**CONSOLIDATED BALANCE SHEETS**

**(IN THOUSANDS EXCEPT SHARE AND PER SHARE DATA)**

---

| | | |
|:---|:---|:---|
|  | **As of December 31,** | **As of December 31,** |
|  | **2022** | **2021** |
| **ASSETS** |  |  |
| **CURRENT ASSETS** |  |  |
| Cash and cash equivalents | $127834 | $134606 |
| Accounts receivable, net | 166357 | 135062 |
| Due from affiliates | 18971 | 5384 |
| Prepaid expenses and other current assets | 54022 | 49212 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total current assets | 367184 | 324264 |
| **PROPERTY, EQUIPMENT AND RIGHT-OF-USE ASSETS** |  |  |
| Property and equipment, net | 565961 | 484247 |
| Operating lease right-of-use assets | 603524 | 584291 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total property, equipment and right-of-use assets | 1169485 | 1068538 |
| **OTHER ASSETS** |  |  |
| Goodwill | 677665 | 513820 |
| Other intangible assets | 106228 | 56603 |
| Deferred financing costs | 2280 | 2135 |
| Investment in joint ventures | 57893 | 42229 |
| Deferred tax assets, net of current portion |  | 14853 |
| Deposits and other | 53172 | 36032 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets | $2433907 | $2058474 |
| **LIABILITIES AND EQUITY** |  |  |
| **CURRENT LIABILITIES** |  |  |
| Accounts payable, accrued expenses and other | 369595 | 263937 |
| Due to affiliates | 23100 | 23530 |
| Deferred revenue related to software sales | 4021 | 10701 |
| Current portion of operating lease | 57607 | 65452 |
| Current portion of notes payable and long term debt | 12400 | 11164 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total current liabilities | 466723 | 374784 |
| **LONG-TERM LIABILITIES** |  |  |
| Operating lease, net of current portion | 604117 | 577675 |
| Notes payable, net of current portion | 839344 | 743498 |
| Deferred tax liability | 9256 |  |
| Other non-current liabilities | 23015 | 16360 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total liabilities | 1942455 | 1712317 |
| **EQUITY** |  |  |
| RadNet, Inc. stockholders' equity: |  |  |
| Common stock - $.0001 par value, 200,000,000 shares authorized; 57,723,125 and 53,458,227 shares issued and outstanding at December 31, 2022 and December 31, 2021, respectively | 6 | 5 |
| Additional paid-in-capital | 436288 | 342592 |
| Accumulated other comprehensive (loss) income | (20677) | (20421) |
| Accumulated deficit | (82622) | (93272) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total RadNet, Inc.'s stockholders' equity | 332995 | 228904 |
| Noncontrolling interests | 158457 | 117253 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total equity | 491452 | 346157 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total liabilities and equity | $2433907 | $2058474 |

---

**RADNET, INC. AND SUBSIDIARIES**

**CONSOLIDATED STATEMENTS OF OPERATIONS**

**(IN THOUSANDS EXCEPT SHARE AND PER SHARE DATA)**

---

| | | | |
|:---|:---|:---|:---|
|  | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
|  | **2022** | **2021** | **2020** |
| **REVENUE** |  |  |  |
| Service fee revenue | $1278016 | $1166743 | $931722 |
| Revenue under capitation arrangements | 152045 | 148334 | 140118 |
| &nbsp;&nbsp;&nbsp;Total revenue | 1430061 | 1315077 | 1071840 |
| Provider relief funding |  | 9110 | 26264 |
| **OPERATING EXPENSES** |  |  |  |
| Cost of operations, excluding depreciation and amortization | 1264346 | 1123274 | 965902 |
| Lease abandonment charges |  | 19675 |  |
| Depreciation and amortization | 115877 | 96694 | 86795 |
| Loss on sale and disposal of equipment and other | 2529 | 1246 | 1200 |
| Loss on impairment |  |  | 4170 |
| Severance costs | 946 | 744 | 4353 |
| &nbsp;&nbsp;&nbsp;Total operating expenses | 1383698 | 1241633 | 1062420 |
| **INCOME FROM OPERATIONS** | 46363 | 82554 | 35684 |
| **OTHER INCOME AND EXPENSES** |  |  |  |
| Interest expense | 50841 | 48830 | 45882 |
| Equity in earnings of joint ventures | (10390) | (10967) | (7945) |
| Non-cash change in fair value of interest rate hedge | (39621) | (21670) | 2528 |
| Loss (gain) on extinguishment of debt and related expenses | 731 | 6044 | (4047) |
| Other expenses | 1833 | 1438 | 120 |
| &nbsp;&nbsp;&nbsp;Total other expenses | 3394 | 23675 | 36538 |
| **INCOME (LOSS) BEFORE INCOME TAXES** | 42969 | 58879 | (854) |
| &nbsp;&nbsp;&nbsp;Provision for income taxes | (9361) | (14560) | (895) |
| **NET INCOME (LOSS)** | 33608 | 44319 | (1749) |
| &nbsp;&nbsp;&nbsp;Net income attributable to noncontrolling interests | 22958 | 19592 | 13091 |
| **NET INCOME (LOSS) ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS** | $10650 | $24727 | $(14840) |
| **BASIC NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS** | $0.19 | $0.47 | $(0.29) |
| **DILUTED NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS** | $0.17 | $0.46 | $(0.29) |
| **WEIGHTED AVERAGE SHARES OUTSTANDING** |  |  |  |
| &nbsp;&nbsp;&nbsp;Basic | 56293336 | 52496679 | 50891791 |
| &nbsp;&nbsp;&nbsp;Diluted | 57320870 | 53421033 | 50891791 |

---

**RADNET, INC. AND SUBSIDIARIES**

**CONSOLIDATED STATEMENTS OF CASH FLOWS**

**(IN THOUSANDS)**

---

| | | | |
|:---|:---|:---|:---|
|  | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
|  | **2022** | **2021** | **2020** |
| **CASH FLOWS FROM OPERATING ACTIVITIES** |  |  |  |
| &nbsp;&nbsp;&nbsp;Net income (loss) | $33608 | $44319 | $(1749) |
| &nbsp;&nbsp;&nbsp;Adjustments to reconcile net income to net cash provided by operating activities: |  |  |  |
| &nbsp;&nbsp;&nbsp;Depreciation and amortization | 115877 | 96694 | 86795 |
| &nbsp;&nbsp;&nbsp;Amortization of operating right-of-use assets | 68847 | 73967 | 67915 |
| &nbsp;&nbsp;&nbsp;Lease abandonment charges |  | 19675 |  |
| &nbsp;&nbsp;&nbsp;Equity in earnings of joint ventures | (10390) | (10967) | (7945) |
| &nbsp;&nbsp;&nbsp;Distributions from joint ventures | 4438 | 4707 | 9522 |
| &nbsp;&nbsp;&nbsp;Amortization and write off of deferred financing costs and loan discount | 2693 | 3254 | 4413 |
| &nbsp;&nbsp;&nbsp;Loss on sale and disposal of equipment | 2529 | 1246 | 1200 |
| &nbsp;&nbsp;&nbsp;Loss (gain) on extinguishment of debt |  | 1496 | (4047) |
| &nbsp;&nbsp;&nbsp;Loss on impairment |  |  | 4170 |
| &nbsp;&nbsp;&nbsp;Amortization of cash flow hedge | 3687 | 3695 | 3448 |
| &nbsp;&nbsp;&nbsp;Non-cash change in fair value of interest rate hedge | (39621) | -21670 | 2528 |
| &nbsp;&nbsp;&nbsp;Stock-based compensation | 23770 | 25203 | 12405 |
| &nbsp;&nbsp;&nbsp;Other non cash item in other expenses |  |  | 242 |
| &nbsp;&nbsp;&nbsp;Change in value of contingent consideration | (325) |  |  |
| &nbsp;&nbsp;Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts receivable | (30078) | (5890) | 25206 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other current assets | (3327) | (15777) | 6588 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other assets | (12166) | 662 | (5425) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Deferred taxes | 13356 | 19834 | (611) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Operating lease liability | (68943) | (72553) | (53906) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Deferred revenue | (7316) | (28319) | 37941 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable, accrued expenses and other | 49778 | 9915 | 45069 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash provided by operating activities | 146417 | 149491 | 233759 |
| **CASH FLOWS FROM INVESTING ACTIVITIES** |  |  |  |
| &nbsp;&nbsp;&nbsp;Purchase of imaging facilities and other operations | (129961) | (77691) | (31265) |
| &nbsp;&nbsp;&nbsp;Purchase of property and equipment | (119451) | (137874) | (94172) |
| &nbsp;&nbsp;&nbsp;Purchase of intangible assets |  | (5130) |  |
| &nbsp;&nbsp;&nbsp;Proceeds from sale of equipment | 3904 | 625 | 828 |
| &nbsp;&nbsp;&nbsp;Equity contributions in existing and purchase of interest in joint ventures | (1441) | (1441) | (1635) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash used in investing activities | (246949) | (221511) | (126244) |
| **CASH FLOWS FROM FINANCING ACTIVITIES** |  |  |  |
| &nbsp;&nbsp;&nbsp;Payments on senior notes | (53750) | (619529) | (43296) |
| &nbsp;&nbsp;&nbsp;Principal payments on notes and leases payable |  | (3302) | (3562) |
| &nbsp;&nbsp;&nbsp;Additional deferred finance costs on revolving loan amendment |  | (938) | (741) |
| &nbsp;&nbsp;&nbsp;Proceeds from debt issuance, net of issuance costs | 147996 | 717307 |  |
| &nbsp;&nbsp;&nbsp;Proceeds from Payment Protection Program |  |  | 4023 |
| &nbsp;&nbsp;&nbsp;Distributions paid to noncontrolling interests | (893) | (2426) | (1985) |
| &nbsp;&nbsp;&nbsp;Proceeds from sale of noncontrolling interest |  | 13073 |  |
| &nbsp;&nbsp;&nbsp;Proceeds from revolving credit facility |  | 128300 | 250900 |
| &nbsp;&nbsp;&nbsp;Payments on revolving credit facility |  | (128300) | (250900) |
| &nbsp;&nbsp;&nbsp;Proceeds from issuance of common stock upon exercise of options | 294 | 488 | – |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash provided by (used in) financing activities | 93647 | 104673 | (45561) |
| **EFFECT OF EXCHANGE RATE CHANGES ON CASH** | 113 | (65) | (101) |
| **NET (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS** | (6772) | 32588 | 61853 |
| **CASH AND CASH EQUIVALENTS, beginning of period** | 134606 | 102018 | 40165 |
| **CASH AND CASH EQUIVALENTS, end of period** | $127834 | $134606 | $102018 |
| **SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION** |  |  |  |
| &nbsp;&nbsp;&nbsp;Cash paid during the period for interest | $39151 | $29042 | $39521 |
| &nbsp;&nbsp;&nbsp;Cash paid during the period for income taxes | $587 | $1950 | $5069 |

---

**RADNET, INC. AND SUBSIDIARIES**

**CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS**

**(IN THOUSANDS EXCEPT SHARE AND PER SHARE DATA)**

---

| | | |
|:---|:---|:---|
|  | **Three Months Ended December 31** | **Three Months Ended December 31** |
|  | **2022** | **2021** |
| **REVENUE** |  |  |
| Service fee revenue | $346197 | $296264 |
| Revenue under capitation arrangements | 37678 | 36885 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total revenue | 383875 | 333150 |
| Provider relief funding |  | 2819 |
| **OPERATING EXPENSES** |  |  |
| Cost of operations, excluding depreciation and amortization | 329589 | 284667 |
| Lease abandonment charges |  | 19675 |
| Depreciation and amortization | 30668 | 25421 |
| Loss on sale and disposal of equipment and other | 1567 | 1524 |
| Severance costs | 450 | 29 |
| Total operating expenses | 362274 | 331316 |
| **INCOME FROM OPERATIONS** | 21601 | 4652 |
| **OTHER INCOME AND EXPENSES** |  |  |
| Interest expense | 15442 | 11801 |
| Equity in earnings of joint ventures | (2040) | (2707) |
| Non-cash change in fair value of interest rate swaps | (45) | (7520) |
| Debt restructuring and extinguishment expenses | 731 |  |
| Other expenses (income) | 270 | (261) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total other expenses | 14358 | 1312 |
| **INCOME BEFORE INCOME TAXES** | 7243 | 3340 |
| Provision for income taxes | (2274) | (2027) |
| **NET INCOME** | 4969 | 1313 |
| Net income attributable to noncontrolling interests | 5903 | 5137 |
| **NET (LOSS) ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS** | $(934) | $(3823) |
| **BASIC NET (LOSS) INCOME PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS** | $(0.02) | $(0.07) |
| **DILUTED NET (LOSS) INCOME PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS** | $(0.02) | $(0.07) |
| **WEIGHTED AVERAGE SHARES OUTSTANDING** |  |  |
| &nbsp;&nbsp;&nbsp;Basic | 57040622 | 53046706 |
| &nbsp;&nbsp;&nbsp;Diluted | 57040622 | 53964751 |

---

**RADNET, INC. AND SUBSIDIARIES**

**RECONCILIATION OF GAAP NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON SHAREHOLDERS TO ADJUSTED EBITDA**

**(IN THOUSANDS)**

---

| | | | | |
|:---|:---|:---|:---|:---|
|  | **Three Months Ended December 31,** | **Three Months Ended December 31,** | **Twelve Months Ended December 31** | **Twelve Months Ended December 31** |
|  | **2022** | **2021** | **2022** | **2021** |
| Net (loss) income attributable to RadNet, Inc. common stockholders | $(934) | $(3823) | $10650 | $24727 |
| Income taxes | 2274 | 2027 | 9361 | 14560 |
| Interest expense | 15442 | 11801 | 50841 | 48830 |
| Severance costs | 450 | 29 | 946 | 744 |
| Depreciation and amortization | 30668 | 25421 | 115877 | 96694 |
| Non-cash employee stock-based compensation | 4658 | 3637 | 23770 | 25203 |
| Loss on sale and disposal of equipment and other | 1567 | 1524 | 2529 | 1246 |
| Debt restructuring and loss on extinguishment expenses | 731 |  | 731 | 6044 |
| Non-cash change in fair value of interest rate hedge | (45) | (7520) | (39621) | (21670) |
| Other adjustment to joint venture investment |  |  |  | (565) |
| Other expenses | 270 | (261) | 1833 | 1438 |
| Legal settlements |  | 831 | 2197 | 831 |
| Change in estimate related refund liability |  |  | 8089 |  |
| Lease Abandonment Charges |  | 19675 |  | 19675 |
| Non operational rent expenses | 1177 |  | 4297 |  |
| Acquisition transaction costs | 927 | 1171 | 927 | 1171 |
| Valuation adjustment for contingent consideration | 47 |  | 47 |  |
| **Adjusted EBITDA Including Losses from AI Segment and Provider Relief funding** | $**57232** | $**54512** | $**192474** | $**218928** |
| Provider relief funding |  | (2819) |  | (9110) |
| **Adjusted EBITDA Including Losses from AI Segment and excluding benefit from Provider Relief Funding** | $**57232** | $**51693** | $**192474** | $**209818** |
| Adjusted EBITDA losses from AI Segment | 4321 | 304 | 16575 | 2121 |
| **Adjusted EBITDA excluding Losses from AI Segment and Provider relief funding** | $**61553** | $**51997** | $**209049** | $**211939** |

---

**RADNET, INC. AND SUBSIDIARIES**

**SCHEDULE OF ADJUSTED EARNINGS AND EARNINGS PER SHARE <sup>(3)</sup>**

**(IN THOUSANDS EXCEPT SHARE DATA)**

(unaudited)

---

| | | |
|:---|:---|:---|
|  | **Three Months Ended<br> December 31,** | **Three Months Ended<br> December 31,** |
|  | **2022** | **2021** |
| **NET (LOSS) INCOME ATTRIBUTABLE TO RADNET, INC.** |  |  |
| &nbsp;&nbsp;&nbsp;**COMMON STOCKHOLDERS** | $(934) | $(3823) |
| &nbsp;&nbsp;&nbsp;Add severance costs | 450 | 29 |
| &nbsp;&nbsp;&nbsp;Add loss on lease abandonment/impairment |  | 19675 |
| &nbsp;&nbsp;&nbsp;Add legal settlement and related expenses |  | 831 |
| &nbsp;&nbsp;&nbsp;Add debt restructuring and loss on extinguishment expenses | 731 |  |
| &nbsp;&nbsp;&nbsp;Add transaction costs Aidence Holdings B.V. & Quantib B.V. |  | 1171 |
| &nbsp;&nbsp;&nbsp;Add non-operational rent expenses (i) | 1177 |  |
| &nbsp;&nbsp;&nbsp;Add AI Segment losses (iv) | 6060 | 652 |
| &nbsp;&nbsp;&nbsp;Add acquisition transaction costs | 927 |  |
| &nbsp;&nbsp;&nbsp;Add valuation adjustment for contingent consideration | 47 |  |
| &nbsp;&nbsp;&nbsp;Subtract Provider Relief Funding |  | (2819) |
| &nbsp;&nbsp;&nbsp;Subtract non-cash gain on swap valuation (ii) | (45) | (7520) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total adjustments - loss (gain) | 9347 | 12019 |
| &nbsp;&nbsp;&nbsp;Subtract tax impact of Adjustments (iii) | 2031 | 2972 |
| **TOTAL ADJUSTMENT TO NET INCOME ATTRIBUTABLE** |  |  |
| &nbsp;&nbsp;&nbsp;**TO RADNET, INC. COMMON SHAREHOLDERS** | 7316 | 9047 |
| **ADJUSTED NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS** | 6382 | 5224 |
| **WEIGHTED AVERAGE SHARES OUTSTANDING** |  |  |
| &nbsp;&nbsp;&nbsp;Diluted | 58164555 | 53964751 |
| **ADJUSTED DILUTED NET INCOME PER SHARE** |  |  |
| &nbsp;&nbsp;&nbsp;**ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS** | $0.11 | $0.10 |

---

____________________

&nbsp;&nbsp;&nbsp;&nbsp;(i) Represents rent expense associated with de novo sites under construction
prior to them becoming operational.

&nbsp;&nbsp;&nbsp;&nbsp;(ii) Impact from the change in fair value of the swaps during the quarter.
Excludes the amortization of the accumulation of the changes in fair value out of Other Comprehensive Income that existed prior to the
hedges becoming ineffective.

&nbsp;&nbsp;&nbsp;&nbsp;(iii) Tax effected using 21.73% and 24.73% blended federal and state
effective tax rate for 2022 and 2021, respectively.

&nbsp;&nbsp;&nbsp;&nbsp;(iv) Represents pre-tax net income losses before income taxes from
Artificial Intelligence reporting segment.

**PAYOR CLASS BREAKDOWN**

---

| | |
|:---|:---|
|  | Fourth Quarter |
|  | 2022 |
| Commercial Insurance | 57.7% |
| Medicare | 22.0% |
| Capitation | 9.8% |
| Medicaid | 2.5% |
| Workers Compensation/Personal Injury | 3.2% |
| Other | 4.7% |
| Total | 100.0% |

---

**RADNET PAYMENTS BY MODALITY**

---

| | | | | |
|:---|:---|:---|:---|:---|
|  | Fourth Quarter<br>2022 | Full Year<br>2022 | Full Year<br>2021 | Full Year<br>2020 |
| MRI | 36.4% | 36.8% | 36.0% | 35.4% |
| CT | 17.2% | 17.5% | 17.2% | 17.6% |
| PET/CT | 5.8% | 5.8% | 5.5% | 6.0% |
| X-ray | 6.4% | 6.7% | 3.9% | 7.3% |
| Ultrasound | 12.8% | 12.6% | 12.7% | 12.3% |
| Mammography | 16.0% | 15.3% | 16.1% | 15.7% |
| Nuclear Medicine | 0.8% | 0.9% | 1.0% | 1.0% |
| Other | 4.6% | 4.5% | 4.6% | 4.7% |
|  | 100.0% | 100.0% | 100.0% | 100.0% |

---

 <u>Footnotes</u>

 

<sup>(1)</sup> The Company defines Adjusted EBITDA as earnings before interest, taxes, depreciation and amortization, each from continuing operations and excludes losses or gains on the disposal of equipment, other income or loss, loss on debt extinguishments, bargain purchase gains and non-cash equity compensation. Adjusted EBITDA includes equity earnings in unconsolidated operations and subtracts allocations of earnings to non-controlling interests in subsidiaries, and is adjusted for non-cash and extraordinary events which took place during the period.

Adjusted EBITDA is reconciled to its nearest comparable GAAP financial measure. Adjusted EBITDA is a non-GAAP financial measure used as analytical indicator by RadNet management and the healthcare industry to assess business performance, and is a measure of leverage capacity and ability to service debt. Adjusted EBITDA should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted EBITDA should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

<sup>(2)</sup> As noted above, the Company defines Free Cash Flow as Adjusted EBITDA less total Capital Expenditures (whether completed with cash or financed) and Cash Interest paid. Free Cash Flow is a non-GAAP financial measure. The Company uses Free Cash Flow because the Company believes it provides useful information for investors and management because it measures our capacity to generate cash from our operating activities. Free Cash Flow does not represent total cash flow since it does not include the cash flows generated by or used in financing activities. In addition, our definition of Free Cash Flow may differ from definitions used by other companies.

Free Cash Flow should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted EBITDA should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

<sup>(3)</sup> The Company defines Adjusted Earnings Per Share as net income or loss attributable to RadNet, Inc. common stockholders and excludes losses or gains on the disposal of equipment, loss on debt extinguishments, bargain purchase gains, severance costs, loss on impairment, loss or gain on swap valuation, gain on extinguishment of debt, unusual or non-recurring entries that impact the Company's tax provision, pre-tax loss or gain from AI segment and any other non-recurring or unusual transactions recorded during the period.

Adjusted Earnings Per Share is reconciled to its nearest comparable GAAP financial measure. Adjusted Earnings Per Share is a non-GAAP financial measure used as analytical indicator by RadNet management and the healthcare industry to assess business performance. Adjusted Earnings Per Share should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted Earnings Per Share should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted Earnings Per Share is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

## Exhibit 99.2

**Exhibit 99.2**

![](image_057.jpg)

![](image_058.jpg)

**C O R P O R A T E P A R T I C I P A N T S**

**Mark Stolper,** *Executive Vice President and Chief Financial Officer*

 

**Dr. Howard Berger, MD,** *President and Chief Executive Officer*

 

 

 

**C O N F E R E N C E C A L L P A R T I C I P A N T S**

**Brian Tanquilut,** *Jefferies*

 

**John Ransom,** *Raymond James*

 

**Mitra Ramgopal,** *Sidoti & Company*

**P R E S E N T A T I O N**

**Operator**

Greetings, and welcome to the RadNet, Inc. Fourth Quarter 2022 Financial Results Call.

At this time, all participants are in a listen-only mode. A brief question-and-answer session will follow the formal presentation. As a reminder, this conference is being recorded.

It is now my pleasure to introduce your host, Mark Stolper, Executive Vice President and Chief Financial Officer. Thank you. Mark, you may begin.

**Mark Stolper**

Thank you. Good morning, and thank you for joining Dr. Howard Berger and me today to discuss RadNet's fourth quarter and full year 2022 results.

Before we begin today, we'd like to remind everyone of the Safe Harbor statement under the Private Securities Litigation Reform Act of 1995. This presentation contains forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. Specifically, statements concerning anticipated future financial and operating performance, RadNet's ability to continue to grow the business by generating patient referrals and contracts with radiology practices, recruiting and retaining technologists, receiving third-party reimbursement for diagnostic imaging services, successfully integrating acquired operations, generating revenue and Adjusted EBITDA for the acquired operations as estimated, among others, are forward-looking statements within the meaning of the Safe Harbor.

Forward-looking statements are based on Management's current preliminary expectations and are subject to risks and uncertainties which may cause RadNet's actual results to differ materially from the statements contained herein. These risks and uncertainties include those risks set forth in RadNet's reports filed with the SEC from time to time, including RadNet's Annual Report on Form 10-K for the year ended December 31, 2022, to be filed shortly.

________________

ViaVid has made considerable efforts to provide an accurate transcription. There may be material errors, omissions, or inaccuracies in the reporting of the substance of the conference call. This transcript is being made available for information purposes only.

1-888-562-0262 1-604-929-1352 www.viavid.com

![](image_058.jpg)

Undue reliance should not be placed on forward-looking statements, especially guidance on future financial performance, which speaks only as of the date it is made. RadNet undertakes no obligation to update publicly any forward-looking statements to reflect new information, events or circumstances after the date they were made, or to reflect the occurrence of unanticipated events.

With that, I'd like to turn the call over to Dr. Berger.

**Dr. Howard Berger**

Thank you, Mark. Good morning, everyone, and thank you for joining us today.

On today's call, Mark and I plan to provide you with highlights from our fourth quarter and full year 2022 results, give you more insight into factors which affected this performance, and discuss our future strategy. After our prepared remarks, we will open the call to your questions.

I'd like to thank all of you for your interest in our Company and for dedicating a portion of your day to participate in our conference call this morning.

Let's begin.

I'm extremely pleased with our strong performance in the fourth quarter. We grew our revenue by over 15% and our Adjusted EBITDA by over 13% from last year's fourth quarter, resulting in quarterly records for both revenue and Adjusted EBITDA. The strong performance was the result of a combination of growing procedural demand for our services and improving conditions in our labor markets. Demand for our services remains robust in virtually all of the markets, as outpatient imaging continues to be shifted from more expensive hospital settings towards more cost-efficient ambulatory sites, like the ones RadNet operates.

Contributing to our record Adjusted EBITDA performance was also an improving labor market. During the fourth quarter, and thus far in 2023, we have been more successful in filling open positions and retaining existing staff. Furthermore, COVID has had less of an impact on our workforce with respect to taking sick days, enabling us to staff our centers more effectively to meet heavy procedural demand.

Consistent with our efforts throughout the pandemic, during the fourth quarter, we continued to focus on strengthening our balance sheet by managing our liquidity and financial leverage. At the year end 2022, we had a cash balance of over $127 million and a net leverage ratio of under 3.5 times Adjusted EBITDA.

Our days sales outstanding, DSOs, at December 31, 2022 was under 39.0 days, close to our historic low. The improvement in revenue cycle operations and collections has materially contributed to our ability to manage the challenges presented by COVID-19 and the difficult labor market, while affording us the ability to make important investments in our future.

These investments in our future have been focused in four principal areas that we believe are key elements to our near-term growth:

First, as we discussed last year, we have been in development of over a dozen de novo facilities, most of which will open for operations in 2023. These facilities are located in markets where we have patient backlogs, require additional capacity, or in locations where we currently lack access points to service identified patient populations. The largest of these de novo centers, in the downtown area of Phoenix, is now operational and has begun to service patient volume.

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A second area of investment and focus will be expanding our joint venture initiatives. We currently have 24 health system joint ventures, representing one-third, or 119 centers, of our 357 centers. We continue to believe that we could have more than half of our centers in health system partnerships within three years. Forward-thinking and entrepreneurial health systems are increasingly seeking a long-term, viable strategy for outpatient diagnostic imaging and RadNet represents an attractive strategic direction for these organizations. During 2022, as an example, we established a new joint venture in Frederick, Maryland, and expanded several others with our partners, including Cedars-Sinai medical center in the Los Angeles area and Dignity Health CommonSpirit in Arizona. As we look ahead to this year, we anticipate the expansion of several health system relationships and the establishment of new joint venture relationships. As payors, patients and referring physicians continue to shift outpatient volumes from hospitals into ambulatory outpatient centers, we are receiving increasing interest in the partnership models we can offer.

Third, tuck-in acquisitions will remain an important part of our growth strategy and investment. Our industry remains fragmented and consolidation will continue as pressure mounts on smaller operators. Motivated sellers are appearing as a result of the rising cost of capital, increased interest rates, reimbursement pressure from Medicare and private payors, and the necessity of scale to drive efficiencies and profitability. Becoming part of RadNet for these smaller operators represents a way to create more security for their future.

In 2022, we completed several tuck-in acquisitions. The largest tuck-in acquisition we completed during 2022 was the fourth quarter acquisition of Montclair Radiology Associates by our New Jersey Imaging Network joint venture with the RWJBarnabas hospital system. Montclair was an entrenched and well-respected operator in Northern New Jersey, with six high-performing imaging centers.

Also notable, during the fourth quarter of 2022, we acquired a controlling interest in Heart & Lung Health, HLH, a London-based teleradiology network focused on lung cancer screening. HLH has established itself as the leading provider of lung cancer screening services to the U.K. National Health Service's Targeted Lung Health Checks Program, which mandates the combined use of artificial intelligence and expert radiologist interpretation for widespread population health lung cancer screening. HLH utilizes software from RadNet's AI subsidiary Aidence and is anticipated that the program could drive over 1 million lung scans in England alone when the program becomes fully implemented, which is targeted by the end of 2026.

Finally, we continue to invest and pursue growth opportunities in artificial intelligence. In November, we initiated a pilot of a new Enhanced Breast Cancer Detection service in Delaware, called EBCD. The offering works in concert with a patient's annual breast screening regimen. For an additional fee, patients can elect to enroll in a suite of premium mammography-related services, including the use of DeepHealth Saige-DX AI, personalized lifetime risk assessment and additional AI-driven review for certain exams, and access to a dedicated 1-800 support line. Upon the successful completion of the pilot, we began to implement a rollout of EBCD to our other East Coast markets during the fourth quarter, and we expect that EBCD will be available in all of the RadNet's mammography centers by the end of this summer. Currently, we perform about 1.4 million screening mammography exams annually.

AI will continue to be an important growth driver for our future. When Mark reviews our 2023 guidance, he will note that we anticipate to narrow our losses from AI in 2023, as a result of both expected revenue from EBCD and growth from the sale and licensing of Quantib and Aidence products. We further expect that our AI segment will turn a profit in 2024.

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At this time, I'd like to turn the call back over to Mark to discuss some of the highlights of our fourth quarter and full year 2022 performance, as well as discuss in detail our guidance levels for 2023. When he is finished, I will make some closing remarks.

**Mark Stolper**

Thank you, Howard.

I'm now going to briefly review our fourth quarter and full year 2022 performance and attempt to highlight what I believe to be some material items. I will also give some further explanation of certain items in our financial statements, as well as provide some insights into some of the metrics that drove our fourth quarter and full year 2022 performance. I will also provide 2023 financial guidance levels, which were released in this morning's financial results press release.

In my discussion, I will use the term Adjusted EBITDA, which is a non-GAAP financial measure. The Company defines Adjusted EBITDA as earnings before interest, taxes, depreciation and amortization, and excludes losses or gains on the disposal of equipment, other income or loss, loss on debt extinguishments and non-cash equity compensation. Adjusted EBITDA includes equity earnings in unconsolidated operations and subtracts allocations of earnings to non-controlling interest in subsidiaries, and is adjusted for non-cash or extraordinary and one-time events taking place during the period. A full quantitative reconciliation of Adjusted EBITDA to net income or loss attributable to RadNet, Inc. common shareholders is included in our earnings release.

With that said, I'd now like to review our fourth quarter and full year 2022 results.

For the fourth quarter of 2022, RadNet reported revenue from its imaging center reporting segment of $382.5 million and Adjusted EBITDA of $61.6 million, which excludes revenue and losses from the AI segment. As compared with last year's fourth quarter, revenue increased $50.3 million, or 15.1%, and Adjusted EBITDA increased $9.6 million, or 18.4%, also excluding $2.9 million of Provider Relieve Funding received in the fourth quarter of 2021. Including our AI reporting segment, revenue was $383.9 million in the fourth quarter of 2022, an increase of 15.2%, from $333.1 million in last year's fourth quarter. Including the Adjusted EBITDA losses of the AI reporting segment, Adjusted EBITDA was $57.2 million in the fourth quarter of 2022, and $51.7 million in the fourth quarter of 2021, also excluding the Provider Relieve Funding received in the fourth quarter of 2021.

For the fourth quarter of 2022, as compared with the prior year's fourth quarter, MRI volume increased 11.9%, CT volume increased 11.8%, and PET CT volume increased 20.7%. Overall volume, taking into account routine imaging exams inclusive of X-ray, ultrasound, mammography and all other exams, increased 8% over the prior year's fourth quarter.

In the fourth quarter of 2022, we performed 2,376,995 total procedures. The procedures were consistent with our multi-modality approach, whereby 75.6% of all the work we did by volume was from routine imaging. Our procedures in the fourth quarter of 2022 were as follows: 352,009 MRIs, as compared with 314,682 MRIs in the fourth quarter of 2021; 213,716 CTs, as compared with 191,180 CTs in the fourth quarter of 2021; 13,359 PET CTs, as compared with 11,066 PET CTs in the fourth quarter of 2021; and 1,797,911 routine imaging exams, compared with 1,684,992 of all these exams in the fourth quarter of 2021.

On a same-center basis, including only those centers which were part of RadNet for both the fourth quarters of 2022 and 2021, MRI volume increased 7.5%, CT volume increased 6%, and PET CT volume increased 16.9%. Overall same-center volume, taking into account all routine imaging exams, increased 3.6% over the prior year same quarter.

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For the fourth quarter of 2022, RadNet reported a net loss of $934,000, as compared with a net loss of $3.8 million for the fourth quarter of 2021. Net loss per share for the fourth quarter of 2022 was negative $0.02, compared with a net loss per share of negative $0.07 in the fourth quarter of 2021, based upon a weighted average number of diluted shares outstanding of 57 million shares in 2022, and 54 million shares in 2021.

There were a number of unusual or one-time items impacting the fourth quarter of 2022, including the following: $45,000 of non-cash gain from interest rate swaps, which excludes the amortization of the accumulation of the changes in fair value out of other comprehensive income; $450,000 of severance paid in connection with headcount reductions related to cost savings initiatives; a $1.2 million expense related to leases of our de novo facilities under construction that have yet to be opened for operation; a $927,000 acquisition transaction cost, primarily related to the purchase of Heart & Lung Imaging Limited; $47,000 of valuation adjustment for contingent consideration related to acquisitions; $731,000 expenses related to debt structuring and loss on extinguishment related to the refinancing of New Jersey Imaging Network's credit facilities completed in October; and $6.1 million of pre-tax losses related to our AI reporting segment.

Adjusting for the above items, adjusted earnings from the imaging centers reporting segment was $6.4 million and diluted adjusted earnings per share was $0.11 during the fourth quarter of 2022. This compares with adjusted earnings per share of $0.10 during the fourth quarter of 2021.

Also affecting net income in the fourth quarter of 2022 were certain non-cash and unusual items, including the following: $4.7 million of non-cash employee stock compensation expense resulting from the vesting of certain options and restricted stock; a $1.6 million loss on the disposal of certain capital equipment; and $750,000 of non-cash amortization of deferred financing costs and loan discounts related to financing fees paid as part of our existing credit facilities.

With regards to some specific income statement accounts, overall GAAP interest expense for the fourth quarter of 2022 was $15.4 million. This compares with GAAP interest expense in the fourth quarter of 2021 of $11.8 million. Cash paid for interest during the period, which excludes non-cash deferred financing expense, accrued interest and payments to and from swap counterparties, was $8.9 million, as compared with $7.6 million in the fourth quarter of last year. The higher interest expense and cash paid for interest in this year's fourth quarter was a function of additional debt on our balance sheet resulting from the $150 million New Jersey Imaging Network refinancing transaction completed on October 7 of 2022, as well as higher interest rates since last year's fourth quarter.

For full year 2022, RadNet reported revenue from its imaging centers reporting segment of $1.426 billion and Adjusted EBITDA, excluding losses from AI reporting segment, of $209 million. Revenue increased $112 million, or 8.5%, and Adjusted EBITDA decreased $2.9 million, or 1.4%, excluding $9.1 million of Provider Relieve Funding received in 2021. Including our AI reporting segment revenue of $4.4 million, revenue was $1.430 billion for full year 2022, an increase of 8.7% from $1.350 billion in 2021. Including Adjusted EBITDA losses from the AI segment, Adjusted EBITDA for 2022 was $192.5 million, as compared with $209.8 million in 2021, which includes a one-time $7.7 million benefit from the employee retention credit and excludes $9.1 million of Provider Relieve Funding, both received in 2021.

For the year ended December 31, 2022, as compared to 2021, MRI volume increased 10.7%, CT volume increased 9.6%, and PET CT volume increased 12.3%. Overall volume, taking into account all routine imaging exams, increased 6.7% for the 12 months of 2022, over 2021.

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In 2022, we performed 9,175,804 total procedures. The procedures were consistent with our multi-modality approach, whereby 75.5% of all the work we did by volume was from routine imaging. Our procedures in 2022 were as follows: 1,346,303 MRIs, as compared with 1,232,427 MRIs in 2021; 828,952 CTs, as compared with 756,509 CTs in 2021; 50,684 PET CTs, as compared with 45,124 PET CTs in 2021; and 6,931,865 routine imaging exams, as compared with 6,564,533 of all these exams in 2021.

For 2022, RadNet reported net income of $10.7 million, a decrease of approximately $14.1 million over 2021. Per share diluted net income for the full year of 2022 was $0.17 per share, compared to a diluted net income per share of $0.46 in 2021. This is based upon a weighted average number of diluted shares outstanding of 57.3 million shares in 2022, and 53.4 million in 2021.

Affecting net income in 2022 were certain non-cash expenses and unusual items, including the following: $39.6 million of non-cash gain from interest rate swaps; $946,000 of severance paid in connection with headcount reductions related to cost savings initiatives; a $4.3 million expense related to leases for our de novo facilities under construction that have yet to open their operations; $24.9 million of pre-tax losses related to our AI reporting segment; $23.8 million of non-cash employee stock compensation expense resulting from the vesting of certain options and restricted stock; $731,000 expenses related to debt restructuring and loss on extinguishment related to the refinancing of our New Jersey Imaging Network's credit facilities; $2.2 million in legal settlements; a $2.5 million loss on the disposal of certain capital equipment; an $8.1 million charge in estimate related to a refund liability; and $2.7 million of non-cash amortization of deferred financing costs and loan discounts related to financing fees paid as part of our existing credit facilities.

With regards to some specific income statement accounts, overall GAAP interest expense in 2022 was $50.8 million. Adjusting for the impacts from items, such as amortization of financing fees, accrued interest and payments to swap counterparties, cash interest expense was $39.2 million in 2022. This compares with GAAP interest expense in 2021 of $48.8 million and cash paid for interest of $29 million.

With regards to our balance sheet, as of December 31, 2022, unadjusted for bond and term loan discounts, we had $735 million of net debt, which is our total debt at par value less our cash balance. Note that this debt balance includes New Jersey Imaging Network's debt of $150 million, for which RadNet is neither a borrower nor guarantor. This compares with $633.3 million of net debt at December 31, 2021. As of year end 2022, we were undrawn on our $195 million revolving line of credit and had a cash balance of $127.8 million.

At December 31, 2022, our accounts receivable balance was $166.4 million, an increase of $31.3 million from year end 2021. Our DSO was 38.8 days at December 31, 2022, which continues to be near our all-time low.

Throughout 2022, we had total capital expenditures, net of asset dispositions and the sale of imaging center assets and joint venture interest, of $109.3 million. This amount excludes $6.3 million of capital expenditures of New Jersey Imaging Network. All of our capital expenditures were paid for in cash, and we recognized $3.9 million in proceeds from the sale of equipment, also excluding proceeds from the sale of equipment from NJIN. Capital expenditures in 2022 were higher than originally budgeted as the result of the construction of certain de novo locations that became operational towards the end of 2022, or are expected to be operational in 2023.

At this time, I'd like to review our 2023 financial guidance levels, which we released this morning in our financial results press release.

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For the imaging center segment, for revenue, we are projecting $1.525 billion to $1.575 billion; for Adjusted EBITDA, we're projecting $220 million to $230 million; for capital expenditures, we're projecting $105 million to $115 million; for cash paid for interest, we're projecting $35 million to $40 million; and for free cash flow generation, we're anticipating $70 million to $80 million.

For our artificial intelligence segment, we're anticipating revenue of between $16 million and $18 million, and we're expecting Adjusted EBITDA losses to be between $9 million and $11 million.

Our guidance anticipates strong results in 2023, demonstrating improvement in all financial and operating metrics. We are projecting revenue growth from imaging center operations of between 7% and 10%, and Adjusted EBITDA growth from imaging center operations of between 5% and 10%. The anticipated growth implicit in our guidance in 2023 is projected to result from same center growth, the contribution of various de novo centers opened in the second half of 2022, and scheduled to open throughout 2023, reimbursement increases from private and capitated payors, new and expanded health system joint ventures, and the further contribution from acquisitions completed at various times during 2022.

Our Adjusted EBITDA guidance for 2023 excludes the anticipated Adjusted EBITDA losses of approximately $10 million from our AI division, which is DeepHealth, Aidence and Quantib. We estimate that these losses will be net of approximately $16 million to $18 million of the anticipated revenue from both the Enhanced Breast Cancer Detection mammography program, or EBCD, currently being implemented, and additional growth from Aidence and Quantib AI operations.

We expect the AI operating segment to be profitable in 2024, and will continue to report the financial results of our AI and imaging center operating segments separately each quarter throughout 2023, providing transparency for our stakeholders to track our progress.

I'd now like to turn the call back over to Dr. Berger, who will make some closing remarks.

**Dr. Howard Berger**

Thank you, Mark.

As we head into 2023, we are firing on all cylinders. We have a core business that is healthy and growing. As we discussed on today's call, procedural volumes and patient demand are strong and expanding. Payors and patients are increasingly moving procedural volume to our centers from hospital-based imaging operations that charge prices that are unsustainable in a healthcare system attempting to manage costs. While the shift is taking place, the overall industry continues to grow, driven, in part, by advances in technology which drive more indications for diagnostic imaging procedures. Additionally, the populations we serve are aging and growing, and continue to seek non-invasive, preventative and cost-effective medicine. All these factors should continue to benefit our core business. As such, I am happy to report that the record volumes we experienced in the fourth quarter of 2022 have continued into the January and February months of 2023.

We believe we have the best and most diverse company in the industry, positioning us for long-term success and growth in a dynamic marketplace. In a period where the cost of capital has risen significantly, we remain modestly leveraged and have more liquidity and capital resources, as compared with virtually all of our other scale operators in our industry. This places us in the best position to pursue growth opportunities, both organic and inorganic, in a time where many others do not have the financial capacity or flexibility.

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This financial capability will allow us to continue to invest aggressively for long-term success of our business. These investments include: executing a de novo strategy, completing strategic acquisitions to strengthen our regional networks; pursuing an industry-leading strategy in artificial intelligence, particularly around population health cancer screening; establishing a teleradiology capability; owning our own information technology platform; and partnering with some of the largest and most respected regional and national health systems.

In conclusion, we have never been more excited than we are today about what lies ahead for RadNet. We feel as if we are better positioned today than at any other time in our history to execute on the multi-faceted strategy that we have created. We look forward to updating our stakeholders throughout the rest of 2023 on our progress.

Operator, we are now ready for the question-and-answer portion of the call.

**Operator**

Thank you. We will now be conducting a question-and-answer session. One moment, please, while we poll for questions.

Our first question comes from the line of Brian Tanquilut with Jefferies. Please proceed with your question.

**Brian Tanquilut**

Hey, good morning, guys. Congrats on the solid quarter and solid year.

I guess, Mark, I'll start with guidance and your commentary on volumes. Do you think this is kind of payor efforts now starting to show up in actual numbers, their efforts to move volume away from the hospitals? I'm just trying to figure out what's driving the strength in same-store.

Then, maybe kind of related to that, I know that there are some weather issues that you guys faced in California early in the quarter, and also some on the East Coast. I know the comment is that volumes have been strong. So, if not for weather, would you have even seen stronger performance January and February?

**Mark Stolper**

Sure. To address the first part of your question, Brian—good morning, by the way—we certainly are benefiting, and I think the entire outpatient market is benefiting—or the freestanding outpatient market, I should say, the non-hospital-based, is definitely benefiting from a shift in procedural volumes out of the hospital in favor of lower cost, more efficient ambulatory centers, like the ones we operate. Although this trend has been a multi-year trend, that I'd say has accelerated over the last five years, it's happening slowly and I still think that we're in the early innings of this patient volume moving out of the hospitals. I mean, there's still a lot of outpatient scheduled imaging that occurs within hospitals and health systems today, that, theoretically, over time, could be moved into the lower cost settings.

We've seen some of the larger payors make public announcements about their intentions to move this business, over time, into the outpatient centers. Companies like Anthem, United and Aetna have all been doing this, and they're doing it through various mechanisms. One mechanism is through plan design by offering advantageous co-pays or lower co-pays or no co-pays if patients seek their imaging outside of hospitals, which drives a financial incentive for the patient. Then, there are also—most, if not all, payors today have some form of preauthorization process which, as part of that process, tries to direct the patient to the lower cost settings or a narrower network of ambulatory settings.

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So, we think we're definitely benefiting from that, and I suspect other outpatient players should be benefiting from that, as well, but I think it's happening slowly. The payors have to carefully balance the fact that they certainly need the hospitals in their networks for more the acute care services, and so they have to play that balancing game of trying to lower costs, but also make sure that they keep the hospitals in their networks.

In our guidance, to answer your second question, we have assumed about a 3% same center growth, and if that should be stronger, like it has been in 2022, we could end up towards the higher end of our guidance or beat our guidance, and we have no reason to think that we shouldn't be able to achieve that baseline.

**Dr. Howard Berger**

Good morning, Brian.

**Brian Tanquilut**

Good morning, Howard.

**Dr. Howard Berger**

I think we should call this a tale of two coasts. Who would have ever thought that we would be talking about weather impacts on the West Coast during the first quarter, as opposed to the weather impacts we normally see on the East Coast, and therein lies the story, because January was extraordinarily kind to RadNet, and for that matter, all other healthcare providers, and our volumes, which normally get impacted by both the beginning of the year, New Year's Eve hangover, literally and figuratively, as well as weather impacts, neither of which occurred this year, so we came into January both guns blazing and had an extraordinarily high volume, unanticipated, on the East Coast.

On the other hand, while there have been weather storms here in California, other than a perhaps sporadic power outage, we have not seen any significant impact in our volumes. Part of that is a reflection of the very high demand and backlogs that we have, and when patients are unable or cancel, we do have a very robust IT infrastructure that allows us to rapidly call other people who have asked to be seen more expeditiously.

So, the overall tone, both for January and now extending into February, is already beyond our initial expectations.

I think, just to perhaps to amplify a little bit more on Mark's results, while I—Mark's comments, excuse me.

**Mark Stolper**

Well, in a good quarter, you can attribute the results to me.

**Dr. Howard Berger**

Yes, okay. But, I believe that part of our success in attracting more volume is not just the efforts on the part of payors, but, really, the efforts on the part of our hospital partners who recognize that they need to be part of the movement to the more cost-effective centers that RadNet has with them in joint ventures, and so as we expand those partnerships and as they bring additional opportunities to us, our volumes are reflective of their own internal policies to begin to be more patient- and payor-friendly and move some of those volumes outside of the hospital.

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So, I think, if nothing else, the success of the fourth quarter, and carrying over here to the first quarter, is a reflection of the strategy that RadNet began more aggressively in the last three years, that's now paying dividends, and I think it's a complement that not only are the hospitals looking to find these soft landings, but they're looking to RadNet to do that, given, I think, the very strong platform that we have not just in operating imaging centers, but artificial intelligence resonating with our hospital partners, radiology informatics with our IT platform, is one that is an exceedingly strong tool, and the overall capabilities of RadNet to deliver high-quality outpatient imaging centers in a lower cost environment has certainly taken root. So, I think all of those factors really come together at a time where we've just laid the right bricks for the foundation here to have an extremely successful 2023.

**Brian Tanquilut**

Got it, that's helpful, and then I guess my second question—as I think about AI, it looks very promising, losses are shrinking and you'll turn to profitability by next year, but as I think about how AI is operationalizing into the RadNet facilities, maybe if you can share with us what you're seeing in terms of a reduction in reading costs or a reduction in the use of external radiologists, I mean, just any context that you can share with us, and also the opportunity for incremental, I guess, savings or margin expansion as you roll out AI fully across the RadNet facilities?

**Dr. Howard Berger**

Good question. We have yet to realize, I think, some of the artificial intelligence benefits that we anticipate. Partially, it's because radiologists, and not surprisingly, are not comfortable completely adopting the artificial intelligence and relying on it as heavily as they can, given that it's a rather dramatic change in their workflow and confidence level. So, the ability for us to benefit from those efficiencies, both at the level of the radiologist and patient throughput, is something, I think, that will take longer than we had perhaps had originally anticipated, but I think that's a positive sign, because once the radiologists get comfortable and adopt these, more importantly, they become not only more dependent, but, in a number of cases, they will tell you that it has improved their clinical skills more than any other single element in their history of practice and education.

Our particular approach, though, to artificial intelligence is really for cancer screening and it's not necessarily meant to be as much of the efficiency tool, but rather to broaden the reach of cancer screening into the marketplace, which, I think, has enormous benefit to population health. We have demonstrated our confidence in being able to detect cancer earlier and more accurately with the use of artificial intelligence, and as these get further adopted inside imaging centers and health systems, and as these offerings become more available, like our Enhanced Breast Cancer Detection program, to our patients, I believe that there will be an expansion of our volumes to reflect the desire for all stakeholders in healthcare to diagnose cancer earlier, which can only lead to better outcomes both from a healthcare standpoint of our patients, as well as cost to the system.

I think this is going to be an unfolding story over the next couple of years. In particular, I think we're getting a lot of recognition for these tools, and it's one of the few things in artificial intelligence that can ultimately be for radiology providers and health systems an opportunity for revenue generation, as opposed to most of the other AI tools which are primarily radiology diagnostic aids and come at a cost, but not necessarily improve revenue generation. So, we believe we've made the right investment in these three companies, not only because of their capabilities, but because of what they represent for the bigger healthcare opportunity to really identify cancer earlier and provide better outcomes. I believe we now, after a couple years of experience in this market, have identified better ways to commercialize and monetize this, while at the same time providing extraordinarily high benefit to all of our patients.

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So, I think we'll be talking more and more about this each quarter, not only as the adoption of these tools become more available, but also to better expand the capabilities that we have internally to make these tools that much more attractive to everybody in the healthcare system. I'm anxious to be able to talk more about this.

We will also be looking at ways of expanding the delivery and the use of these tools outside of the RadNet centers, but before we can get there, we want to make certain that we fine-tune these capabilities inside RadNet on its enormously large platform to both better implement and design the best way to roll this out on a commercial basis.

So, I think these are things that we will be talking about more throughout the year and which I'm particularly excited to be able to bring to you as these developments unfold.

**Brian Tanquilut**

Awesome. Thank you, guys.

**Dr. Howard Berger**

Thanks, Brian.

**Mark Stolper**

Thanks, Brian.

**Operator**

Thank you. Our next question comes from the line of John Ransom with Raymond James. Please proceed with your question.

**John Ransom**

Hey, good afternoon. I was wondering, your guidance on AI getting to breakeven in '24, what kind of revenue assumptions are we thinking there, and then where is that coming from? Thanks.

**Dr. Howard Berger**

That primarily is going to be driven—by the way, good morning, John. That's primarily driven by the rollout after our successful pilot on our Enhanced Breast Cancer Detection system. We're now almost fully rolled out on the East Coast for this, the last of our regions will go live here in March, and the West Coast will begin rolling out sometime in the third quarter. The revenue that we expect from that alone is somewhere between $11 million and $13 million in 2023, and then growing substantially more than that in 2024, as more and more of the markets are fully implemented over a longer period of time. While we expect some growth in our Aidence and Quantib units, which do lung screening and prostate screening with AI, we are working on ways to also commercialize and monetize those, but they are probably a little bit lagging behind, since our primary efforts in this area were really in breast cancer, given the enormous number of women who get breast cancer, one out of every eight, and where the amount of mammography done all leads (inaudible) any other application of artificial intelligence.

Hopefully, that gives you a little bit more perspective there, John.

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**Mark Stolper**

John, in our guidance, we're assuming $16 million to $18 million of total revenue in 2023. Although we're not giving multi-year guidance, if I had to estimate today what that revenue might look like in 2024, in order for us to breakeven or have profitability, it'd probably be in the $25 million to $30 million range, based upon where the expenses are in Quantib, Aidence and DeepHealth. That shows a lot of growth, and that $25 million to $30 million would likely make us the biggest AI radiology company that we're aware of.

**John Ransom**

So, I have to say you guys were AI before it was cool. Who knew a couple of old guys from Los Angeles would be that far ahead of the curve? That's all for me …

**Mark Stolper**

Hey, hey, we're not that old, come on.

**Dr. Howard Berger**

Speak for yourself.

**John Ransom**

I'm old. Thank you.

**Dr. Howard Berger**

I like to think that we're not ahead of the curve, we're making the curve. I think what we're doing is very unique inside healthcare, and, in particular, radiology, and I'm extraordinarily proud of the companies that we have acquired here that will help RadNet continue to raise its visibility and not just be a name for radiologists, but be a strong player in the healthcare industry, that I think I'll be sharing more of that story with you later this year.

**John Ransom**

Thank you.

**Dr. Howard Berger**

Thanks, John.

**Operator**

Thank you. Our next question comes from the line of Mitra Ramgopal with Sidoti & Company. Please proceed with your question.

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**Mitra Ramgopal**

Yes, hi, good morning, and thanks for taking the questions, just a couple from me. First, just as it relates to the de novo expansion, how quickly do you expect locations to, at least, breakeven, and even become profitable?

**Dr. Howard Berger**

Well, if we were building a de novo center, Mitra, it probably could take a year to get to profitability here. The difference with our centers is that, by and large, they're all in markets where we already have demand and where we can anticipate filling capacity almost, literally, the day that we're open. In our model for these, sometimes in the first quarter, or certainly by the second quarter, after they're operational, they become EBITDA positive generators. But, again, I think that's an unusual circumstance, given that we build these centers because we need them, not just because we think that there's future opportunity. So, these are all responsive to the growing demand that we have in our markets and where we're limited by the physical capabilities of our centers to ramp up.

**Mitra Ramgopal**

Okay, no, that's great. Then, just switching to the labor front, obviously, that was a headwind for you in '22, both from cost side and also being able to staff your operations fully. How comfortable are you, in terms of '23, in what you're seeing out there, given the expansion and more locations you're adding, and your ability to fill open positions and being able to have adequate staffing without necessarily incurring significantly higher costs?

**Dr. Howard Berger**

Yes, that's a great question. We've been very fortunate that the labor markets in our centers, and in the regions that we operate, appear to have loosened up, if you will, a little bit, and while we still have a number of open positions, we've made some good impact on that. It's hard to really put in perspective how significant the labor market challenges were in all of 2022, including the fourth quarter. While our results were extraordinarily good in the fourth quarter, they would have been better if we didn't have some of those challenges that, while we were turning the corner, were still impacting the fourth quarter.

I'll give you an example. In New York and California, the state has mandated that any individual who believes they have contracted COVID can isolate or report in sick and the company is required to continue to pay their salaries without them using up any sick pay or PTO. That's a double impact for us, because not only does it cost us double to find that capability for coverage, but because then we have to pay more overtime, we are getting hit with both of those. Unfortunately, in the first quarter of last year—or excuse me, the fourth quarter, I guess it was, of the year before, we had close to 8% of our workforce out at one time with COVID. Currently, it's down to less than 1%. That has been a huge benefit for us. So, it's not just hiring more people, but it's getting our current workforce back into normal workday, which allows us to expand our hours of operation.

In addition, we've been using temp agencies and locums temps businesses, that the price for this staffing has doubled or tripled from a year ago. Fortunately, we've been successful in hiring more radiologists and other technical staff, so we've been able to reduce that. Built into our 2023 budget is still the use of temp agencies, but as we're more and more successful, hopefully, that cost will continue to go down and improve our results.

I believe the issues that we're faced with are faced by virtually every healthcare provider out there, as well as other segments in our economy, but I believe some of the changes may be, also, as a result of the economic factors that are causing layoffs in almost every other industry, except for healthcare. So, I believe that that trend is not only sustainable, but will continue to improve as people seek alternatives—or people have fewer alternatives than they might had before, and where I think pressure on wages will start coming down.

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**Mitra Ramgopal**

Okay, that was very helpful. Thanks again for taking the questions. That's it for me.

**Mark Stolper**

Thanks, Mitra.

**Operator**

Thank you. There are no further questions at this time. I'd like to turn the floor back over to Management for closing comments.

**Dr. Howard Berger**

Okay. Again, I would like to take the opportunity to thank all of our shareholders for their continued support and the employees and Management of RadNet for their dedication and hard work. Management will continue its endeavor to be a market leader that provides quality services with an appropriate return on investment for all of our stakeholders.

Thanks for your time today, and I look forward to our next call.

Thank you, Operator.

**Operator** 

That does conclude today's teleconference, you may disconnect your lines at this time. Thank you for your participation and have a wonderful day.