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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
CASH FLOWS FROM OPERATING ACTIVITIES      
Net income $ 23,440 $ 38,133 $ 2,075
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 80,607 72,899 66,796
Amortization of operating lease right-of-use assets 66,842    
Provision for bad debts 0 0 46,555
Equity in earnings of joint ventures, net of dividends 248 13,469 (4,864)
Amortization and write off of deferred financing costs and loan discount 4,184 3,898 3,483
Loss (gain) on sale and disposal of equipment and other 2,383 (2,054) 1,142
Gain on sale of imaging centers 0 0 (3,146)
Gain on re-measurement of pre-existing interest (768) (39,539) 0
Loss on impairment 0 3,937 0
Stock-based compensation 8,730 7,662 6,787
Other non cash item in other expenses (559) 0 0
Non cash severance 188 0 1,047
Change in value of contingent consideration (3,123) 1,749 0
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:      
Accounts receivable (17,482) 2,145 (37,164)
Other current assets (3,557) (9,248) 1,461
Other assets (2,326) (1,687) (801)
Deferred taxes (3,888) (6,935) 19,504
Operating lease liability (66,831)    
Deferred rent 0 6,312 2,135
Deferred revenue (1,082) (208) 1,034
Accounts payable, accrued expenses and other 17,316 26,221 36,181
Net cash provided by operating activities 104,322 116,754 142,225
CASH FLOWS FROM INVESTING ACTIVITIES      
Purchase of imaging facilities (27,150) (73,192) (27,612)
Investment at cost (143) (2,200) (500)
Purchase of property and equipment (74,153) (72,180) (61,336)
Proceeds from sale of equipment 1,160 2,575 852
Proceeds from the sale of equity interests in a joint venture 132 0 0
Proceeds from sale of imaging and medical practice assets 0 0 8,429
Proceeds from sale of internal use software 0 248 492
Nulogix return of capital 792 0 0
Cash contribution from partner in JV formation 0 0 1,473
Equity contributions in existing and purchase of interest in joint ventures (103) (2,000) (1,118)
Net cash used in investing activities (99,465) (146,749) (79,320)
CASH FLOWS FROM FINANCING ACTIVITIES      
Principal payments on notes and leases payable (6,494) (6,072) (6,836)
Payments on term loan debt (40,742) (33,830) (196,666)
Proceeds from debt issuance, net of issuance costs 97,144 0 164,938
Distributions paid to noncontrolling interests (3,057) (1,427) (1,528)
Proceeds from sale of noncontrolling interest 5,275 0 7,720
Contributions from noncontrolling partners 750 2,640 125
Proceeds from revolving credit facility 261,200 204,300 200,800
Payments on revolving credit facility (289,200) (176,300) (200,800)
Purchase of noncontrolling interests 0 (200) 0
Proceeds from issuance of common stock upon exercise of options 75 20 0
Net cash provided by (used in) financing activities 24,951 (10,869) (32,247)
EFFECT OF EXCHANGE RATE CHANGES ON CASH (32) (69) 26
NET INCREASE (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS 29,776 (40,933) 30,684
CASH AND CASH EQUIVALENTS, beginning of period 10,389 51,322 20,638
CASH AND CASH EQUIVALENTS, end of period 40,165 10,389 51,322
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION      
Cash paid during the period for interest 46,254 37,016 34,197
Cash paid during the period for income taxes 5,884 4,933 4,939
Equipment acquired and leasehold improvements 51,700 47,800 18,500
Capital lease debt 51 6,700 5,500
Gain (loss) on equity method investment (134)    
Contingent consideration liability adjustment (3,123) 1,749 0
Medical Arts Radiology      
Adjustments to reconcile net income to net cash provided by operating activities:      
Change in value of contingent consideration   1,700  
Contingent consideration liability adjustment   1,700  
Business consideration liability adjustment recorded amount 2,400    
Noncontrolling Interest      
CASH FLOWS FROM OPERATING ACTIVITIES      
Net income 8,684 5,890 2,022
Special distribution from noncontrolling interest 9,200    
Radnet, Inc. Stockholders' Equity      
CASH FLOWS FROM OPERATING ACTIVITIES      
Net income 14,756 $ 32,243 $ 53
Special distribution from noncontrolling interest $ 3,000