<SEC-DOCUMENT>0001683168-24-000062.txt : 20240208
<SEC-HEADER>0001683168-24-000062.hdr.sgml : 20240208
<ACCEPTANCE-DATETIME>20240103200204
<PRIVATE-TO-PUBLIC>
ACCESSION NUMBER:		0001683168-24-000062
CONFORMED SUBMISSION TYPE:	CORRESP
PUBLIC DOCUMENT COUNT:		2
FILED AS OF DATE:		20240103

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			RadNet, Inc.
		CENTRAL INDEX KEY:			0000790526
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-MEDICAL LABORATORIES [8071]
		ORGANIZATION NAME:           	08 Industrial Applications and Services
		IRS NUMBER:				133326724
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		CORRESP

	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
</SEC-HEADER>
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"><IMG SRC="image_001.jpg" ALT="" STYLE="height: 113px; width: 266px"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">January 3, 2024</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Mr. Al Pavot</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Division of Corporation Finance</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Office of Industrial Applications and Services</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">United States Securities and Exchange Commission</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Washington, D.C. 20549</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<TR STYLE="vertical-align: top">
  <TD STYLE="width: 1in">Re:</TD>
  <TD>RadNet, Inc.</TD></TR>
</TABLE>


<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 1in">Form 10-K for the Fiscal Year Ended December 31,
2022</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 1in">Filed March 1, 2023</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 1in">File No. 1-33307</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Dear Mr. Pavot:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">This letter is submitted in
response to comments from the staff (the &ldquo;Staff&rdquo;) of the Securities and Exchange Commission contained in its letter dated
December 20, 2023 (the &ldquo;Letter&rdquo;) to Mr. Mark Stolper, Chief Financial Officer of RadNet, Inc. (the &ldquo;Company&rdquo;).</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">For convenience of reference,
each comment contained in the Letter is reprinted below in italics followed by the Company&rsquo;s response.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><U>Form 10-K for Fiscal Year Ended December 31, 2022</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><U>Results of Operations, page 38</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt; width: 100%"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in; text-align: left"><I>1.</I></TD><TD STYLE="text-align: justify"><I>Please expand your disclosure to identify the specific factors
that caused the 2022 &quot;Net income attributable to noncontrolling interests&quot; to increase by 17% whereas both your operating income
and pre-tax income decreased significantly. Similarly, it is not clear why the corresponding 2023 variances are similarly disproportionate.
The expanded disclosure should identify the specific causal factors relevant to the period presented and not merely reference speculative
factors that could impact the account balance. See Item 303(b) of Regulation S-K.</I></TD>
</TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify; text-indent: -0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><U>Response to Comment 1:</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">The Company respectfully acknowledges the Staff&rsquo;s
comment and, in future filings, will provide additional disclosure if percentage changes in Net Income Attributable to Noncontrolling
Interests are significant. Our net income attributable to noncontrolling interests relates to the operations of non-wholly owned subsidiaries
which represents only a portion of our business. Further, it excludes our AI segment which generated losses of $25.8 million in 2022.
Given these factors, we do not expect net income attributable to noncontrolling interests to correlate with consolidated operating income
or pretax income and are proposing to disclose the nature of the relationship as presented below. The following represents an example
of the presentation and discussion that we propose to include in future filings, using 2022 versus 2021 for illustrative purposes:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><B>Net
income attributable to noncontrolling interests</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">At December 31, 2022, our consolidated subsidiaries
included 318 centers of which 81 were not wholly-owned and thus a portion of their operating results were attributable to noncontrolling
interests. At December 31, 2021, our consolidated subsidiaries included 323 centers of which 66 were not wholly-owned. As noncontrolling
interests only represent a portion of our imaging center business and excludes our AI segment, which generated losses of $25.8 million
in 2022, we do not expect changes in net income attributable to noncontrolling interests to correlate with changes in consolidated operating
income or pretax income.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt; color: rgb(105,103,103)">1510 Cotner Avenue, Los Angeles, CA
90025 <B>|</B> Tel: (310) 445-2800 <B>|</B> (800) 2- RADNET <B>|</B> Fax: (310) 445-2980 <B>|</B> www.RadNet.com</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: -27pt; color: gray">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Mr. Al Pavot&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">SEC Division of Corporate Finance&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">January 3, 2024&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Page 2</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">For the twelve months ended December 31, 2022,
we recognized net income attributable to noncontrolling interests of $23.0 million versus $19.6 million for the twelve months ended December
31, 2021, an increase of $3.4 million. The increase in net income attributable to noncontrolling interests was primarily due to the formation
of a new majority owned subsidiary, Frederick County Radiology, LLC in April 2022 as described in Note 4 to the consolidated financial
statements. We contributed the operations of four centers to Frederick County Radiology, LLC, and Frederick Health Hospital, Inc. contributed
two additional centers. Additionally, in September 2021 we sold a noncontrolling interest in West Valley Imaging Group, LLC (&ldquo;West
Valley&rdquo;) to Tarzana Medical Center, LLC for cash, which increased net income attributable to noncontrolling interests subsequent
to the sale as a result of the profitability of West Valley.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><U>Interest Expense, page 42</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in; text-align: left"><I>2.</I></TD><TD STYLE="text-align: justify"><I>The $39.6 million 2022 gain from interest rate swaps comprised
92% of your pre-tax income. However, it is not clear from the existing MD&amp;A disclosure what specific events and circumstances occurred
in 2022 to precipitate this gain. Further, it is not clear how this gain impacted your provision for income taxes. Additionally, it is
not clear what the liquidity impact of these derivatives has been in the periods presented and what your maximum loss exposure is on
these investments. For example, if you received cash payments from these investments due to increased market interest rates in 2022 and
the impact was to offset the higher interest payments required on your variable rate debt then please provide a quantified disclosure
that illustrates this outcome. Please expand your disclosures to clarify these issues in light of the significant financial statement
impact. See Item 303(b)(1) of Regulation S-K.</I></TD>
</TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify; text-indent: -0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><U>Response to Comment 2:</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">The Company respectfully acknowledges the Staff&rsquo;s
comment and, in future filings, will provide additional disclosure of the reasons for any significant changes in the fair value of our
interest rate swaps, the impact of such changes on our provision for income taxes, and our exposure to loss and the cash activity associated
with such swaps for the relevant periods presented. The following represents an example of the presentation and discussion that we propose
to include in the future filings, using 2022 versus 2021 for illustrative purposes. In addition to the disclosure previously included
under the &ldquo;Interest Expense&rdquo; section of the MD&amp;A, we intend to add the below disclosure and separately we intend to add
a new section to the MD&amp;A under &ldquo;Non-cash change in fair value of interest rate hedge&rdquo;.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><B>Interest expense</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">To mitigate our future floating rate interest
expense exposure we entered into the 2019 swaps with locked in interest rates for one-month LIBOR of 1.96% for $100 million of notional
value and 2.05% for $400 million of notional value. We are liable for premium payments to the 2019 swap counterparties if interests rates
are below the arranged rates, and receive payments from the 2019 swap counterparties if interest rates exceed the arranged rates. If interest
rates were to theoretically reduce to 0%, our maximum premium payment would be the difference between the two swapped rates and 0% then
multiplied by the notional value of the swaps, or $1.96 million per year for the $100 million swap and $8.2 million per year for the $400
million swap. Payments under the 2019 swaps are settled in cash on a monthly basis. During the year ended December 31, 2022, interest
rates were below the arranged rates for most of the year and we paid a net of $2.8 million in cash payments to our 2019 swap counterparties,
which was reported a component of interest expense. See Derivative Instruments section of Note 2, Significant Accounting Policies, to
the financial statements included in this report and Item 7A, Quantitative and Qualitative Disclosure About Market Risk below for more
details on our derivative instruments.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><B>Non-cash change in fair value of interest rate
hedge</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">In 2020, we determined that the cash flows from
the 2019 swaps did not match the cashflows of our First Lien Term Loans and were therefore ineffective as cash flow hedges. Since that
time, in accordance with accounting guidelines, all changes in fair value are being recognized in other income and expenses.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt; color: rgb(105,103,103)">1510 Cotner Avenue, Los Angeles, CA
90025 <B>|</B> Tel: (310) 445-2800 <B>|</B> (800) 2- RADNET <B>|</B> Fax: (310) 445-2980 <B>|</B> www.RadNet.com</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: -27pt; color: gray">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Mr. Al Pavot&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">SEC Division of Corporate Finance&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">January 3, 2024&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Page 3</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>


<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">The fair value of the 2019 swaps at December 31,
2021 was a net liability of $16.3 million and at December 31, 2022 was a net asset of $23.3 million, resulting in a gain of $39.6 million
during the year ended December 31, 2022, which increased the Company&rsquo;s tax provision by $10.3 million. The significant change in
fair value of interest rate hedge was caused by the increase in market interest rates and the steepening of the yield curve, which reflects
expectations of future interest rates. The one-month LIBOR rate at December 31, 2021 was approximately 0.10%, significantly below the
1.96% and 2.05% arranged rates under the 2019 swaps. However, one-month LIBOR rates had climbed to 4.33% at December 31, 2022, significantly
above the arranged rates in the 2019 swaps.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><U>Non-GAAP Financial Measures, page 43</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt; width: 100%"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in; text-align: left"><I>3.</I></TD><TD STYLE="text-align: justify"><I>Your disclosures here and in your Form 10-Q's indicate that
Adjusted EBITDA is used as both a performance measure and as a liquidity measure. In this regard, we note that you use it to measure
your cash generated from operations. Please expand your disclosures to include a reconciliation between Adjusted EBITDA and GAAP operating
cash flows. Also, please do not adjust out any cash settled expenses or liabilities. See Item 10(e) of Regulation S-K.</I></TD>
</TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify; text-indent: -0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><U>Response to Comment 3:</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">The Company respectfully acknowledges the Staff&rsquo;s
comment and notes that the Company inadvertently implied in its disclosure that Adjusted EBITDA is used as a liquidity measure. In prior
periods, the Company had presented a liquidity measure, Free Cash Flow, and accidentally retained certain language in its disclosure from
periods when Free Cash Flow was presented. The following is a revised version of our disclosure (marked for changes) which we will include
in future filings and which we believe eliminates the confusion created with our previous disclosure:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><B>Non-GAAP Financial Measures</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">We use both GAAP and non-GAAP
metrics to measure our financial results. We believe that, in addition to GAAP metrics, non-GAAP metrics such as Adjusted EBITDA <FONT STYLE="color: red"><STRIKE>and
Free Cash Flow</STRIKE></FONT> assist us in measuring our core operations from period to period <FONT STYLE="color: red"><STRIKE>as well
as our cash generated from operations and ability to service our debt obligations</STRIKE></FONT>.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><B>Adjusted EBITDA</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">Our adjusted EBITDA metric
removes non-cash and non-recurring charges that occur in the affected period and provides a basis for measuring the Company&rsquo;s core
financial performance against other periods.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">We define Adjusted EBITDA
as earnings before interest, taxes, depreciation and amortization, as adjusted to exclude losses or gains on the disposal of equipment,
other income or loss, loss on debt extinguishment, bargain purchase gains, loss on de-consolidation of joint ventures and non-cash equity
compensation. Adjusted EBITDA includes equity in earnings in unconsolidated operations and subtracts allocations of earnings to non-controlling
interests in subsidiaries and is adjusted for non-cash or one-time events that take place during the period.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">Adjusted EBITDA is a non-GAAP
financial measure used as an analytical indicator by us and the healthcare industry to assess business performance<FONT STYLE="color: red"><STRIKE>,
and is a measure of leverage capacity and ability to service debt</STRIKE></FONT>. Adjusted EBITDA should not be considered a measure
of financial performance under GAAP, and Adjusted EBITDA should not be considered in isolation or as alternatives to net income<FONT STYLE="color: red"><STRIKE>,
cash flows generated by operating, investing or financing activities</STRIKE></FONT> or other financial statement data presented in the
consolidated financial statements as an indicator of financial performance <FONT STYLE="color: red"><STRIKE>or liquidity</STRIKE></FONT>.
Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation
and this metric, as presented, may not be comparable to other similarly titled measure of other companies.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">*************************</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt; color: rgb(105,103,103)">1510 Cotner Avenue, Los Angeles, CA
90025 <B>|</B> Tel: (310) 445-2800 <B>|</B> (800) 2- RADNET <B>|</B> Fax: (310) 445-2980 <B>|</B> www.RadNet.com</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: -27pt; color: gray">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"></P>

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    <DIV STYLE="margin-top: 6pt; margin-bottom: 6pt; border-bottom: Black 1pt solid"><TABLE CELLPADDING="0" CELLSPACING="0" STYLE="border-collapse: collapse; width: 100%; font-size: 10pt"><TR STYLE="vertical-align: top; text-align: left"><TD STYLE="width: 33%">&nbsp;</TD><TD STYLE="width: 34%; text-align: center"><!-- Field: Sequence; Type: Arabic; Name: PageNo; Options: Hidden -->&nbsp;<!-- Field: /Sequence --></TD><TD STYLE="width: 33%; text-align: right">&nbsp;</TD></TR></TABLE></DIV>
    <DIV STYLE="break-before: page; margin-top: 6pt; margin-bottom: 6pt"><P STYLE="margin: 0pt">&nbsp;</P></DIV>
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Mr. Al Pavot&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">SEC Division of Corporate Finance&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">January 3, 2024&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Page 4</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>


<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">If you should have any additional questions, please contact me directly
at (310) 445-2800.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Very truly yours,</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><U>/s/ Mark Stolper</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Mark Stolper</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Chief Financial Officer</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" BORDER="0" STYLE="width: 100%; margin-top: 0pt; margin-bottom: 0pt; font: 10pt Times New Roman, Times, Serif">
<TR STYLE="vertical-align: top">
  <TD STYLE="width: 0.5in">cc:</TD>
  <TD>Terence O&rsquo;Brien, SEC Division of Corporation Finance</TD></TR>
</TABLE>


<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">Dr. Howard G Berger, Chief Executive Officer</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 1in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: right">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: right">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; color: gray">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; color: gray">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; color: gray">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; color: gray">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; color: gray"><I>&nbsp;</I></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt; color: rgb(105,103,103)">1510 Cotner Avenue, Los Angeles, CA
90025 <B>|</B> Tel: (310) 445-2800 <B>|</B> (800) 2- RADNET <B>|</B> Fax: (310) 445-2980 <B>|</B> www.RadNet.com</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: -27pt; color: gray">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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