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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021
Operating activities: |  |  |
Net loss | $ (186,638) | $ (151,293) | $ (143,032)
Adjustments to reconcile net loss to net cash used in operating activities: |  |  |
Depreciation and amortization | 56,139 | 41,168 | 26,756
Stock-based compensation | 81,244 | 40,556 | 36,450
Amortization of debt discount and debt issuance costs | 3,634 | 2,038 | 1,868
Amortization of right-of-use assets | 3,543 | 2,760 | 3,418
Write-down for excess and obsolete inventories | 13,608 | 9,792 | 11,147
Loss on disposal of assets | 3,708 | 2,594 | 1,976
Loss on debt extinguishment, net |  |  | 7,434
Impairment of investment |  |  | 3,000
Other | 455 | 1,187 | 2,721
Changes in operating assets and liabilities: |  |  |
Accounts receivable | (12,795) | (18,832) | (10,141)
Inventories | (45,562) | (20,704) | (27,746)
Prepaid expenses and other current assets | (11,098) | 552 | 1,258
Other assets | (541) | (109) | 11
Accounts payable | 6,989 | 9,796 | 757
Accrued expenses and other current liabilities | 17,000 | 13,508 | 8,023
Lease liability | (3,602) | (2,678) | 150
Contract liabilities | 1,793 | (2,280) | (1,040)
Other long-term liabilities | (6,362) | (3,189) | 3,673
Net cash used in operating activities | (78,485) | (75,134) | (73,317)
Investing activities: |  |  |
Purchases of property and equipment | (80,508) | (49,453) | (68,544)
Purchase of intangible assets | (6,467) | (8,827) |
Acquisition of business, net of cash acquired | (55,000) |  | (62,133)
Purchase of OCEANE |  |  | (21,097)
Cash paid for investments |  |  | (3,000)
Settlement of forward contract |  |  | (2,988)
Net cash used in investing activities | (141,975) | (58,280) | (157,762)
Financing activities: |  |  |
Proceeds from Revolving Credit Facility and line of credit | 134,000 | 62,500 |
Payment of debt issuance costs | (3,321) | (1,315) | (10,028)
Proceeds from common stock offerings, net of offering costs | 213,181 |  | 131,828
Proceeds from issuance of convertible notes |  |  | 316,250
Net cash paid for common stock exercises | (1,064) | (3,041) | (5,963)
Purchase of capped calls |  |  | (39,866)
Repurchase of common stock |  |  | (25,000)
Proceeds from term debt, net of debt discount | 148,473 |  |
Repayment of Revolving Credit Facility and line of credit | (119,500) | (27,500) |
Repayment of OCEANEs | (13,315) |  |
Repayment of Squadron Medical Term Loan |  |  | (45,000)
Repayment of Inventory Financing Agreement |  |  | (8,088)
Other | (1,535) | 584 | (2,167)
Net cash provided by financing activities | 356,919 | 31,228 | 311,966
Effect of exchange rate changes on cash | (185) | (366) | (1,404)
Net change in cash and cash equivalents | 136,274 | (102,552) | 79,483
Cash and cash equivalents at beginning of year | 84,696 | 187,248 | 107,765
Cash and cash equivalents at end of year | 220,970 | 84,696 | 187,248
Supplemental disclosure of cash flow information: |  |  |
Cash paid for interest | 17,269 | 3,860 | 5,027
Cash paid for income taxes | 333 | 272 | 223
Supplemental disclosure of noncash investing and financing activities: |  |  |
PPP Loan Forgiveness |  |  | 4,271
Debt issuance costs |  | 2,760 |
Financed insurance | 1,328 | 1,959 |
Financed property and equipment |  | 600 |
Financed inventory |  |  | 4,015
Purchases of property and equipment in accounts payable and accrued expenses | 10,406 | 2,128 | 2,577
Purchase of intangible assets | 99 | 750 |
Recognition of lease liability | $ 424 | 1,694 | $ 23,403
Modification of lease liability for lease amendment |  | $ 4,288 |

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