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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) | 3 Months Ended
--- | ---
Mar. 31, 2018 | Mar. 31, 2017
Cash flows from operating activities |  |
Net income | $ 15,717,655 | $ 11,723,791
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 5,058,512 | 4,836,351
Loss on disposal of property and equipment | 41,782 | 0
Share-based compensation | 833,944 | 321,233
Unrealized loss from investment in equity securities | 8,550 | 0
Change in fair value of derivative instrument | 0 | (1,522,222)
Loss (income) from equity method investments | 28,024 | (2,227,262)
Deferred tax | 2,807,407 | 2,109,535
Changes in operating assets and liabilities: |  |
Receivable, net | (21,087,819) | 14,410,196
Prepaid expenses and other current assets | (398,571) | (428,871)
Other assets | (59,444) | (54,368)
Accounts payable and accrued expenses | (1,169,363) | (2,350,949)
Incentives payable | (6,600,000) | (9,721,645)
Medical liabilities | 5,138,508 | (257,945)
Income taxes payable | 4,416,174 | 4,267,804
Net cash provided by operating activities | 4,735,359 | 21,105,648
Cash flows from investing activities |  |
Purchases of marketable securities | (3,932) | (1,301)
Advances to related parties - loans receivable | 0 | (5,000,000)
Dividends received from equity method investments | 0 | 1,000,000
Proceeds on sale of investments - cost method | 0 | 25,000
Purchases of property and equipment | (485,121) | (318,821)
Net cash used in investing activities | (489,053) | (4,295,122)
Cash flows from financing activities |  |
Repayment of bank loan | (140,608) | 0
Dividends paid | (2,000,000) | (8,750,000)
Change in noncontrolling interest capital | 0 | (27,500)
Payment of capital lease obligations | (24,407) | (30,980)
Proceeds from exercise of stock options and warrants | 1,923,784 | 425,025
Net cash used in financing activities | (241,231) | (8,383,455)
Net increase in cash, cash equivalents and restricted cash | 4,005,075 | 8,427,071
Cash, cash equivalents and restricted cash, beginning of period | 118,500,095 | 54,925,712
Cash, cash equivalents and restricted cash, end of period | 122,505,170 | 63,352,783
Supplemental disclosures of cash flow information |  |
Cash paid for income taxes | 0 | 1,511,000
Cash paid for interest | 73,610 | 811
Supplemental disclosures of non-cash investing and financing activities |  |
Cashless exercise of stock options | 43 | 0
Reclassification of stock options exercised to liability for unissued common shares | 0 | 425,025
Deferred tax liability adjustment to goodwill | 914,011 | 0
Cumulative effect adjustment for ASC 606 included in accounts receivable | 11,600,000 | 0
Cumulative effect adjustment for ASC 606 included in deferred tax liabilities | 3,246,098 | 0
Reclassification of fiduciary cash to payable | 630,963 | 32,485
Reconciliation of cash, cash equivalents, and restricted cash |  |
Cash and cash equivalents | 103,731,761 | 63,251,651
Restricted cash - long-term - letters of credit | 745,293 | 101,132
Restricted cash - short-term - distributions to former NMM shareholders | 18,028,116 | 0
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows | $ 122,505,170 | $ 63,352,783

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- Definition Cash outflow for purchase of trading, available-for-sale securities and held-to-maturity securities. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 320 -SubTopic 10 -Section 45 -Paragraph 11 -URI http://asc.fasb.org/extlink&oid=82896770&loc=d3e26853-111562 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (a),(b) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3213-108585 + Details
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- Definition The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3213-108585 + Details
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- Definition The cash outflow associated with extending a long-term loan to a related party. Alternate caption: Payments for Advances to Affiliates. + References No definition available. + Details
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- Definition Amount of distribution received from equity method investee for return of investment, classified as investing activities. Excludes distribution for return on investment, classified as operating activities. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 21D -URI http://asc.fasb.org/extlink&oid=98514028&loc=SL94080555-108585 + Details
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- Definition Amount of cash inflow (outflow) from (to) a noncontrolling interest. Excludes dividends paid to the noncontrolling interest. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3291-108585 + Details
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- Definition Amount of cash inflow from exercise of stock options granted under share-based compensation arrangement. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3255-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2A -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=96867065&loc=SL79508275-113901 + Details
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- Definition The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 55 -Paragraph 4K -URI http://asc.fasb.org/extlink&oid=84234705&loc=SL4591552-111686 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 45 -Paragraph 19 -URI http://asc.fasb.org/extlink&oid=96868048&loc=SL4569616-111683 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (c)(1) -URI http://asc.fasb.org/extlink&oid=84161450&loc=SL4573702-111684 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 55 -Paragraph 4J -URI http://asc.fasb.org/extlink&oid=84234705&loc=SL4591551-111686 Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (a)(2) -URI http://asc.fasb.org/extlink&oid=84161450&loc=SL4573702-111684 + Details
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- Definition The cash outflow during the period from the repayment of aggregate short-term and long-term debt and payment of capital lease obligations. + References No definition available. + Details
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- Definition The cash outflow for the payment of a long-term borrowing made from a related party where one party can exercise control or significant influence over another party; including affiliates, owners or officers and their immediate families, pension trusts, and so forth. Alternate caption: Payments for Advances from Affiliates. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3291-108585 + Details
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- Definition Amount of cash restricted as to withdrawal or usage, classified as current. Cash includes, but is not limited to, currency on hand, demand deposits with banks or financial institutions, and other accounts with general characteristics of demand deposits. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=98513485&loc=SL98516268-108586 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section 45 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=82887183&loc=d3e6676-107765 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02(1)) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3044-108585 + Details
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- Definition Amount of cash restricted as to withdrawal or usage, classified as noncurrent. Cash includes, but is not limited to, currency on hand, demand deposits with banks or financial institutions, and other accounts with general characteristics of demand deposits. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=98513485&loc=SL98516268-108586 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02(17)) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section 45 -Paragraph 4 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=82887183&loc=d3e6812-107765 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3044-108585 + Details
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- Definition The fair value of stock issued in noncash financing activities. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=98513485&loc=d3e4332-108586 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=98513485&loc=d3e4304-108586 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=98513485&loc=d3e4313-108586 + Details
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- Definition The net change in the difference between the fair value and the carrying value, or in the comparative fair values, of investments, not including unrealized gains or losses on securities separately or otherwise categorized as trading, available-for-sale, or held-to-maturity, held at each balance sheet date and included in earnings for the period. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3602-108585 + Details
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