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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) | 3 Months Ended
--- | ---
Mar. 31, 2019 | Mar. 31, 2018
Cash flows from operating activities |  |
Net (loss) income | $ (2,450,129) | $ 15,717,655
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 4,417,581 | 5,058,512
Loss of disposal of property and equipment | 0 | 41,782
Provision for doubtful accounts | 951,014 | 247,102
Share-based compensation | 345,134 | 833,944
Unrealized (gain) loss from investment in equity securities | (7,727) | 8,550
Loss from equity method investments | 849,657 | 28,024
Deferred tax | (2,623,145) | 2,807,407
Changes in operating assets and liabilities: |  |
Receivable, net | 486,981 | 1,296,519
Receivable, net – related parties | (7,511,121) | (22,631,440)
Other receivables | (11,244,643) | 0
Prepaid expenses and other current assets | (728,631) | 232,392
Right-of-use assets | 447,960 |
Other assets | (442,882) | (59,444)
Accounts payable and accrued expenses | 22,578,982 | (1,169,363)
Incentives payable | 0 | (6,600,000)
Fiduciary accounts payable | 546,328 | (630,963)
Medical liabilities | (10,375,836) | 5,138,508
Income taxes payable | 1,209,978 | 4,416,174
Lease liabilities | (416,255) | 0
Net cash (used in) provided by operating activities | (3,966,754) | 4,735,359
Cash flows from investing activities |  |
Purchases of marketable securities | (8,177) | (3,932)
Purchases of property and equipment | (103,616) | (485,121)
Net cash used in investing activities | (111,793) | (489,053)
Cash flows from financing activities |  |
Repayments on bank loan | (40,257) | (140,608)
Dividends paid | (10,000,000) | (2,000,000)
Payment of capital lease obligations | (25,151) | (24,407)
Proceeds from exercise of stock options and warrants | 139,974 | 1,923,784
Repurchase of shares | (40,000) | 0
Proceeds from common stock offering | 155,000 | 0
Net cash used in financing activities | (9,810,434) | (241,231)
Net (decrease) increase in cash, cash equivalents and restricted cash | (13,888,981) | 4,005,075
Cash, cash equivalents and restricted cash, beginning of period | 107,636,973 | 118,500,095
Cash, cash equivalents and restricted cash, end of period | 93,747,992 | 122,505,170
Supplemental disclosures of cash flow information |  |
Cash paid for income taxes | 0 | 0
Cash paid for interest | 181,819 | 73,610
Supplemental disclosures of non-cash investing and financing activities |  |
Cashless exercise of stock options | 0 | 43
Deferred tax liability adjusted to goodwill | 0 | 914,011
Reconciliation of cash, cash equivalents, and restricted cash |  |
Cash and cash equivalents | 93,007,780 | 103,731,761
Restricted cash – short-term - distributions to former NMM shareholders | 0 | 18,028,116
Restricted cash – long-term - letters of credit | 740,212 | 745,293
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows | $ 93,747,992 | $ 122,505,170

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- Definition The cash outflow to reacquire common stock during the period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition Cash outflow in the form of capital distributions and dividends to common shareholders, preferred shareholders and noncontrolling interests. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition Amount of cash outflow for purchase of marketable security. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 320 -SubTopic 10 -Section 45 -Paragraph 11 -URI http://asc.fasb.org/extlink&oid=109979856&loc=d3e26853-111562 + 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://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3213-108585 + Details
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- Definition The cash inflow from the additional capital contribution to the entity. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3255-108585 + Details
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- Definition The cash inflow associated with the amount received from holders exercising their stock warrants. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3255-108585 + 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/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 220 -SubTopic 10 -Section 45 -Paragraph 1A -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=114867106&loc=SL7669619-108580 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (a)(1) -URI http://asc.fasb.org/extlink&oid=109239629&loc=SL4573702-111684 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 220 -SubTopic 10 -Section 45 -Paragraph 1B -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=114867106&loc=SL7669625-108580 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (c)(1) -URI http://asc.fasb.org/extlink&oid=109239629&loc=SL4573702-111684 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8736-108599 Reference 6: http://www.xbrl.org/2003/role/exampleRef -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 7: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3000-108585 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 45 -Paragraph 19 -URI http://asc.fasb.org/extlink&oid=108774443&loc=SL4569616-111683 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8933-108599 Reference 10: http://www.xbrl.org/2003/role/exampleRef -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 + 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://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 + Details
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