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SIGNIFICANT ACCOUNTING POLICIES (Tables)
 3 Months Ended
Mar. 31, 2024
Accounting Policies [Abstract]  
Schedule of Service Fee Revenue
Our total service revenues during the three months ended March 31, 2024 and 2023 are presented in the table below based on an allocation of the estimated transaction price with the patient between the primary patient classification of insurance coverage (in thousands):
 Three Months Ended
March 31,
20242023
Commercial insurance$240,628 $213,061 
Medicare93,525 84,970 
Medicaid10,887 9,959 
Workers' compensation/personal injury11,794 12,433 
Other patient revenue11,470 9,559 
Management fee revenue5,908 4,248 
Heart and lung3,921 1,813 
Other4,395 5,300 
Revenue under capitation arrangements34,518 38,144 
Imaging Center Segment Revenue417,046 379,487 
Digital Health Segment Revenue
14,661 11,077 
Total service revenue$431,707 $390,564 
Schedule of Goodwill Activity in goodwill for the three months ended March 31, 2024 is provided below (in thousands):
Imaging Center
Digital Health
Total
Balance as of December 31, 2023606,557 $72,906 $679,463 
Goodwill from acquisitions16,156 — 16,156 
Currency translation— (1,327)(1,327)
Segment reorganization(12,300)12,300 — 
Balance as of March 31, 2024$610,413 $83,879 $694,292 
Schedule of Annual Amortization Expense The components of intangible assets, both finite and indefinite, along with annual amortization expense that will be recorded over the next five years at March 31, 2024 and December 31, 2023 are as follows (in thousands):
As of March 31, 2024:

20242025202620272028ThereafterTotalWeighted average amortization period remaining in years
Management Service Contracts$1,715 $2,287 $2,287 $2,287 $2,287 $6,673 $17,536 7.7
Covenant not to compete and other contracts683 774 487 192 102 20 2,258 2.3
Customer Relationships918 1,093 971 794 757 10,470 15,003 17.6
Patent and Trademarks228 303 303 303 303 178 1,618 5.7
Developed Technology & Software5,651 7,534 7,494 6,960 6,960 6,551 41,150 6.4
Trade Names amortized58 77 77 77 63 27 379 5.0
Trade Names indefinite life— — — — — 7,100 7,100 — 
IPR&D— — — — — 1,839 1,839 — 
Total Annual Amortization$9,253 $12,068 $11,619 $10,613 $10,472 $32,858 $86,883 
*Excluding the three months ended March 31, 2024
As of December 31, 2023:
20242025202620272028ThereafterTotalWeighted average amortization period remaining in years
Management Service Contracts$2,287 $2,287 $2,287 $2,287 $2,287 $6,671 $18,106 7.9
Covenant not to compete and other contracts946 714 427 132 45 6 2,270 3.4
Customer Relationships1,234 1,104 981 797 764 10,564 15,444 17.7
Patent and Trademarks316 316 316 315 300 164 1,727 5.8
Developed Technology & Software7,785 7,785 7,745 7,210 7,046 6,117 43,688 5.7
Trade Names amortized77 77 77 77 63 27 398 5.3
Trade Names indefinite life— — — — — 7,100 7,100 — 
IPR&D— — — — — 1,882 1,882 — 
Total Annual Amortization$12,645 $12,283 $11,833 $10,818 $10,505 $32,531 $90,615 
Schedule of Effect of Derivative Instruments on Comprehensive Income( Loss)
A tabular presentation of the effect of derivative instruments on our consolidated statement of comprehensive income (loss) of the 2019 Swaps which remain ineffective is as follows (amounts in thousands):
For the three months ended March 31, 2024
AccountDecember 31, 2023 BalanceAmount of comprehensive loss recognized on derivative net of taxesAmount of loss reclassified out of accumulated OCI into income (prior period effective portion), net of taxesMarch 31, 2024 BalanceLocation
Accumulated Other Comprehensive Loss, net of taxes$(11,625)$—$739$(10,886)Equity
A tabular presentation of the effect of derivative instruments on our statement of operations of the 2019 Swaps which remain ineffective is as follows (amounts in thousands):

For the three months ended March 31, 2024
Ineffective interest rate swapAmount of gain recognized in income on derivative (current period ineffective portion)Location of loss recognized in Income on derivative (current period ineffective portion)Amount of loss reclassified from accumulated OCI into income (prior period effective portion)Location of loss reclassified from accumulated OCI into income (prior period effective portion)
Interest rate contracts$1,216 Other income (expense)$(739)Interest Expense
Schedule of Business Acquisitions by Acquisition, Contingent Consideration
A tabular rollforward of contingent consideration is as follows (amounts in thousands):
For the three months ended March 31, 2024
EntityAccountDecember 31, 2023 BalanceSettlement of contingent considerationChange in valuation of Contingent ConsiderationCurrency TranslationMarch 31, 2024 Balance
Heart and Lung LimitedAccrued Expenses6,879 $(4,607)$1,060 $914 $4,246 
Schedule of Fair Value of Assets and Liabilities
The tables below summarize the estimated fair values of certain of our financial assets that are subject to fair value measurements, and the classification of these assets on our condensed consolidated balance sheets, as follows (in thousands):
 As of March 31, 2024
Level 1Level 2Level 3Total
Current and long term assets    
2019 Swaps - Interest Rate Contracts$— $16,334 $— $16,334 
 As of December 31, 2023
Level 1Level 2Level 3Total
Current and long term assets    
2019 Swaps - Interest Rate Contracts$— $15,118 $— $15,118 
The table below summarizes the estimated fair values of contingencies and holdback relating to our Heart and Lung Imaging Limited acquisition on November 1, 2022 that are subject to fair value measurements and the classification of these liabilities on our consolidated balance sheets, as follows (in thousands):
 As of March 31, 2024
Level 1Level 2Level 3Total
Accrued expenses:liabilities    
Heart and Lung Imaging Limited$— $— $4,246 $4,246 
The table below summarizes the estimated fair value compared to our face value of our long-term debt as follows (in thousands):
 As of March 31, 2024
Level 1Level 2Level 3Total Fair ValueTotal Face Value
Barclays Term Loans and Truist Term Loan$— $822,884 $— $822,884 $821,187 
 As of December 31, 2023
Level 1Level 2Level 3Total Fair ValueTotal Face Value
Barclays Term Loans and Truist Term Loan$— $824,759 $— $824,759 $823,063 
Schedule of Earnings Per Share Earnings per share is based upon the weighted average number of shares of common stock and common stock equivalents outstanding, net of common stock held in treasury, as follows (in thousands except share and per share data):
 Three Months Ended March 31,
20242023
Net loss attributable to RadNet, Inc.'s common stockholders
$(2,779)$(21,005)
BASIC AND DILUTED NET LOSS PER SHARE ATTRIBUTABLE TO RADNET, INC.'S COMMON STOCKHOLDERS
Weighted average number of common shares outstanding during the period69,307,078 57,701,439 
Basic and diluted net loss per share attributable to RadNet, Inc.'s common stockholders$(0.04)$(0.36)
Earnings per share disclosures:
Fair value change for contingently issuable shares excluded from the computation of diluted per share amounts as its effect would be antidilutive$— $769 
Stock options and non-vested restricted awards excluded from the computation of diluted per share amounts as their effect would be antidilutive:
Non-vested restricted stock subject to service vesting699,721 594,758 
Shares issuable upon the exercise of stock options863,792 750,075 
Weighted average shares for which the exercise price exceeds average market price of common stock— 273,111 
Schedule of Investment in Joint Ventures
The following table is a summary of our investment in joint ventures during the three months ended March 31, 2024 (in thousands):
Balance as of December 31, 2023$92,710 
Equity in earnings in these joint ventures4,324 
Distribution of earnings— 
Balance as of March 31, 2024$97,034 
Schedule of Joint Venture Investment and Financial Information
The following table is a summary of key balance sheet data for these joint ventures as of March 31, 2024 and December 31, 2023 and income statement data for the three months ended March 31, 2024 and 2023 (in thousands):
Balance Sheet Data:March 31, 2024December 31, 2023
Current assets$51,292 $39,819 
Noncurrent assets227,812 224,936 
Current liabilities(49,464)(46,587)
Noncurrent liabilities(74,075)(70,834)
Total net assets$155,565 $147,334 
Income statement data for the three months ended March 31,
20242023
Net revenue$61,208 $42,086 
Net income$5,810 $2,909