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LifeMD Reports Second Quarter 2024 Results
Source: Nasdaq GlobeNewswire / 07 Aug 2024 16:05:01 America/New_York
- Revenue increased 41% year-over-year to $50.7 million with telehealth revenue up 67%
- Telehealth achieved standalone profitability one quarter ahead of guidance, with adjusted EBITDA of $820,000
- Weight management subscribers exceeded 60,000 as of June 30, 2024
- Adjusted EBITDA increased 44% to $2.5 million
- Cash of $35.7 million as of June 30, 2024, and positive net cash flow in three of the last four quarters
Conference call begins at 4:30 p.m. Eastern time today
NEW YORK, Aug. 07, 2024 (GLOBE NEWSWIRE) -- LifeMD, Inc. (Nasdaq: LFMD), a leading provider of virtual primary care services, today reported financial results for the three and six months ended June 30, 2024.
Management Commentary
“LifeMD’s core telehealth business had a very strong quarter, led by continued outperformance in our GLP-1 weight management offering. Telehealth revenue increased 67% over the prior year and our patient subscriber base grew to approximately 254,000 by quarter end. Importantly, our telehealth business became profitable on an adjusted EBITDA basis, one quarter ahead of guidance,” said Justin Schreiber, Chairman and CEO of LifeMD. “The demand we continue to generate for our virtual care services and pharmacy offerings is indicative of the significant market opportunity that exists for the convenient and affordable access to high-quality healthcare our telehealth platform and affiliated medical group offers. What we continue to demonstrate, quarter over quarter, is that we have a sustainable and now profitable business that is well positioned to leverage the transformational shift that is occurring in how consumers access healthcare.”
“WorkSimpli’s performance during the quarter was pressured by an unexpectedly challenging advertising environment for its products and executional issues, which have since been addressed by their leadership. Based on its current operational performance and following recent strategic efforts, we expect WorkSimpli’s financial results to improve in the second half of the year, and to return to peak profitability by year-end 2024 on a monthly run-rate basis with significant growth in 2025. While we remain confident in our ability to monetize this non-core asset, we expect our core telehealth business will be the driving force of long-term growth in revenue and profitability,” he added.
“We are extremely pleased with the performance of our telehealth business, which led to positive net cash flow for LifeMD on a consolidated basis. On a standalone basis, this business posted cash flow from operations of approximately $3 million for the quarter and generated positive adjusted EBITDA,” commented Marc Benathen, Chief Financial Officer of LifeMD. “Our core telehealth business’ performance continues to be ahead of expectations and, as such, we are raising our 2024 telehealth revenue guidance to $150 million from $140 million previously and are introducing adjusted EBITDA guidance for telehealth of $3 to $4 million, both ahead of previous expectations. Despite the outperformance of telehealth, due to WorkSimpli’s first half results we are revising 2024 consolidated adjusted EBITDA guidance to $13 million to $15 million, with no change to consolidated revenue guidance. We remain bullish on the consolidated business led by our core telehealth platform, which remains well positioned as the long-term growth driver.”
Second Quarter Financial Highlights
- Revenue increased 41% year-over-year to $50.7 million with telehealth revenue up 67% versus the year-ago period.
- Telehealth active subscribers increased 32% over the year-ago period to approximately 254,000 at quarter-end.
- WorkSimpli active subscribers declined 8% versus the year-ago period driven by softness in first half 2024 customer acquisition.
- Weight management revenue grew 82% versus the first quarter of 2024.
- Gross margin expanded to 90%, up from 87% in the year-ago period.
- GAAP net loss was $7.7 million or $0.19 per share, compared with GAAP net loss of $7.5 million or $0.23 per share in the year-ago period.
- Adjusted EBITDA was $2.5 million compared with $1.7 million in the year-ago period (see definition below of this non-GAAP financial measure and reconciliation to GAAP).
- Telehealth achieved adjusted EBITDA of $820,000, reaching profitability one quarter ahead of guidance (see definition below of this non-GAAP financial measure and reconciliation to GAAP).
- Adjusted diluted EPS was $0.06 compared with $0.05 in the year-ago period (see definition below of this non-GAAP financial measure and reconciliation to GAAP).
- Cash and cash equivalents were $35.7 million as of June 30, 2024.
Second Quarter Key Performance Metrics
($ in 000s) Three Months Ended June 30, Y-o-Y Key Performance Metrics 2024 2023 % Growth Revenue Telehealth $ 37,432 $ 22,351 67 % WorkSimpli $ 13,230 $ 13,596 -3 % Total Revenue $ 50,662 $ 35,947 41 % Subscription Revenue as % of Total 96 % 95 % 1 % Active Subscribers Telehealth Active Subscribers 253,759 192,667 32 % WorkSimpli Active Subscribers 158,514 171,775 -8 % Total Active Subscribers 412,273 364,442 13 % Financial Guidance
For the third quarter of 2024, the Company expects:
- Revenue of $53 million to $54 million, with telehealth revenue of $39.5 million to $40.5 million and WorkSimpli revenue of approximately $13.5 million.
- Adjusted EBITDA of $3.0 million to $4.0 million, with telehealth adjusted EBITDA of $500,000 to $1.5 million and WorkSimpli adjusted EBITDA of approximately $2.5 million.
For the full year 2024, the Company expects:
- Revenue of at least $205 million, unchanged from previous guidance, with telehealth revenue guidance increasing to $150 million from $140 million and WorkSimpli revenue guidance decreasing to $55 million from $65 million.
- Adjusted EBITDA of $13 million to $15 million, from $18 million to $22 million previously, with telehealth adjusted EBITDA of $3 million to $4 million and WorkSimpli adjusted EBITDA of $10 million to $11 million. This revised guidance is solely due to lower-than-expected customer acquisition at WorkSimpli, with telehealth outperforming previous expectations.
Conference Call
LifeMD’s management will host a conference call today at 4:30 p.m. Eastern time to discuss the Company’s financial results and outlook, and answer questions. Details for the call are as follows:
Toll-free dial-in number: 800-245-3047 International dial-in number: 203-518-9765 Conference ID: LIFEMD A live and archived webcast will be available in the Investors section of the Company’s website at ir.lifemd.com.
About LifeMD
LifeMD is a leading provider of virtual primary care. LifeMD offers telemedicine, access to laboratory and pharmacy services, and specialized treatment across more than 200 conditions, including primary care, men’s and women's health, weight management, and hormone therapy. The Company leverages a vertically-integrated, proprietary digital care platform, a 50-state affiliated medical group, and a U.S.-based patient care center to increase access to high-quality and affordable care. For more information, please visit LifeMD.com.
Cautionary Note Regarding Forward Looking Statements
This news release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended; Section 21E of the Securities Exchange Act of 1934, as amended; and the safe harbor provision of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements contained in this news release may be identified by the use of words such as: “believe,” “expect,” “anticipate,” “project,” “should,” “plan,” “will,” “may,” “intend,” “estimate,” predict,” “continue,” and “potential,” or, in each case, their negative or other variations or comparable terminology referencing future periods. Examples of forward-looking statements include, but are not limited to, statements regarding our financial outlook and guidance, short and long-term business performance and operations, future revenues and earnings, regulatory developments, legal events or outcomes, ability to comply with complex and evolving regulations, market conditions and trends, new or expanded products and offerings, growth strategies, underlying assumptions, and the effects of any of the foregoing on our future results of operations or financial condition.
Forward-looking statements are not historical facts and are not assurances of future performance. Rather, these statements are based on our current expectations, beliefs, and assumptions regarding future plans and strategies, projections, anticipated and unanticipated events and trends, the economy, and other future conditions, including the impact of any of the aforementioned on our future business. As forward-looking statements relate to the future, they are subject to inherent risk, uncertainties, and changes in circumstances and assumptions that are difficult to predict, including some of which are out of our control. Consequently, our actual results, performance, and financial condition may differ materially from those indicated in the forward-looking statements. These risks and uncertainties include, but are not limited to, “Risk Factors” identified in our filings with the Securities and Exchange Commission, including, but not limited to, our most recently filed Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, and any amendments thereto. Even if our actual results, performance, or financial condition are consistent with forward-looking statements contained in such filings, they may not be indicative of our actual results, performance, or financial condition in subsequent periods.
Any forward-looking statement made in the news release is based on information currently available to us as of the date on which this release is made. We undertake no obligation to update or revise any forward-looking statement, whether as a result of new information, future events, or otherwise, except as may be required under applicable law or regulation.
Investor Contact
LifeMD, Inc.
Marc Benathen, Chief Financial Officer
marc@lifemd.comMedia Contact
Jessica Friedeman, Chief Marketing Officer
press@lifemd.comTables to Follow
++++++LIFEMD, INC. CONDENSED CONSOLIDATED BALANCE SHEETS June 30, 2024 December 31, 2023 (Unaudited) ASSETS Current Assets Cash $ 35,703,215 $ 33,146,725 Accounts receivable, net 5,667,942 5,277,250 Product deposit 116,134 485,850 Inventory, net 2,060,719 2,759,932 Other current assets 1,521,420 934,510 Total Current Assets 45,069,430 42,604,267 Non-current Assets Equipment, net 1,123,582 476,303 Right of use assets 2,534,731 594,897 Capitalized software, net 12,573,579 11,795,979 Intangible assets, net 2,519,167 3,009,263 Total Non-current Assets 18,751,059 15,876,442 Total Assets $ 63,820,489 $ 58,480,709 LIABILITIES, MEZZANINE EQUITY AND STOCKHOLDERS' EQUITY (DEFICIT) Current Liabilities Accounts payable $ 15,051,729 $ 11,084,855 Accrued expenses 14,751,501 13,937,494 Notes payable, net 13,020 327,597 Current operating lease liabilities 337,276 603,180 Current portion of long-term debt 6,333,333 - Deferred revenue 15,161,659 8,828,598 Total Current Liabilities 51,648,518 34,781,724 Long-term Liabilities Long-term debt, net 11,795,281 17,927,727 Noncurrent operating lease liabilities 2,336,194 73,849 Contingent consideration 100,000 131,250 Total Liabilities 65,879,993 52,914,550 Commitments and Contingencies Mezzanine Equity Preferred Stock, $0.0001 par value; 5,000,000 shares authorized Series B Convertible Preferred Stock, $0.0001 par value; 5,000 shares authorized, zero shares issued and outstanding, liquidation value, $0 per share as of June 30, 2024 and December 31, 2023 - - Stockholders’ Equity (Deficit) Series A Preferred Stock, $0.0001 par value; 1,610,000 shares authorized, 1,400,000 shares issued and outstanding, liquidation value approximately $25.55 per share as of June 30, 2024 and December 31, 2023 140 140 Common Stock, $0.01 par value; 100,000,000 shares authorized, 41,759,572 and 38,358,641 shares issued, 41,656,532 and 38,255,601 outstanding as of June 30, 2024 and December 31, 2023, respectively 417,596 383,586 Additional paid-in capital 225,001,992 217,550,583 Accumulated deficit (229,462,356 ) (214,265,236 ) Treasury stock, 103,040 shares, at cost, as of June 30, 2024 and December 31, 2023 (163,701 ) (163,701 ) Total LifeMD, Inc. Stockholders’ (Deficit) Equity (4,206,329 ) 3,505,372 Non-controlling interest 2,146,825 2,060,787 Total Stockholders’ (Deficit) Equity (2,059,504 ) 5,566,159 Total Liabilities, Mezzanine Equity and Stockholders’ Equity (Deficit) $ 63,820,489 $ 58,480,709 LIFEMD, INC. CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Revenues Telehealth revenue, net $ 37,432,309 $ 22,351,128 $ 68,273,711 $ 42,553,931 WorkSimpli revenue, net 13,229,536 13,595,785 26,532,398 26,519,317 Total revenues, net 50,661,845 35,946,913 94,806,109 69,073,248 Cost of revenues Cost of telehealth revenue 4,553,843 4,125,945 8,748,438 8,046,126 Cost of WorkSimpli revenue 471,072 422,485 876,654 717,273 Total cost of revenues 5,024,915 4,548,430 9,625,092 8,763,399 Gross profit 45,636,930 31,398,483 85,181,017 60,309,849 Expenses Selling and marketing expenses 26,378,928 19,567,903 50,552,808 36,285,548 General and administrative expenses 18,521,385 12,119,573 33,827,117 22,722,336 Customer service expenses 2,733,418 1,912,078 4,581,459 3,467,482 Other operating expenses 1,906,175 1,313,789 4,206,622 3,018,554 Development costs 2,402,590 1,380,686 4,489,822 2,564,285 Total expenses 51,942,496 36,294,029 97,657,828 68,058,205 Operating loss (6,305,566 ) (4,895,546 ) (12,476,811 ) (7,748,356 ) Other expenses Interest expense, net (531,468 ) (995,670 ) (1,009,146 ) (1,260,135 ) Loss on debt extinguishment - - - (325,198 ) Net loss (6,837,034 ) (5,891,216 ) (13,485,957 ) (9,333,689 ) Net income attributable to noncontrolling interests 38,606 841,784 158,038 1,407,767 Net loss attributable to LifeMD, Inc. (6,875,640 ) (6,733,000 ) (13,643,995 ) (10,741,456 ) Preferred stock dividends (776,562 ) (776,562 ) (1,553,125 ) (1,553,125 ) Net loss attributable to LifeMD, Inc. common stockholders $ (7,652,202 ) $ (7,509,562 ) $ (15,197,120 ) $ (12,294,581 ) Basic loss per share attributable to LifeMD, Inc. common stockholders $ (0.19 ) $ (0.23 ) $ (0.38 ) $ (0.38 ) Diluted loss per share attributable to LifeMD, Inc. common stockholders $ (0.19 ) $ (0.23 ) $ (0.38 ) $ (0.38 ) Weighted average number of common shares outstanding: Basic 41,296,042 32,560,035 40,269,139 32,189,954 Diluted 41,296,042 32,560,035 40,269,139 32,189,954 LIFEMD, INC. CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 CASH FLOWS FROM OPERATING ACTIVITIES Net loss $ (6,837,034 ) $ (5,891,216 ) $ (13,485,957 ) $ (9,333,689 ) Adjustments to reconcile net loss to net cash provided by operating activities: Amortization of debt discount 100,444 115,381 200,888 153,842 Amortization of capitalized software 1,937,708 1,260,022 3,725,112 2,348,667 Amortization of intangibles 246,066 245,968 492,032 479,528 Accretion of consideration payable - 48,738 13,644 114,216 Depreciation of fixed assets 104,451 48,783 170,366 96,434 Loss (gain) on debt extinguishment - - - 325,198 Operating lease payments 184,588 186,095 391,397 370,428 Stock compensation expense 4,191,176 2,861,969 6,735,606 5,525,483 Changes in Assets and Liabilities Accounts receivable (331,451 ) (731,544 ) (390,692 ) (833,793 ) Product deposit 172,804 11,164 369,716 (107,850 ) Inventory 312,921 (315,720 ) 699,213 5,061 Other current assets (222,683 ) 401,868 (586,910 ) 14,827 Operating lease liabilities (130,846 ) (194,531 ) (334,790 ) (388,077 ) Deferred revenue 1,958,902 (227,335 ) 6,333,061 120,704 Accounts payable 2,656,697 2,690,345 3,966,874 (513,414 ) Accrued expenses 196,020 4,134,337 1,442,362 4,232,140 Other operating activity - - - (579,319 ) Net cash provided by operating activities 4,539,763 4,644,324 9,741,922 2,030,386 CASH FLOWS FROM INVESTING ACTIVITIES Cash paid for capitalized software costs (2,488,039 ) (2,121,869 ) (4,502,712 ) (3,899,852 ) Purchase of equipment (642,053 ) (30,563 ) (817,645 ) (64,219 ) Purchase of intangible assets (1,936 ) (148,868 ) (1,936 ) (148,868 ) Net cash used in investing activities (3,132,028 ) (2,301,300 ) (5,322,293 ) (4,112,939 ) CASH FLOWS FROM FINANCING ACTIVITIES Proceeds from long-term debt, net - - - 14,473,002 Proceeds from notes payable - - - 2,000,000 Repayment of notes payable, net of prepayment penalty (102,887 ) (1,086,956 ) (314,577 ) (4,386,915 ) Cash proceeds from exercise of options 100,000 - 107,813 - Preferred stock dividends (776,562 ) (776,562 ) (1,553,125 ) (1,553,125 ) Contingent consideration payment for ResumeBuild - (62,500 ) (31,250 ) (125,000 ) Net payments for membership interest of WorkSimpli - 889 - (305,625 ) Distributions to non-controlling interest (36,000 ) (36,000 ) (72,000 ) (72,000 ) Net cash (used in) provided by financing activities (815,449 ) (1,961,129 ) (1,863,139 ) 10,030,337 Net increase in cash 592,286 381,895 2,556,490 7,947,784 Cash at beginning of period 35,110,929 11,524,846 33,146,725 3,958,957 Cash at end of period $ 35,703,215 $ 11,906,741 $ 35,703,215 $ 11,906,741 Cash paid for interest Cash paid during the period for interest $ 637,788 $ 495,188 $ 1,282,707 $ 768,188 Non-cash investing and financing activities: Cashless exercise of options $ 4,486 $ 165 $ 5,127 $ 165 Cashless exercise of warrants $ 3,620 $ - $ 16,305 $ - Stock issued for noncontingent consideration payments $ - $ 642,000 $ 642,000 $ 1,284,000 Warrants issued for debt instruments $ - $ - $ - $ 873,100 Right of use asset $ 1,045,305 $ - $ 2,331,231 $ 93,115 Right of use lease liability $ 1,045,305 $ - $ 2,331,231 $ 93,115 About the Use of Non-GAAP Financial Measures:
To supplement our financial information presented in accordance with GAAP, we use adjusted EBITDA, cash-adjusted EBITDA and adjusted EPS as non-GAAP financial measures to clarify and enhance an understanding of past performance. Additionally, we report telehealth adjusted EBITDA as a non-GAAP financial measure to clarify the financial performance of our core telehealth business excluding WorkSimpli. We believe that the presentation of these financial measures enhances an investor’s understanding of our financial performance. We further believe that these financial measures are useful financial metrics to assess our operating performance from period-to-period by excluding certain items that we believe are not representative of our core business. We use certain financial measures for business planning purposes and in measuring our performance relative to that of our competitors.Adjusted EBITDA is defined as income (loss) attributable to common shareholders before interest, taxes, depreciation, amortization, accretion, financing transaction expense, non-controlling interests, foreign currency translation, inventory valuation, sales return reserves, litigation costs, loss on debt extinguishment, dividends, insurance acceptance and Sarbanes-Oxley readiness, acquisition costs, severance expenses and stock-based compensation expense. We have provided below a reconciliation of adjusted EBITDA to net loss attributable to common shareholders, its most directly comparable GAAP financial measure.
Cash adjusted EBITDA is defined as adjusted EBITDA before the change in the Company's deferred revenue balance. We have provided below a reconciliation of cash adjusted EBITDA to adjusted EBITDA.
Adjusted EPS is defined as the diluted net loss attributable to LifeMD, Inc common shareholders before interest, taxes, depreciation, amortization, accretion, financing transaction expense, non-controlling interests, foreign currency translation, inventory valuation, sales return reserves, litigation costs, loss on debt extinguishment, dividends, insurance acceptance and Sarbanes-Oxley readiness, acquisition costs, severance expenses and stock-based compensation expense. We have provided below a reconciliation of adjusted EPS to Diluted loss per share attributable to LifeMD, Inc common shareholders, its most directly comparable GAAP financial measure.
Telehealth adjusted EBITDA is defined as adjusted EBITDA for the telehealth business excluding WorkSimpli. We have provided below a reconciliation of telehealth adjusted EBITDA to net loss attributable to common shareholders solely related to the telehealth business excluding WorkSimpli.
We believe the above financial measures are commonly used by investors to evaluate our performance and that of our competitors. However, our use of the terms adjusted EBITDA and adjusted EPS may vary from that of others in our industry. Adjusted EBITDA, cash adjusted EBITDA, telehealth adjusted EBITDA and adjusted EPS should not be considered as an alternative to net loss before taxes, net loss per share, operating loss or any other performance measures derived in accordance with GAAP as measures of performance.
Reconciliation of GAAP Net Loss to Adjusted EBITDA to Cash Adjusted EBITDA (in whole numbers, unaudited) Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net loss attributable to common shareholders $ (7,652,202 ) $ (7,509,562 ) $ (15,197,120 ) $ (12,294,581 ) Interest expense (excluding amortization of debt discount) 431,024 525,374 808,258 639,186 Depreciation, amortization and accretion expense 2,288,225 1,603,511 4,401,154 3,038,845 Amortization of debt discount 100,444 115,381 200,888 153,842 Loss on debt extinguishment - - - 325,198 Financing transactions expense 151,143 285,626 323,372 430,077 Litigation costs 495,784 933,126 678,331 1,005,926 Inventory and reserve adjustments 263,513 132,991 566,142 232,630 Severance costs 360,182 - 520,677 - Acquisitions expenses - 15,070 - 40,196 Insurance acceptance readiness 263,493 58,540 969,834 58,540 Sarbanes Oxley readiness 23,220 - 183,128 - Accrued interest on Series B Convertible Preferred Stock - 354,915 - 467,107 Foreign exchange (gain) loss 504,969 168,098 478,721 523,720 Taxes 3,000 - 3,000 - Dividends 1,040,793 1,346,197 2,120,173 2,158,760 Stock-based compensation expense 4,191,176 2,861,969 6,735,606 5,525,483 Net income attributable to noncontrolling interests 38,606 841,784 158,038 1,407,767 Adjusted EBITDA $ 2,503,370 $ 1,733,020 $ 2,950,201 $ 3,712,696 Change in Deferred Revenue 1,958,902 (227,335 ) 6,333,061 120,704 Cash Adjusted EBITDA $ 4,462,272 $ 1,505,685 $ 9,283,262 $ 3,833,400 Reconciliation of GAAP Diluted Loss per Share Attributable to Common Shareholders to Adjusted EPS (unaudited) Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Diluted loss per share attributable to LifeMD, Inc. common shareholders $ (0.19 ) $ (0.23 ) $ (0.38 ) $ (0.38 ) Adjustments to Reconcile GAAP Diluted Loss Per Share to Adjusted EPS Interest expense (excluding amortization of debt discount) 0.01 0.01 0.02 0.02 Depreciation, amortization and accretion expense 0.06 0.05 0.11 0.09 Amortization of debt discount - - 0.01 - Loss on debt extinguishment - - - 0.02 Financing transactions expense - 0.01 0.01 0.02 Litigation costs 0.01 0.03 0.02 0.03 Inventory and reserve adjustments 0.01 - 0.01 0.01 Severance costs 0.01 - 0.01 - Acquisitions expenses - - - - Insurance acceptance readiness 0.01 - 0.02 - Sarbanes Oxley readiness - - - - Accrued interest on Series B Convertible Preferred Stock - 0.01 - 0.01 Foreign exchange (gain) loss 0.01 0.01 0.01 0.02 Taxes - - - - Dividends 0.03 0.04 0.05 0.07 Stock-based compensation expense 0.10 0.09 0.17 0.17 Net income attributable to noncontrolling interests - 0.03 0.01 0.04 Adjusted EPS $ 0.06 $ 0.05 $ 0.07 $ 0.12 Reconciliation of Telehealth GAAP Net Loss to Telehealth Adjusted EBITDA (in whole numbers, unaudited) Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Telehealth net loss attributable to common shareholders $ (7,796,900 ) $ (10,754,681 ) $ (15,789,465 ) $ (17,686,828 ) Interest expense (excluding amortization of debt discount) 430,606 524,171 806,969 636,563 Depreciation, amortization and accretion expense 1,485,696 1,059,963 2,848,770 2,025,643 Amortization of debt discount 100,444 115,381 200,888 153,842 Loss on debt extinguishment - - - 325,198 Financing transactions expense 151,143 285,626 323,372 430,077 Litigation costs 495,784 933,126 678,331 1,005,926 Inventory and reserve adjustments 263,513 132,991 566,142 232,630 Severance costs 360,182 - 520,677 - Acquisitions expenses - 15,070 - 40,196 Insurance acceptance readiness 263,493 58,540 969,834 58,540 Sarbanes Oxley readiness 23,220 - 183,128 467,107 Accrued interest on Series B Convertible Preferred Stock - 354,915 - - Foreign exchange (gain) loss - - - - Taxes - - - - Dividends 812,562 812,562 1,625,125 1,625,125 Stock-based compensation expense 4,191,176 2,861,969 6,735,606 5,525,483 Net income attributable to noncontrolling interests 38,606 841,784 158,038 1,407,767 Telehealth adjusted EBITDA $ 819,525 $ (2,758,583 ) $ (172,586 ) $ (3,752,731 )