Forward-Looking Statements
You should read the following discussion and analysis of our financial condition and results of operations together with our financial statements and the related notes appearing elsewhere in this report. In addition to historical information, this discussion and analysis contains forward-looking statements that involve risks, uncertainties and assumptions. Our actual results may differ materially from those discussed below. Factors that could cause or contribute to such differences include, but are not limited to, those identified below, and those discussed in the section titled "Item 1A. Risk Factors" included elsewhere in this Annual Report on Form 10-K. All amounts in this report are inU.S. dollars, unless otherwise noted. Overview GeneralHealthLynked Corp. (the "Company," "we," "our," or "us") was incorporated in theState of Nevada onAugust 4, 2014 . We currently operate in three distinct divisions: theHealth Services Division , the Digital Healthcare Division, and the Medical Distribution Division. OurHealth Services division is comprised of the operations of (i)Naples Women's Center ("NWC"), a multi-specialty medical group including OB/GYN (both Obstetrics and Gynecology) and General Practice, (ii)Naples Center for Functional Medicine ("NCFM"), a Functional Medical Practice engaged in improving the health of its patients through individualized and integrative health care, (iii) Bridging the Gap Physical Therapy ("BTG"), a physical therapy practice inBonita Springs, FL that provides hands-on functional manual therapy techniques to speed patients' recovery and manage pain without pain medication or surgery, and (iv)Aesthetic Enhancements Unlimited ("AEU"), a patient service facility specializing in minimally and non-invasive cosmetic services acquired by the Company inMay 2022 . OurDigital Healthcare division develops and operates an online personal medical information and record archive system, the "HealthLynked Network," which enables patients and doctors to keep track of medical information via the Internet in a cloud-based system. Our Medical Distribution Division is comprised of the operations ofMedOffice Direct LLC ("MOD"), a virtual distributor of discounted medical supplies selling to both consumers and medical practices throughoutthe United States we acquired onOctober 19, 2020 . 24
During the fourth quarter of 2022, the Board approved a plan to sell our ACO/MSO Division, which assists physician practices in providing coordinated and more efficient care to patients via the MSSP as administered by the CMS, which rewards providers for efficiency in patient care. OnJanuary 17, 2023 , we entered into the AHP Merger Agreement with the Buyer,PBACO Holding, LLC , an operator of ACOs, pursuant to which the Buyer agreed to buy, and we agreed to sell, AHP. Pursuant to the terms of the AHP Merger Agreement, we received or will receive the following consideration: (1)$750,000 in cash paid upon signing of the definitive agreement (receivedJanuary 18, 2023 ); (2) up to$2,250,000 incremental cash (up to$500,000 of which will be allocated to AHP's participating physicians and reimbursed toHealthLynked by the Buyer in 2024) based on agreement to participate in Buyer's ACO by AHP's existing physician practices or newly added practices, scaled based on the number of covered patients transferred to PBACO byJuly 31, 2023 ; (3) in the event that Buyer completes a planned IPO byAugust 1, 2024 , shares in the public entity at the time of the IPO with a value equal to AHP's 2021 EBITDA times the multiple of EBITDA used to value the public entity's IPO shares, net of any cash consideration previously paid by the Buyer and subject to vesting requirements detailed in the AHP Merger Agreement; (4) net proceeds, including allocation for expenses, from any MSSP Shared Savings related to AHP's plan year 2022, which, if earned, would be determined and paid by the CMS byOctober 2023 . In the event Buyer goes public through means other than an IPO, the parties agreed to modify the terms of the IPO Share Consideration to implement such alternate structure. In the event Buyer does not go public by IPO or other means byAugust 1, 2024 , the Company receives no IPO Share Consideration, and the Transaction consideration is capped at the cash consideration of up to$3,000,000 plus the MSSP Consideration. We will allocate up to$500,000 of the incremental$2,250,000 participation-based cash proceeds as an advance to AHP's participating physicians to incentivize participation in PBACO. Any such participating physician advances will be repaid to us out of AHP's 2023 performance year MSSP Shared Savings, which would be received in 2024. Pursuant to the terms of the Merger Agreement, formal transfer of the equity ownership of AHP from us to the Buyer will occur at the earlier of (i) Buyer's IPO, (ii) Buyer going public by other means, or (iii) if Buyer does not go public, onAugust 1, 2024 . Until that time, we have the right, but not the obligation, to reacquire AHP for a price equal to any consideration already paid by the Buyer for AHP, plus all expenses incurred by Buyer in operating AHP
afterJanuary 16, 2023 . We have classified the results of the ACO/MSO Division as discontinued operations in the accompanying consolidated statement of operations for all periods presented. Additionally, the assets and liabilities associated with the ACO/MSO Division are classified as held for sale in our consolidated balance sheet for all periods presented.
Critical accounting policies and significant judgments and estimates
For a discussion of our critical accounting policies, see Note 2, "Significant Accounting Policies," in the Notes to consolidated Financial Statements.
25
Results of Operations: Years Ended
The following table summarizes the changes in our results of operations for the year endedDecember 31, 2022 compared with the year endedDecember 31, 2021 : Year Ended December 31, Change 2022 2021 $ %
Patient service revenue, net$ 5,407,416 $ 5,764,186 $ (356,770 ) -6 % Subscription and event revenue 20,835 14,883
5,952 40 % Product revenue 429,951 718,062 (288,111 ) -40 % Total revenue 5,858,202 6,497,131 (638,929 ) -10 % Operating Expenses and Costs Practice salaries and benefits 3,335,695 3,114,991 220,704 7 % Other practice operating expenses 2,566,191 2,349,279 216,912 9 % Cost of product revenue 463,156 606,521 (143,365 ) -24 % Selling, general and administrative expenses 4,577,490 4,929,668 (352,178 ) -7 % Depreciation and amortization 829,481 827,696
1,785 0 % Impairment loss 2,745,563 --- 2,745,563 * Loss from operations (8,659,374 ) (5,331,024 ) (3,328,350 ) 62 % Other Income (Expenses)
Gain (loss) on extinguishment of debt --- (4,957,168 ) 4,957,168 -100 % Change in fair value of debt --- (19,246 ) 19,246 -100 % Financing cost (110,000 ) --- (110,000 ) * Amortization of original issue discounts on notes payable (55,282 ) --- (55,282 ) * Change in fair value of contingent acquisition consideration 779,999 (373,656 ) 1,153,655 -309 % Interest expense (22,825 ) (19,144 ) (3,681 ) 19 % Total other income (expenses) 591,892 (5,369,214 )
5,961,106 -111 %
Loss from continuing operations (8,067,482 ) (10,700,238 ) 2,632,756 -25 % Income (loss) from operations of discontinued operations (748,262 ) 287,656
(1,035,918 ) -360 % Net loss$ (8,815,744 ) $ (10,412,582 ) $ 1,596,838 -15 %
* - Denotes line item on statement of operations for which there was no
corresponding activity in the same period of prior year.
Revenue Patient service revenue in the year endedDecember 31, 2022 decreased by$356,770 , or 6% year-over-year, from$5,764,186 , to$5,407,416 , primarily as a result of decreased patient service revenue at our NWC practice of$758,172 due to the departure of two physicians and a decrease at BTG of$100,591 , offset by a year-over-year increase at our NCFM practice of$291,232 and the addition of AEU revenue of$210,761 following its acquisition inMay 2022 . Subscription and event revenue in the year endedDecember 31, 2022 increased by$5,952 , or 40% year-over-year, to$20,835 due to an increase inHealthLynked Network subscriptions of$9,377 , offset by a decrease in event revenue of$3,425 . Product revenue was$429,951 in the year endedDecember 31, 2022 , compared to$718,062 in the year endedDecember 31, 2021 , a decrease of$288,111 , or 40%. Product revenue was earned by the Medical Distribution Division, comprised
of the operations of MOD.
Operating Expenses and Costs
Practice salaries and benefits increased by$220,704 , or 7%, to$3,335,695 in the year endedDecember 31, 2022 , compared to$3,114,991 in the year endedDecember 31, 2021 , as a result of increased production pay and personnel costs corresponding to increased revenue and the addition of AEU salaries and benefits starting inMay 2022 with no corresponding cost in 2021, offset by fewer full-time equivalents at NWC and BTG. Other practice operating costs increased by$216,912 , or 9%, to$2,566,191 in the year endedDecember 31, 2022 , primarily as a result of the addition of AEU operating costs starting inMay 2022 with no corresponding cost in 2021, increased practice operating costs at NCFM corresponding to increased revenue, offset by lower costs at our NWC and BTG facilities. 26
Cost of product revenue was$463,156 in the year endedDecember 31, 2022 , a decrease of$143,365 , or 24%, compared to the same period of 2021, corresponding to the decline in product sales for the period compared to the same period in the prior year. During the year endedDecember 31, 2022 , we also made two sales with corresponding cost of product revenue of$89,395 for which we do not believe it is probable that we will collect from the customers. As a result, the cost of product revenue is recognized in 2022 with no corresponding revenue recognized. Selling, general and administrative costs decreased by$352,178 , or 7%, to$4,577,490 in the year endedDecember 31, 2022 compared to the year endedDecember 31, 2021 , primarily due to lower stock-based and cash-based consulting fees, and legal and accounting fees in 2022 compared to 2021, offset by more personnel, overhead, promotional and development costs in our corporate function in connection with our continued investment in the HealthLynked Network.
Depreciation and amortization increased in the year ended
During the year endedDecember 31, 2022 , we determined that triggering events had occurred that required impairment assessments of the MOD Website. The triggering events included (i) a material decline in revenue during 2022, and during fourth quarter 2022 in particular, from the reporting unit's existing customer base, (ii) delays in realization of material increases in revenue from new marketing channels, and (iii) an inability to achieve profitability during 2022 despite a fundamental pricing and profit margin restructuring implemented in fourth quarter of 2022. We determined that the asset group, which included the MOD Website and goodwill related to MOD, was not recoverable and, accordingly, recorded an impairment charge in the amount of$2,745,563 to adjust carrying value to its estimated fair value of$-0 -. The impairment charge was allocated$1,979,314 to the intangible Website asset and$766,249 to goodwill. Loss from operations increased by$3,328,350 , or 62%, to$8,659,374 in the year endedDecember 31, 2022 compared to$5,331,024 in the year endedDecember 31, 2021 , primarily as a result of the impairment charge related to MOD intangible assets and goodwill recorded in fourth quarter of 2022, lower patient service and product revenue in 2022 and an increase in practice operating costs, offset by a decrease in selling, general and administrative costs. Other Income (Expenses) Loss on extinguishment of debt in the year endedDecember 31, 2021 was$4,957,168 resulting from (i) a loss on debt extinguishment of$5,589,994 representing the excess of the fair value of shares and a warrant issued at conversion of convertible notes over the carrying value of the host instruments and accrued interest, and (ii) a debt extinguishment gain of$632,826 related to the forgiveness of PPP loans in May andJune 2021 . There were no gains or losses from the extinguishment of debt in the year endedDecember 31, 2022 . Losses from the change in fair value of debt was$19,246 in the year endedDecember 31, 2021 . Such losses resulted from certain convertible notes and notes payable to related parties that, in previous periods, were extended and treated as an extinguishment and reissuance for accounting purposes, requiring these notes to be subsequently carried at fair value. The change in fair value at the end of each reporting period was recorded as "Change in fair value of debt." After conversion of our remaining convertible notes outstanding inJanuary 2021 , we had no further debt carried at fair value, and therefore no change in fair value of debt in the year endedDecember 31, 2022 . Financing cost in the year endedDecember 31, 2022 was$110,000 , resulting from cash and stock-based fees paid in connection with theJuly 2022 SEPA. There were no financing costs in the year endedDecember 31, 2021 . Amortization of original issue and debt discounts on notes payable and convertible notes in the year endedDecember 31, 2022 was$55,282 , resulting from amortization of original issue discounts on notes payable issued in the second half of 2022. There was no corresponding amortization of original issue and debt discounts in the year endedDecember 31, 2021 . Gain (loss) from the change in fair value of contingent acquisition consideration increased by$1,153,655 , or 309%, to a gain of$779,999 in the year endedDecember 31, 2022 , compared to a loss of$373,656 in the year endedDecember 31, 2021 . Because contingent acquisition consideration related to our acquisition of MOD is payable in a fixed number of shares, changes in the fair value of the contingent acquisition consideration fluctuates with our share price. During the year endedDecember 31, 2021 , our share price increased substantially, resulting in an increase in the fair value of the contingent acquisition consideration liability and a corresponding loss from the change in fair value. During the year endedDecember 31, 2022 , our share price decreased substantially, resulting in a gain from the decrease in fair value of the liability.
Interest expense increased by
27 Total other income (expenses) increased by$5,961,106 , or 111%, to income of$591,892 in the year endedDecember 31, 2022 compared to expense of$5,369,214 in the year endedDecember 31, 2021 . The change was primarily a result of a$5,589,994 loss on extinguishment of debt associated with the retirement of our last remaining convertible notes payable in 2021, and a gain from the change in fair value of contingent acquisition consideration recognized in the year endedDecember 31, 2022 , contrasted to a loss in the year endedDecember 31, 2021 , due principally to the fixed-share structure of the MOD contingent consideration. Loss from continuing operations decreased by$2,632,756 , or 25%, to$8,067,482 in the year endedDecember 31, 2022 , compared to loss from continuing operations of$10,700,238 in the year endedDecember 31, 2021 . The decrease was due primarily to (i) a large loss on extinguishment of debt incurred in 2021 with no corresponding charges in 2022, (ii) a gain from the change in fair value of contingent acquisition consideration in 2022 resulting from the fixed share structure of the MOD contingent acquisition consideration coupled with a drop in our stock price during 2022, and (iii) lower selling, general and administrative costs in 2022, offset by (iv) an impairment charge related to MOD intangible assets and goodwill recorded in fourth quarter of 2022, and (v) lower aggregate patient service and product revenue in 2022.
Income (Loss) from Operations of Discontinued Operations
Our ACO/MSO Division was classified as discontinued operations in the accompanying consolidated statement of operations for the years endedDecember 31, 2022 and 2021 due to an approved plan of sale initiated in fourth quarter of 2022 and completed inJanuary 2023 with the signing of the AHP Merger Agreement. Income (loss) from operations of discontinued operations decreased by 360% from income of$287,656 in the year endedDecember 31, 2021 to loss of$748,262 in the year endedDecember 31, 2022 . The change from income to loss was due primarily to a determination during third quarter 2022 from the CMS that AHP narrowly missed its plan year 2021 benchmark expenditures, for which we would have received payment inSeptember 2022 . As a result, AHP received no shared savings revenue in 2022, in the year endedDecember 31, 2022 , compared to shared savings revenue of$2,419,312 received in the year endedDecember 31, 2021 . DuringSeptember 2022 , we filed a reconsideration appeal with the CMS, which was unsuccessful. The decline resulting from shared savings revenue was offset by an increase in consulting revenue of$58,316 and, because we did not receive shared savings revenue in 2022, a decrease in shared savings expense for the portion of such revenue that would have been paid to our ACO participating providers.
Net Loss Net loss decreased by$1,596,838 , or 15%, to$8,815,744 in the year endedDecember 31, 2022 , compared to net loss of$10,412,582 in the year endedDecember 31, 2021 , primarily as a result of (i) a large loss on extinguishment of debt incurred in 2021 with no corresponding charges in 2022, (ii) a gain from the change in fair value of contingent acquisition consideration in 2022 resulting from the fixed share structure of the MOD contingent acquisition consideration coupled with a drop in our stock price during 2022, and (iii) lower selling, general and administrative costs in 2022, offset by (iv) an impairment charge related to MOD intangible assets and goodwill recorded in fourth quarter of 2022, (v) a loss from our discontinued ACO/MSO Division in 2022 due to the determination by CMS that no shared savings revenue was earned in 2022, and (vi) lower aggregate patient service and product revenue in 2022. Seasonal Nature of Operations We do not experience any material seasonality related to any of our continuing operations. Prior to the discontinuation of our ACO/MSO Division, that division's primary source of revenue was from payments earned under the Medicare shared savings program for which shared savings determinations were made annually by the CMS in the third calendar quarter of each year, resulting in potential revenue spikes in the third quarter. With the sale of the ACO/MSO Division inJanuary 2023 , we will no longer be subject to this type of seasonality. Impairment
Impairment reviews of long-lived assets
Long-lived assets (including amortizable identifiable intangible assets) or asset groups held for use are tested for recoverability whenever events or changes in circumstances indicate that their carrying amount may not be recoverable. When such events occur, we compare the sum of the undiscounted cash flows expected to result from the use and eventual disposition of the asset or asset group to the carrying amount of a long-lived asset or asset group. The cash flows are based on our best estimate of future cash flows derived from the most recent business projections. If this comparison indicates that the asset is not recoverable, we estimate the fair value of the asset group using a discounted cash flow model. An impairment charge is then recorded for any excess carrying value above the estimated fair value of the asset group.Goodwill and indefinite-lived intangible assets are tested for impairment on an annual basis and more often if circumstances indicate that an impairment may be necessary.Goodwill impairment is recognized for any excess carrying value above the estimated fair value of the asset group. Fair value is estimated using the same approach as described above for long-lived asset testing. 28 The significant assumptions we use in the discounted cash flow models are revenue growth rate, gross profit margins on product sales, operating income margin, and the discount rate used to determine the present value of the cash flow projections. Among other inputs, revenue growth rate and operating income margin are determined by management using historical performance trends, projected performance from existing partnerships, industry data, relevant changes in the reporting unit's underlying business, and other market trends that may affect the reporting unit. The discount rate is based on the estimated weighted average cost of capital as of the test date of market participants in the industry in which the reporting unit operates. The assumptions used in the DCF model are subject to significant judgment and uncertainty. Changes in projected revenue growth rates, gross profit margins, projected operating income margins, or estimated discount rates due to uncertain market conditions, loss of our sole product supplier in the Medical Distribution reporting unit, losses of key physicians in our Health Services reporting unit, changes in technology, or other factors, could result in one or more of our reporting units with a significant amount of identifiable intangible assets recognizing material impairment charges, which could be material to our results of operations and financial position. Our historical or projected revenues or cash flows may not be indicative of actual future results.
Impairment of MOD Website and
During the fourth quarter of 2022, we determined that triggering events had occurred that required impairment assessments of the MOD Website. The triggering events included (i) a material decline in revenue during 2022, and during fourth quarter 2022 in particular, from the reporting unit's existing customer base, (ii) delays in realization of material increases in revenue from new marketing channels, and (iii) an inability to achieve profitability during 2022 despite a fundamental pricing and profit margin restructuring implemented in fourth quarter of 2022. We determined that the asset group, which included the MOD Website and goodwill related to MOD, was not recoverable and, accordingly, recorded an impairment charge in the amount of$2,745,563 to adjust carrying value to its estimated fair value of$-0 -. The impairment charge was allocated$1,979,314 to the intangible Website asset and$766,249 to goodwill. The fair value of our MOD Website and goodwill was determined using an expected present value approach, which applies a market discount rate to a probability-weighted stream of cash flows based on multiple scenarios, as estimated by management. As such, the fair values of the MOD Website and goodwill rely on significant unobservable inputs and assumptions and there is uncertainty in the expected future cash flows used in the impairment review. 29
Liquidity and Capital Resources
Liquidity Condition During the second quarter of 2014, the FASB issued ASU No. 2014-15, Presentation of Financial Statements - Going Concern (Subtopic 205-40): Disclosure of Uncertainties about an Entity's Ability to Continue as a Going Concern. This update providedU.S. GAAP guidance on management's responsibility in evaluating whether there is substantial doubt about a company's ability to continue as a going concern and about related footnote disclosures. Under this standard, we are required to evaluate whether there is substantial doubt about our ability to continue as a going concern each reporting period, including interim periods. In evaluating our ability to continue as a going concern, management considered the conditions and events that could raise substantial doubt about our ability to continue as a going concern within 12 months after our financial statements
were issued (March 31, 2024 ). Management considered our current financial condition and liquidity sources, including current funds available, forecasted future cash flows and our obligations due beforeMarch 31, 2024 and concluded that, without additional funding, we will not have sufficient funds to meet our obligations within one year from the date the consolidated financial statements were issued. Without raising additional capital, either via additional advances made pursuant to the SEPA or from other sources, there is substantial doubt about our ability to continue as a going concern throughMarch 31, 2024 . The accompanying consolidated financial statements have been prepared assuming that we will continue as a going concern. This basis of presentation contemplates the recovery of our assets and the satisfaction of liabilities in the normal course of business. We are subject to a number of risks, including uncertainty related to product development and generation of revenues and positive cash flow from ourDigital Healthcare division and a dependence on outside sources of capital. The attainment of profitable operations is dependent on future events, including obtaining adequate financing to fulfill our growth and operating activities and generating a level of revenues adequate to support our cost structure. As ofDecember 31, 2022 , we had cash balances of$61,891 , a working capital deficit of$1,330,157 and an accumulated deficit of$41,020,933 . For the year endedDecember 31, 2022 , we had a net loss of$8,815,744 , net cash used by operating activities of$4,363,020 , and$1,678,015 provided by financing activities. We expect to continue to incur net losses and have significant cash outflows for at least the next 12 months.
Significant Liquidity Transactions
ThroughDecember 31, 2022 , we have funded our operations principally through a combination of sales of our common stock, convertible and non-convertible promissory notes, government issued debt, and related party debt, as described below. OnJuly 5, 2022 , we entered into a Standby Equity Purchase Agreement (the "SEPA") withYA II PN, Ltd. ("Yorkville"). Pursuant to the SEPA, we shall have the right to sell to Yorkville up to 30,000,000 shares of our common stock, par value$0.0001 per share, at our request any time during the three-year commitment period set forth in the SEPA. Because the purchase price per share to be paid by Yorkville for the shares of common stock sold by us to Yorkville pursuant to the SEPA, if any, will fluctuate based on the market prices of our common stock during the applicable pricing period, we cannot reliably predict the actual purchase price per share to be paid by Yorkville for those shares, or the actual gross proceeds to be raised by us from those sales, if any. During the year endedDecember 31, 2022 , we made 21 advances under the SEPA, receiving$451,202 in proceeds for the issuance of 5,683,100 shares of common stock, of which$279,415 was applied to the balance of the Promissory Note (as defined below).
OnJuly 19, 2022 , we issued to Yorkville a promissory note with an initial principal amount equal to$561,000 , including payment fees (the "Promissory Note"). The Promissory Note will mature onMarch 15, 2023 . During the year endedDecember 31, 2022 , we made payments of$392,700 against the Promissory Note, including$279,415 applied from proceeds of sales of common stock under the SEPA, leaving an unpaid principal balance as ofDecember 31, 2022 of$168,300 . The balance of the Promissory Note was repaid in full during first quarter 2023. DuringOctober 2022 , the Board approved a plan to sell our ACO/MSO Division. OnJanuary 17, 2023 , we entered into the AHP Merger Agreement, pursuant to which the Buyer agreed to buy, and we agreed to sell, AHP. We received$750,000 cash payments upon signing of the AHP Merger Agreement. Pursuant to the terms of the transaction, we may also earn (i) up to an additional$2,250,000 cash (up to$500,000 of which will be allocated to AHP's participating physicians and reimbursed toHealthLynked by the Buyer in 2024) byJuly 31, 2023 for meeting participating physician transfer milestones outlined in the AHP Merger Agreement, (ii) common shares of the Buyer in the event that the Buyer completes an IPO or other public listing transaction prior toAugust 1, 2024 , with the value to be determined based on Buyer's valuation in such a transaction, and (iii) net proceeds, including allocation for expenses, from any MSSP Shared Savings related to AHP's plan year 2022, which, if earned, would be determined and paid by the CMS byOctober 2023 . 30
During November andDecember 2022 , we issued two separate notes payable to our CEO, Dr.Michael Dent , with aggregate principal amount of$338,000 . The notes are repaid in weekly installments over a one-year period. During the year endedDecember 31, 2022 , we sold 8,998,485 shares of common stock to eight separate investors in private placement transactions. We received$785,000 in proceeds from the sales. In connection with the stock sales, we also issued 6,249,244 five-year warrants to purchase shares of common stock at exercise prices between$0.10 and$0.25 per share. Without raising additional capital, whether via additional advances made pursuant to the SEPA, from the sale of equity or debt instruments, from contingent consideration related to the sale of the ACO/MSO Division, or from other sources, there is substantial doubt about the Company's ability to continue as a going concern throughMarch 31, 2024 . The accompanying consolidated financial statements have been prepared assuming that the Company will continue as a going concern. This basis of presentation contemplates the recovery of the Company's assets and the satisfaction of liabilities in the normal course of business.
Plan of operation and future funding requirements
Our plan of operations is to profitably operate our Health Services business and continue to invest in ourDigital Healthcare business, including our cloud-based online personal medical information and record archiving system, the "HealthLynked Network." We are marketing the HealthLynked Network by targeting large health systems, hospitals and universities. In addition, we are marketing via direct-to-patient marketing, affiliated marketing campaigns, co-marketing with our Medical Distribution businesses subsidiary MOD, and expanded southeast regional sales efforts. Our initial sales strategy is utilizing Internet-based marketing to increase penetration to targeted geographical areas. These campaigns are focused on both physician practices and patient members. We also are leveraging MOD's discounted medical supplies as an offering to our patient and physician members in the HealthLynked Network. We also intend to utilize physician telesales through the use of telesales representatives whom we will hire as access to capital allows. If we fail to complete the development of, or successfully market, the HealthLynked Network, our ability to realize future increases in revenue and operating profits could be impacted, and our results of operations and financial position would be materially adversely affected. We plan to raise additional capital to fund our ongoing plan of operation.
Historical Cash Flows Year Ended December 31, 2022 2021 Net cash (used in) provided by: Net cash used in continuing operating activities$ (3,673,950 ) $ (4,019,274 ) Net cash used in discontinued operating activities (689,070 ) 249,420 Net cash used in operating activities (4,363,020
) (3,769,854 )
Net cash used in continuing investing activities (544,750 ) (341,356 ) Net cash used in discontinued investing activities --- --- Net cash used in investing activities (544,750
) (341,356 )
Net cash provided by continuing financing activities 1,678,015
7,240,672
Net cash provided by discontinued financing activities --- --- Net cash provided by financing activities 1,678,015
7,240,672
Net increase (decrease) in cash from continuing operating (2,540,685 ) 2,880,042 Net increase (decrease) in cash from discontinued operating (689,070 ) 249,420 Net increase (decrease) in cash $ (3,229,755
)$ 3,129,462 Operating Activities - During the year endedDecember 31, 2022 , we used cash from operating activities of$4,363,020 , as compared with$3,769,854 in the year endedDecember 31, 2021 . The increase in cash usage results primarily from an increase of$938,490 in cash used in operations of our discontinued ACO/MSO Division, due primarily to the unit not receiving MSSP shared savings revenue in 2022. Net cash used in continuing operating activities decreased by$345,324 , due primarily to decreased selling, general and administrative expenses and cash received in the fourth quarter of 2022 for the sale of annual Medical Membership and Concierge Services at NCFM for which revenue and a portion of the related cost are deferred and recognized over the contract life, most of which will
be recognized in 2023. 31 Investing Activities - During the year endedDecember 31, 2022 , we used$544,750 in investing activities, including$313,802 used to acquire AEU (net of cash acquired),$207,384 contingent acquisition consideration payment paid to the sellers of NCFM related to the third and final year of earn-out, and$23,564 to acquire fixed assets. During the year endedDecember 31, 2021 , we used$341,356 in investing activities, including$196,000 contingent acquisition consideration payment paid the sellers of NCFM and$126,106 contingent acquisition consideration payment paid the sellers of CHM, plus$19,250 for the acquisition of furniture, computers and equipment. There were no investing activities related to our discontinued operations. Financing Activities - During the year endedDecember 31, 2022 and 2021, we realized$1,678,015 and$7,240,672 , respectively, in financing activities. Cash realized in 2022 was comprised of$956,787 from the sale of common stock (net of$279,415 received from sales of common stock under the SEPA that were applied to the balance of the Note Payable),$943,300 from the issuance of notes payable, and$222,072 repayments against notes payable balances (net of$279,415 received from sales of common stock under the SEPA that were applied to the balance of the Note Payable). Cash realized in 2021 was comprised of$5,229,360 from the sale of common stock pursuant to private placements and puts under the Investment Agreement,$1,719,921 net proceeds from the Registered Direct Offering, and$350,200 proceeds from the exercise of options and warrants. We also made cash repayments against a vendor note in the amount of$51,109 , retiring the note in full.
Exercise of Warrants and Options
During the year ended
During the year endedDecember 31, 2021 , we received$333,750 upon the exercise of 3,065,278 warrants with exercise prices between$0.09 and$0.15 and$16,450 upon the exercise of 145,500 options with exercise prices between$0.10 and$0.252 . Additionally, we issued 9,047,332 shares upon cashless exercise of 10,571,742 warrant shares exercised using a cashless exercise feature in settlement of litigation and other disputes totaling$614,221 that had been accrued in 2020.
Other Outstanding Obligations at
As of
As of
As of
Off Balance Sheet Arrangements
We did not have, during the periods presented, and we do not currently have, any
off-balance sheet arrangements, as defined under applicable
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