Special Note Regarding Forward-Looking Statements
You should read the following discussion and analysis of financial condition and operating results together with our financial statements and the related notes and other financial information included elsewhere in this annual report on Form 10-K. References in this "Management's Discussion and Analysis of Financial Condition and Results of Operations" to "us," "we," "our," and similar terms refer toNexalin Technology, Inc. This discussion contains forward-looking statements as that term is defined within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), which are subject to the "safe harbor" created by those sections. The events described in forward-looking statements contained in this discussion may not occur. Generally, these statements relate to business plans or strategies, projected or anticipated benefits or other consequences of our plans or strategies, projected or anticipated benefits from acquisitions that may be made by us, or projections involving anticipated revenues, earnings or other aspects of our operating results. The words "may," "will," "expect," "believe," "anticipate," "project," "plan," "intend," "estimate," and "continue," and their opposites and similar expressions, are intended to identify forward-looking statements. We caution you that these statements are not guarantees of future performance or events and are subject to a number of uncertainties, risks and other influences, many of which are beyond our control, which may influence the accuracy of the statements and the projections upon which the statements are based. Reference is made to "Risk Factors" in this annual report on Form 10-K Our actual results may differ materially from those anticipated in these forward-looking statements. For convenience of presentation some of the numbers have been rounded in the text below. Overview
We design and develop innovative neurostimulation products to uniquely and effectively help combat the ongoing global mental health epidemic. We developed an easy-to-administer medical device - referred to as Generation 1 or Gen-1 - that utilizes bioelectronic medical technology to treat anxiety and insomnia, without the need for drugs or psychotherapy. Our original Gen-1 devices are cranial electrotherapy stimulation (CES) devices that emit waveform at 4 milliamps during treatment and are presently classified by theU.S. Food and Drug Administration ("FDA") as a Class II device. Medical professionals inthe United States have utilized the Gen-1 device to administer to patients in clinical settings. While the Gen-1 device had been cleared by the FDA to treat depression, anxiety, and insomnia, three prevalent and serious diseases, because of theFDA's December 2019 reclassification of CES devices, the Gen-1 device was reclassified as a Class II device for the treatment of anxiety and insomnia. We are required to file a new application under Section 510(k) of the Federal Food, Drug and Cosmetic Act ("510(k) Application") to be approved by the FDA for the sales and marketing of our devices for the treatment of anxiety and insomnia. In theFDA's December 2019 reclassification ruling, the treatment of depression with our device will require a Class III certification and require a new PMA (premarket approval) application to demonstrate safety and effectiveness. While we continue providing services to medical professionals to support patients' use of the Gen-1 devices which were in operation prior toDecember 2019 , we are not making new sales or new marketing efforts of Gen-1 devices inthe United States . We continue to derive revenue from devices which we sold or leased prior to theFDA's December 2019 reclassification announcements. This revenue consists of monthly licensing fees and payments for the sale of electrodes and patient cables. We have suspended marketing efforts for new sales of devices related to the Gen-1 device for treatment of anxiety and insomnia inthe United States until theNexalin regulatory team makes a decision on a new 510(k) application at 4 milliamps based on FDA comments expected to be received inApril 2023 . Our regulatory team continues to inform the FDA of the suspension of the marketing and sale of the Gen-1 products to new providers. We are analyzing whether to proceed with an amended application with the FDA for Gen-1 devices for the treatment of insomnia and anxiety. 49 We have designed and developed a new advanced waveform technology to be emitted at 15 milliamps through new and improved medical devices referred to as Generation 2 or Gen-2 and Generation 3 or Gen-3. Gen-2 is a clinical use device with a modern enclosure to emit the new 15 milliamp advanced waveform. Gen-3 is a new patient headset that will be prescribed by licensed medical professionals in a virtual clinic setting similar to existing Tele-health platforms. TheNexalin research team believes that the new 15 milliamp Gen-2 and Gen-3 devices can penetrate deeper into the brain and stimulate associated structures of mental illness, which we believe will generate enhanced patient response without any risk or unpleasant side effects. TheNexalin regulatory team has made a strategic decision to develop strategies for pilot trials in various mental health disease states. In addition, a new PMA application inthe United States is in development for the treatment of depression utilizing both Gen-2 and Gen-3. The new Gen-3 device is also scheduled for additional pilot trials for anxiety and insomnia inthe United States and China beginning in the third quarter of 2023. Preliminary data provided by theUniversity of California San Diego supports the safety of utilizing our 15 milliamp waveform technology. However, the determination of safety and efficacy of medical devices inthe United States is subject to clearance by the FDA. Additionally, we are currently designing clinical trial strategies for the use of Gen-3 for the treatment of substance use disorders including opiate, cocaine, and alcohol abuse. Recently the Gen-2 device was tested in pilot trials inChina for the treatment of Alzheimer's disease and dementia. Continued pilot testing for Alzheimer's and dementia is planned inChina in 2023. In part due to increasing incidence attributed to the devastating impacts of the COVID-19 pandemic, mental health and cognitive disorders are widespread across the globe and cause substantial health, social and economic losses, and hardships accordingly. Our focus is on the continued development of our innovative bioelectronic medical technologies and rapid regulatory approval. We intend to help reverse these losses, and hardships of these losses, by safely and effectively treating various mental health disorders associated with post Covid and long Covid mental disease states. All our products are non-invasive, safe, undetectable to the human body and can provide relief to those afflicted with mental health issues without adverse side effects. We have a proprietary design that eliminates voltage while stabilizing currents, electromagnetic fields, and various frequencies - referred to collectively as waveform - particularly our proprietary, 15 milliamp patented symmetrical waveform. Our devices generate a high frequency carrier wave that is charge balanced. It is applied to the brain with an array of electrodes on the forehead and behind each ear at the mastoid. The features of this proprietary waveform and the array of electrodes allow the application of the waveform to the entire brain rather than a small, targeted area of the brain. To ensure deeper penetration into the brain, we have eliminated the voltage from the waveform which allows the increase of the power from < 4 mAmps to 15 mAmps, more than a 400% increase without incurring any patient discomfort, risk, or adverse side effects. By increasing the power, our waveform can penetrate deeper into the brain and stimulate deep mid-brain structures associated with mental illness. Our research and clinical teams believe that a more powerful waveform will create a stronger response in the brain. A stronger response creates a higher level of efficacy. This entire proprietary technique allowsNexalin to provide a safe and comfortable treatment that is more powerful than any stimulation device in the market. Current pilot study protocols and randomized clinical trials have been designed and submitted to the FDA to provide feedback on final reports and data sets for the purpose of safety and efficacy evaluations in the future. Determinations of the safety and efficacy of our devices are solely within the authority of the FDA. Currently, the waveform that comprises the basis of Gen-2 and new Gen-3 headset devices has been tested in research settings to develop safety data that has been submitted for review by the FDA for safety evaluation and eventual marketing inthe United States and around the world. Determinations of the safety and efficacy of our devices inthe United States are solely within the authority of the FDA. We recognize that an additional barrier to treatment in today's mental health treatment landscape -- beyond the concerns about safety, efficacy and side-effects that have been associated with conventional mental health treatments such as ECT (shock therapy), drugs and psychotherapy -- is stigma. We have received industry reports and feedback that many patients that struggle with mood disorders have the stigma of embarrassment associated with psychiatrists and psychotherapy (e.g., counselling with a therapist). Additional stigmas and other issues are associated with the side effects of medication prescribed by psychiatrists. When we researched the current pharmaceuticals model, public information highlighted the many side effects associated with these medications. Frequently, patients would stop taking the medication because of the uncomfortable side effects. Additional public information mentions dependency and withdrawal issues associated with medication for psychiatric
disorders. 50
To address the embarrassment stigma, we are developing a new virtual clinic that will allow the physician to diagnose a mental health issue in the privacy of a tele-psychiatry virtual platform. After diagnosis, the physician will prescribe the Nexalin Gen-3 headset to the patient for treatment. Next, the Gen-3 device will be shipped to the patient's home. After patient receives the device, they will pair the headset device with an app in the patient's smart phone. The app will communicate with theNexalin cloud servers to authorize the device for treatment according to the protocol designed by the physician. The physician will monitor treatment compliance and other health related issues in a private physician dashboard that connects through theNexalin app and cloud servers. We believe that to preserve product safety and integrity for home use, the headset device will require physician oversight that will include a prescription for use with a monthly authorization provided by the physician after a monthly virtual visit. All appointments will be in a virtual setting to provide privacy and convenience for the physician and patient. TheNexalin virtual clinic will be provided in a proprietary virtual platform currently in the design stage. OurChina Gen -2 15 milliamp device was recently approved inChina by the NMPA for the treatment of insomnia and depression inChina . This device and all other clinical devices will include a single use electrode for long term revenue streams. TheUSA Gen-2 device will have a fresh and modern appearance that meets the technology standards of the digital tech world of 2023. Early adopters of the Gen-1 device will be able to access additional firmware upgrades which are planned to enhance the previously purchased devices to the new symmetric15-milliamp waveform. Our Gen-2 device will be equipped with RFID technology that exchanges electrode usage data with a reader in the main device. The purpose of RFID is to track and maintain control of the proprietary single use electrode. Our electrode chip will be programmed to exchange data with the device and allow activation for a single treatment with a new electrode only. This ensures a recurring revenue stream on the device and protects against any generic knockoffs designed to avoid treatment costs. This upgrade in technology also ensures the proprietary nature of the electrodes that support treatment outcomes are sustained. Overall, we believe that our advanced waveform, technological upgrades and the development of a modern headset monitored with our IT management platform will position us with the opportunity to disrupt the traditional mental health treatment model. Our mission is to remove the stigma of expensive psychotherapy or pharmaceuticals with the attendant side effects and dependency issues and replace such stigma with clinically proven and cost-effective technology that is easily accessible in the privacy of the patient's home and monitored by licensed healthcare providers. Since our inception, we have generated significant losses; we expect to continue to incur significant expenses and increasing operating losses for at least the next two years. Our net losses may fluctuate significantly from period to period, depending on the timing of our planned clinical trials and expenditures for other research and development activities. We expect our expenses will increase substantially over time as we:
? Continue the ongoing and planned preclinical and clinical development of our
products;
? review and analyze the value of amending our previous 510(k) Application for
anxiety and insomnia in accordance with the FDA and seek other regulatory
approvals for any future products that successfully complete clinical trials;
? arrange for a sales, marketing and distribution infrastructure and scale up
external manufacturing capabilities to commercialize any product candidate for
which we may obtain regulatory approval and intend to commercialize on our
own; ? maintain, expand and protect our intellectual property portfolio;
? engage additional clinical, scientific, manufacturing and controls personnel;
? add additional operational, financial and management information systems and
personnel, including personnel to support our product development and planned
future commercialization efforts; ? seek to discover and develop additional products; and
? initiate preclinical studies and clinical trials for any additional products
that we may pursue in the future.
Furthermore, we expect to incur additional costs associated with operating as a public company, including significant legal, accounting, investor relations and other expenses that we did not incur as a private company. 51 Recent Developments
Completion of Initial Public Offering
The Company completed its initial public offering onSeptember 16, 2022 . The initial public offering consisted of 2,315,000 units consisting of 2,315,000 shares of its Common Stock and 2,315,000 accompanying warrants to purchase up to 2,315,000 shares of common stock. Each share of common stock was sold together with one warrant, each to purchase one share of common stock with an exercise price of$4.15 per share at a combined offering price of$4.15 , for gross proceeds of$9,607,250 before deducting underwriting discounts and offering expenses. In addition,Nexalin granted the underwriters a 45-day option to purchase up to an additional 347,250 shares of common stock and/or warrants to purchase up to 347,250 shares of common stock to cover over-allotments at the initial public offering price, less the underwriting discount. The underwriters exercised their option to purchase 347,250 warrants for net proceeds of$3,473 . The registration statement on Form S-1 (File No. 333-261989) for our initial public offering was filed with theSecurities and Exchange Commission ("SEC") and became effective onSeptember 15, 2022 . A final prospectus relating to the offering was filed with theSEC and is available on theSEC's website at http://www.sec.gov. The offering was being made only by means of a prospectus forming part of the effective registration statement. The shares and warrants began trading on the Nasdaq Capital Market tier of theNasdaq Stock Market ("Nasdaq") inSeptember 2022 , under the symbols "NXL" and "NXLIW", respectively. Impact of COVID-19 Pandemic We continue to monitor how the COVID-19 pandemic is affecting our employees, business and clinical trials. Such pandemic has delayed our clinical trials and our receipt of marketing approvals from the FDA. Such pandemic also might have reduced, and continue to reduce, participation in our clinical trials, due to both travel restrictions and a general unwillingness of subjects to travel. We cannot presently predict the scope and severity of any other potential business shutdowns or disruptions, but if we or any of the third parties with whom we engage, including the suppliers, clinical trial sites, regulators and other third parties with whom we conduct business, were to experience shutdowns or other business disruptions, our ability to conduct our business in the manner and on the timelines presently planned could be materially and negatively impacted. We continue to be indirectly impacted because of our current dependence upon our distributor relationship withWider Come Limited (Wider".) Wider acts as a distributor for the Company's devices inChina andAsia . Because of significant restrictions imposed by the Chinese government during the Covid pandemic, Wider's ability to market and sell the Company's devices has been negatively impacted, resulting in decreased revenue to the Company. Patients and salespeople are restricted in their movements resulting in a significant slowdown in the medical and other sectors. Fortunately, our Chinese distributor continues our strategy of multiple clinical studies in the major institution inBeijing in an array of brain related diseases. Very significant efforts and funds expended by our Chinese distributor has led to regulatory approval inChina in both depression and insomnia thus far which has allowed for sales of our devices inChina this year. The extent of future impact will depend on future developments, including future activities by the Chinese government and other possible events which are highly uncertain and not in the Company's control, including new information which may emerge concerning the spread and severity of COVID-19, or any of its variants, and actions taken to address its impact, among others. In addition, the spread of an infectious disease, including COVID-19, may also result in the inability of our suppliers to deliver components or raw materials on a timely basis. Such events may result in a period of business and manufacturing disruption, and in reduced operations, any of which could materially affect our business, financial condition and results of operations. The extent to which the coronavirus impacts our business will depend on future developments, which are highly uncertain and cannot be predicted, including new information which may emerge concerning the severity of COVID-19 and the actions to contain the coronavirus or treat its impact, among other things. 52
Potential Joint Venture; China Related Activities
InSeptember 2018 , we entered into an agreement withWider Come Limited , a company formed under the laws ofthe People's Republic of China ("Wider"), pursuant to which we and Wider have agreed to investigate the formation of a joint venture entity to be domiciled inHong Kong (the "potential Joint Venture") to conduct additional clinical research and implement a business distribution plan for our devices inChina ,Macau ,Hong Kong , andTaiwan . We do not have any existing operations inChina and will not in the future. We do have current distribution inChina through Wider, our potential Joint Venture partner. As of the date of this Annual Report on Form 10-K, (i) our operations are carried on outside of China; and (ii) the potential Joint Venture does not maintain any variable interest entity structure or operate any data center inChina . However, because of the intended formation of the potential Joint Venture, we may become subject to laws ofThe People's Republic of China (PRC or China) relating to, among other topics, data security and restrictions over foreign investments. Further, as a result of the complexity and vagaries of the legal system in the PRC and recent statements and regulatory actions by the PRC government relating to data security, our ability to operate the potential Joint Venture may be adversely affected or subject to change and adversely impact our ability to offer or continue to offer securities to investors, with the result that our securities may significantly decline or be worthless. There can be no assurance that regulators inChina will not take a contrary view or will not subsequently require us to undergo the approval procedures and subject us to penalties for non-compliance. InMarch 2022 , we entered into a second supplement to the Joint Venture agreement with Wider whereby the parties confirmed that the potential Joint Venture had not yet been established and is subject to further review and analysis of regulatory issues inChina andthe United States . Pursuant to the second supplement, the parties agreed to use their commercial efforts to complete documentation bySeptember 30, 2022 . In light of general economic conditions inChina andthe United States , the continued impact of regulatory issues within China andthe United States and trade and political issues between the two counties, the parties determined to further extend the time frame to complete establishment of the joint venture toSeptember 30, 2023 and entered into a Supplement 3 to the potential Joint Venture Agreement to memorialize such extension. The parties intend to continue to work together to complete the establishment prior to such extended time. Further, the parties agreed that all references within the Joint Venture agreements to funding and formation were amended fromDecember 21, 2018 to beSeptember 30, 2023 . We anticipate that the Joint Venture will be formed by the third quarter of 2023. However, that will be dependent on the situation at that time. When and if the Joint Venture is formed and Wider completes sales of our devices inChina on behalf of the potential Joint Venture, we believe that there are no regulatory or other restrictions that would restrict either (i) the transfer from China of any proceeds resulting from such sales by Wider to the potential Joint Venture inHong Kong , other than standard compliance with China'sState Administration of Foreign Exchange ("SAFE") policies and approval process, or (ii) our receipt of our share of such proceeds fromHong Kong to us inthe United States , which is not subject to SAFE's policies and approval process. The Company does not currently believe any of the Company's scientific data resulting from activities inChina by the potential Joint Venture would fall within the Measures for the Management of Scientific Data promulgated by theGeneral Office of the PRC State Council . In the event any existing or new laws or regulations or detailed implementations and interpretations are modified or promulgated, we and the potential Joint Venture will take all actions to remain in compliance with any such laws or regulations or detailed implementations and interpretations thereof. Neither we nor our potential Joint Venture Partner can at this point speak to any future changes in rules, regulations or the commercial and potentials situation that lies ahead which could affect the formation of the Joint Venture. In September of 2021, theChina National Medical Products Administration (NMPA), the equivalent of the United States FDA, approved the Gen-2 device for marketing and sale inChina for the treatment of insomnia and depression. These treatment indications and clearances from the NMPA have allowed Wider to market and sell the Gen-2 device inChina for the treatment of insomnia and depression. 53 Results of Operations
Comparison of the Years ended
Our financial results for the years endedDecember 31, 2022 and 2021 are summarized as follows: Years Ended December 31, December 31, 2022 2021 Change Change(1) $ % Revenues, net$ 1,321,357 $ 144,065 $ 1,177,292 817 % Cost of Revenues 363,212 21,442 341,770 1,594 % Gross profit 958,145 122,623 835,522 681 % Operating expenses: Professional fees 605,329 697,063 (91,734 ) (13 )% Salaries and benefits 694,108 228,738 465,370 203 % Selling, general and administrative 1,491,739 5,215,423
(3,723,684 ) (71 )% Total operating expenses 2,791,176 6,141,224 (3,350,048 ) (55 )% Loss from operations (1,883,031 ) (6,018,601 ) 4,185,570 (70 )% Other income (expense), net: Interest expense, net (59,382 ) (82,319 ) 22,937 28 % Other income 171,681 - 171,681 100 % PPP loan forgiveness 22,916 22,916 - -
Total other income (expense), net 135,215 (59,403
) 194,618 328 % Net loss (1,697,816 ) (6,078,004 ) 4,380,188 72 % Other comprehensive income:
Unrealized gain on short-term investments 36,313 -
36,313 100 % Comprehensive loss$ (1,661,503 ) $ (6,078,004 ) $ 4,416,501 73 %
(1) Percentages may not foot due to rounding.
Revenues
For the years endedDecember 31, 2022 and 2021, we generated$1,321,357 and$144,065 , respectively, of revenue primarily from the sale of devices, supplies and from the reimbursement of costs. In addition, we generated income from licensing and treatment fee agreements with our customers by charging a monthly licensing fee for the duration of the agreement. We also generated revenue from treatment fee agreements by collecting fees based on the number of treatments per month the customer performs. In addition, we derive revenue from equipment by selling electrodes and patient cables to customers for use with our device. The increase in revenue for 2022 compared to 2021 was primarily due to the sale of 221 devices in 2022. There were no sales of devices in 2021.
Cost of Revenues and Gross Profit
For the years endedDecember 31, 2022 and 2021, cost of revenues were$363,212 and$21,442 , respectively, yielding a gross profit of$958,145 and$122,623 , respectively, or 73% and 85%, respectively. Such decrease in gross margin was due to the change in our sources of revenue. In 2021 our revenue was from licensing fees and the sales of electrodes and patient cables. The licensing fees have no related costs. Our cost of revenue in 2021 included shipping supplies and the cost of the electrodes and patient cables. In 2022 our revenue was primarily from sales of equipment. The equipment has higher related costs of revenue and related shipping costs. 54 Operating Expenses Total operating expenses for the years endedDecember 31, 2022 and 2021 were$2,791,176 and$6,141,224 , respectively. The decrease was primarily due to the decrease of approximately$4,200,000 in stock-based compensation for the issuance of our common stock to various employees and consultants for services, and a decrease in professional fees for legal and accounting of approximately$100,000 offset by an increase in salaries and related expenses of approximately$465,000 , an increase in research and development costs of approximately$372,000 , an increase in consulting costs of approximately$80,000 , and an increase in insurance of approximately$88,000 . The decrease in legal and accounting fees are primarily due to the treatment of costs relating to our initial public offering as a direct cost of the offering. The increase in salary is primarily due to the hiring of our CFO, our Senior Vice President of Quality, Clinical and Regulatory, and other staff. The increases in research and development and consulting costs are attributable to the development of our Gen-2 and Gen-3 devices. The increase in insurance is a result of being a public company. Other Income (Expense), net
Other income (expense), net, as ofDecember 31, 2022 and 2021 were$135,215 and ($59,403 ), respectively, consisting of interest expense net of the PPP loan forgiveness, settlement income as a result of interest forgiveness, and interest and dividend income.
Liquidity and Capital Resources
Working Capital As of December 31, December 31, 2022 2021 Current Assets$ 7,425,462 $ 752,659 Current Liabilities 1,948,986 2,363,634 Working Capital$ 5,476,476 $ (1,610,975 )
Current assets increased for the year endedDecember 31, 2022 primarily as a result of the proceeds of the Initial Public Offering. Cash and cash equivalents decreased approximately$500,000 , Short-term investments increased approximately$6,800,000 , accounts receivable decreased approximately$10,000 , inventory increased approximately$125,000 and prepaid and other current assets increased approximately$230,000 . Current liabilities decreased for year endedDecember 31, 2022 primarily as a result of the reduction of accounts payable, settlement of accrued interest and a decrease in deferred revenue. Accounts payable decreased approximately$185,000 , accrued expenses decreased approximately$72,000 , lease liability - current portion increased approximately$10,000 , and deferred revenue decreased approximately$130,000 . Cash Flows
The following table summarizes our consolidated cash flows for the twelve months
ended
December 31 , December
31,
2022 2021
Net cash used in operating activities
-
Net cash provided by financing activities
Net cash used in operating activities was$2,215,699 for the year endedDecember 31, 2022 , as compared to$1,076,791 for the respective period in 2021, primarily due to the net loss of$1,697,816 and$6,078,004 , respectively, as well as increases in accounts payable, deferred revenue, prepaid assets and inventory. These amounts were also offset by$270,670 and$4,478,035 of stock compensation during the periods, respectively. 55
Net cash used in investing activities during the year ended
Net Cash Provided by Financing Activities
Net cash provided by financing activities during the year endedDecember 31, 2022 and 2021 was$8,511,543 and$1,660,133 , respectively, which was primarily due to the sale of common stock at IPO, for cash in 2022 and 2021.
Uses and Availability of Additional Funds
Our primary uses of capital are, and we expect will continue to be, compensation and related expenses, third-party clinical research and development services, manufacturing development costs, legal and other regulatory expenses, and general administrative costs. Although we have produced Gen-2, which is selling inChina where it is approved for certain utilizations by medical practitioners, the successful development of our future products is highly uncertain. At this time, we cannot reasonably estimate or know the nature, timing and estimated costs of the efforts that will be necessary to complete the clinical development of Gen-3 and obtain regulatory approvals. We are also unable to predict when, if ever, net cash inflows from revenues will enable us to be cash flow positive. This is due to the numerous risks and uncertainties associated with developing products, including, among others, the uncertainty of: ? successful enrollment in, and completion of clinical trials;
? performing preclinical studies and clinical trials in compliance with the FDA
or any comparable regulatory authority requirements;
? the ability of collaborators to manufacture sufficient quantity of product for
development, clinical trials and/ or potential commercialization;
? obtaining and maintaining patent, trademark and trade secret protection for
our products; ? making arrangements with third parties for manufacturing;
? scaling the commercial sales of products, if and when approved, whether alone
or in collaboration with others;
? acceptance of existing therapies, and future therapies, if and when approved,
by healthcare providers, physicians, clinicians, patients and third-party
payors; ? competing effectively with other therapies;
? obtaining and maintaining healthcare coverage and adequate reimbursement;
? protecting our rights in our intellectual property portfolio; and
? maintaining a continued acceptable safety profile of our products following
approval.
Liquidity and Capital Resources
AtDecember 31, 2022 , the Company had a significant accumulated deficit of$72.4 million . For the year endedDecember 31, 2022 , the Company had a loss from operations of$1.8 million and negative cash flows from operations of$2.2 million . The Company's operating activities consume the majority of its cash resources. The Company will continue to service existing customers inthe United States . The Company sold devices inChina to its acting distributor. The Company anticipates that it will continue to incur operating losses as it executes its development plans through 2023, as well as other potential strategic and business development initiatives. In addition, the Company has had and expects to have negative cash flows from operations, at least into the near future. The Company previously funded these losses primarily through the sale of equity and issuance of convertible notes. The accompanying audited consolidated financial statements do not include any adjustments that might be necessary should the Company be unable to continue as a going concern. As of the year endedDecember 31, 2022 , the Company had cash and cash equivalents on hand of$162,743 and short-term investments of$6,831,192 . 56
At the closing onSeptember 16, 2022 , the Company sold 2,315,000 Units and 347,250 of Warrants in an Initial Public Offering (the "Initial Public Offering") at a price of$4.15 per Unit and$0.01 per Warrant for a total of$9,610,723 . The Company incurred offering costs of$1,067,078 , consisting of$878,858 of underwriting fees and expenses and$188,220 of costs related to the Initial Public Offering. Although no assurances can be given as to the Company's ability to deliver on its revenue plans or that unforeseen expenses may arise, management has evaluated the significance of the conditions and has concluded that because of the completion of our initial public offering inSeptember 2022 , the Company has sufficient cash and investments on hand to satisfy its anticipated cash requirements for the next twelve months from the issuance date of these financial statements.
Critical Accounting Policies and Significant Judgments and Estimates
Our audited consolidated financial statements are prepared in accordance with generally accepted accounting principles inthe United States . The preparation of our audited consolidated financial statements and related disclosures requires us to make estimates and judgments that affect the reported amounts of assets, liabilities, costs and expenses, and the disclosure of contingent assets and liabilities in our audited consolidated financial statements. We base our estimates on historical experience, known trends and events and various other factors that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. We evaluate our estimates and assumptions on an ongoing basis. Our actual results may differ from these estimates under different assumptions or conditions. While our significant accounting policies are described in more detail in Note 3 to our consolidated financial statements appearing elsewhere in this Form 10-K, we believe that the following accounting policies are those most critical to the judgments and estimates used in the preparation of our consolidated financial statements. Revenue Recognition The Company recognizes revenue when its performance obligations with its customers have been satisfied. At contract inception, the Company determines if the contract is within the scope of ASC Topic 606 and then evaluates the contract using the following five steps: (1) identify the contract with the customer; (2) identify the performance obligations; (3) determine the transaction price; (4) allocate the transaction price to the performance obligations; and (5) recognize revenue when (or as) the entity satisfies a performance obligation. The Company only recognizes revenue to the extent that it is probable that a significant revenue reversal will not occur in a future period. The Company has existing licensing and treatment fee agreements with its customers for the use of the Nexalin Device in their practices. These agreements generally have terms of one year with automatic renewal if certain requirements are met and amounts due per these agreements are billed monthly. The Company also sells products related to the provision of services. The Company sells its Devices inChina to its acting distributor and sells products relating to the use of the Devices. The Company has a Royalty Agreement whereby the manufacturer of the Company's electrodes will pay a royalty to the Company for a three year period beginningJanuary 1, 2022 . The amount of the Royalty is equal to 20% of the amount that the manufacturer invoices to the acting distributor for the
sale of the electrodes. Revenue Streams The Company derives revenues from its license agreements by charging a monthly licensing fee for the duration of the agreement. The Company derives revenues from equipment by selling additional individual electrodes and patient cables to customers for use with the Nexalin Device. The Company receives revenue from the sale inChina of its Devices to its acting distributor and from the sale of products relating to the use of those Devices. The Company derives revenue as a royalty fee from the China-based manufacturer for electrodes ordered in connection with the Company's China sales.
Performance Obligations
Management identified that subsequent licensing revenue has one performance obligation. That performance obligation is satisfied as long as the licensing contract remains valid and is not terminated. The licensing revenue is invoiced monthly and is recognized at a point in time in which the invoice is sent to the customer. 57 Management identified that our equipment revenue has one performance obligation. That performance obligation is satisfied when the electrodes and devices are shipped to the customer. We do not offer a warranty on the electrodes or devices.
Management identified that treatment fee revenue has one performance obligation. The performance obligation is satisfied upon the completion of individual treatments on patients by customers.
Management identified that our royalty fee has one performance obligation. The performance obligation is satisfied as long as the royalty agreement remains valid and is not terminated. The royalty revenue is invoiced when the manufacturer advises the Company that the invoice has been sent to the customer.
Practical Expedients
As part of ASC 606, the Company has adopted several practical expedients including:
? Significant Financing Component - we do not adjust the promised amount of
consideration for the effects of a significant financing component since we
expect, at contract inception, that the period between when we transfer a
promised goods or services to the customer and when the customer pays for that
service will be one year or less.
? Unsatisfied Performance Obligations -for all performance obligations related
to contracts with a duration of less than one year, we have elected to apply
the optional exemption provided in ASC Topic 606 and therefore, are not
required to disclose the aggregate amount of the transaction price allocated
to performance obligations that are unsatisfied or partially unsatisfied at
the end of the reporting period.
? Shipping and Handling Activities - we elected to account for shipping and
handling activities as a fulfilment cost rather than as a separate performance
obligation.
? Right to invoice - we have the right to consideration from a customer in an
amount that corresponds directly with the value to the customer of our
performance completed to date we may recognize revenue in the amount to which
the entity has a right to invoice.
Recent Accounting Pronouncements
InNovember 2021 , the FASB issued ASU 2021-10, Government Assistance (Topic 832). ASU 2021-10 and its amendments will be effective for the Company for interim and annual periods in fiscal years beginning afterDecember 15, 2021 . The Company believes the disclosure requirements related to governmental assistance have been appropriately made, specifically pertaining to PPP Loans that were forgiven by the government in 2021. The total impact of the forgiveness on the consolidated financial statements was immaterial. 58
InFebruary 2020 , the FASB issued ASU 2020-02, Financial Instruments-Credit Losses (Topic 326) and Leases (Topic 842) - Amendments to SEC Paragraphs Pursuant toSEC Staff Accounting Bulletin No. 119 and Update to SEC Section on Effective Date Related to Accounting Standards Update No. 2016-02, Leases (Topic 842), which amends the effective date of the original pronouncement for smaller reporting companies. ASU 2016-13 and its amendments will be effective for the Company for interim and annual periods in fiscal years beginning afterDecember 15, 2022 . The Company believes the adoption will modify the way the Company analyzes financial instruments, but it does not anticipate a material impact on results of operations. The Company is in the process of determining the effects adoption will have on its audited consolidated financial statements.
All other newly issued but not yet effective accounting pronouncements have been deemed to be not applicable or immaterial to the Company.
Factors That May Affect Future Results and Financial Condition
The information contained under the caption "Risk Factors" beginning on page 15 of this Form 10-K provides examples of risks, uncertainties and events that may cause our actual results to differ materially from the expectations we describe in our forward-looking statements. Readers should be aware that the occurrence of any of the events described in these risk factors could have a material adverse effect on our business, results of operations and financial condition. We undertake no obligation to update or revise publicly any forward-looking statements, whether as a result of new information, future events, or otherwise.
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