8-K
American Well Corp false 0001393584 0001393584 2022-02-24 2022-02-24

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): February 24, 2022

 

 

AMERICAN WELL CORPORATION

(Exact Name of Registrant as Specified in its Charter)

 

 

 

Delaware   001-39515   20-5009396

(State or other jurisdiction

of incorporation)

 

(Commission

File Number)

 

(I.R.S. Employer

Identification No.)

 

75 State Street, 26th Floor

Boston, MA

  02109
(Address of Principal Executive Offices)   (Zip Code)

Registrant’s telephone number, including area code: (617) 204-3500

Not Applicable

(Former name or former address, if changed since last report)

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):

 

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Securities Exchange Act of 1934:

 

Title of each class

 

Trading

symbol(s)

 

Name of each exchange

on which registered

Class A Common Stock, $0.01 Par Value   AMWL   New York Stock Exchange

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (17 CFR §230.405) or Rule 12b-2 of the Securities Exchange Act of 1934 (17 CFR §240.12b-2).

Emerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

 

 

 


Item 2.02.

Results of Operations and Financial Condition.

On February 24, 2022, American Well Corporation issued a press release announcing its financial results for the fourth quarter and full year ended December 31, 2021. A copy of the press release is furnished as Exhibit 99.1 to this Form 8-K and is incorporated by reference herein.

The information contained in this Item 2.02 and Exhibit 99.1 attached hereto shall not be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference in such filing.    

 

Item 9.01.

Financial Statements and Exhibits

(d) Exhibits. The following exhibit is being filed herewith:

 

99.1    Press Release, dated February 24, 2022, issued by American Well Corporation.
104    Cover Page Interactive Data File (embedded within the Inline XBRL document).


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

Date: February 24, 2022

 

AMERICAN WELL CORPORATION
By:  

/s/ Bradford Gay

  Bradford Gay
  Senior Vice President & General Counsel

Exhibit 99.1

 

Amwell® Announces Results for Fourth Quarter 2021 and Full Year 2021

 

   

Total 2021 revenue of $252.8 million

 

   

Gross margins of 41% for full year

 

   

Total visits of 5.8 million

 

   

Total active providers of approximately 91,000 at year end versus 80,000 last quarter and 72,000 last year

 

   

Provides initial 2022 guidance

BOSTON, February 24, 2021 /BusinessWire/ — Amwell® (NYSE: AMWL) (the “Company”), a leading enterprise software company enabling digital delivery of care for healthcare’s key stakeholders, today announced financial results for the fourth quarter and full year ended December 31, 2021.

“Our fourth quarter marks a strong end to a strategic year. We continue to make meaningful progress on the launch and implementation of Converge, our scalable, omnichannel platform designed to enable trusted healthcare players to deliver the next-generation of care and enhance their ability to meet their strategic, operational, financial and clinical objectives. Feedback has been strong, and is demonstrated by a record number of active providers on the platform and recent recognition from industry leaders,” said Dr. Ido Schoenberg, Chairman and CEO.

Dr. Schoenberg continued, “During 2022, we expect to complete the build out of Converge and begin to normalize our recent Converge-related R&D expenditures. We will also strive to resume our bookings momentum as we migrate existing customers to the platform, incorporate new modules of care, and drive new customer bookings. We believe this will result in a mix shift to margin rich revenue growth and ultimately, EBITDA profitability.”

Fourth Quarter 2021 Financial Highlights:

All comparisons, unless otherwise noted, are to the three months ended December 31, 2020.

 

   

Total Revenue was $72.8 million, compared to $60.4 million

 

   

Subscription revenue was $30.1 million, compared to $26.3 million

 

   

Visit revenue was $31.2 million, compared to $26.2 million

 

   

Gross margin was 39.9%, compared to 37.4%

 

   

Net loss was ($47.9) million, compared to ($50.6) million

 

   

Adjusted EBITDA was ($41.1) million, compared to ($35.4) million

 

   

Total active providers were ~91,000, compared to ~80,000 last quarter

 

   

Total visits were ~1.5 million, compared to ~1.4 million last quarter


Full Year 2021 Financial Highlights:

All comparisons, unless otherwise noted, are to the full year ended December 31, 2020.

 

   

Total visits were ~5.8 million, compared to ~5.9 million

 

   

AMG visits were ~1.4 million or 24% of total visits, compared to ~1.6 million or 27% of total visits

 

   

Total Revenue was $252.8 million, compared to $245.3 million

 

   

Subscription revenue was $108.3 million, compared to $98.4 million

 

   

Visit revenue was $116.6 million, compared to $117.2 million

 

   

Average number of health plans clients of 58 and average number of health system clients of 154

 

   

Average contract values increased from $334,000 to $356,000 for Health Systems and from $612,000 to $723,000 for Health Plans

 

   

AMG Revenue per visit increased from $73 to $82

 

   

Gross margin was 41.3%, compared to 36.1%

 

   

Net loss was $176.8 million, compared to $228.6 million

 

   

Adjusted EBITDA was ($122.7) million, compared to ($92.7) million

 

   

Cash and short-term securities as of quarter-end were approximately $746.4 million

Financial Outlook

The Company is providing the initial outlook for 2022 and expects:

 

   

Revenue between $275 and $285 million

 

   

AMG visits between 1.4 and 1.5 million

 

   

Adjusted EBITDA between ($200) million and ($190) million

Quarterly Conference Call Details

The company will host a conference call to review the results today, Thursday, February 24, 2022 at 5:00 p.m. E.T. to discuss its financial results. The call can be accessed via a line audio webcast at https://investors.amwell.com or by dialing 1-888-510-2008 for U.S. participants, or 1-646-960-0306 for international participants, referencing conference ID #7830032. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days.

About Amwell

Amwell is a leading enterprise software company enabling digital delivery of care for healthcare’s key stakeholders in the United States and globally, connecting and enabling providers, insurers, patients, and innovators to deliver greater access to more affordable, higher quality care. Amwell believes that digital care delivery will transform healthcare. The Company offers a single, comprehensive platform to support all telehealth needs from urgent to acute and post-acute care, as well as chronic care management and healthy living. With over a decade of experience, Amwell powers the digital care programs of over 55 health plans, which collectively represent more than 80 million covered lives, as well as approximately 150 of the nation’s largest health systems, encompassing more than 2,000 hospitals. For more information, please visit https://business.amwell.com.


American Well, Amwell, Converge, and Carepoint are registered trademarks or trademarks of American Well Corporation in the United States and other countries. All other trademarks used herein are the property of their respective owners.

Forward-Looking Statements

This press release contains forward-looking statements about us and our industry that involve substantial risks and uncertainties and are based on our beliefs and assumptions and on information currently available to us. All statements other than statements of historical facts contained in this press release, including statements regarding our future results of operations, financial condition, business strategy and plans and objectives of management for future operations, are forward-looking statements. In some cases, you can identify forward-looking statements because they contain words such as “anticipate,” “believe,” “could,” “estimate,” “expect,” “intend,” “may,” “plan,” “potential,” “predict,” “project,” “should,” “will,” or “would,” or the negative of these words or other similar terms or expressions.

Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. Forward-looking statements represent our beliefs and assumptions only as of the date of this release. These statements, and related risks, uncertainties, factors and assumptions, include, but are not limited to: weak growth and increased volatility in the telehealth market; inability to adapt to rapid technological changes; increased competition from existing and potential new participants in the healthcare industry; changes in healthcare laws, regulations or trends and our ability to operate in the heavily regulated healthcare industry; our ability to comply with federal and state privacy regulations; the significant liability that could result from a cybersecurity breach; and other factors described under ‘Risk Factors’ in our most recent form 10-K filed with the SEC. These risks are not exhaustive. Except as required by law, we assume no obligation to update these forward-looking statements, or to update the reasons actual results could differ materially from those anticipated in the forward-looking statements, even if new information becomes available in the future. Further information on factors that could cause actual results to differ materially from the results anticipated by our forward-looking statements is included in the reports we have filed or will file with the Securities and Exchange Commission. These filings, when available, are available on the investor relations section of our website at investors.amwell.com and on the SEC’s website at www.sec.gov.

Media Contact:

Lindsay Sharifipour

press@amwell.com

508-494-3422

Investor Contact:

Asher Dewhurst

investors@amwell.com


AMERICAN WELL CORPORATION

CONSOLIDATED BALANCE SHEETS

(In thousands, except share and per share amounts)

 

     As of December 31,  
     2021     2020  

Assets

    

Current assets:

    

Cash and cash equivalents

   $ 746,416     $ 941,616  

Investments

     —         99,963  

Restricted cash

     —         1,095  

Accounts receivable ($2,054 and $12,053, from related parties and net of allowances of $1,809 and $1,556, respectively)

     51,375       45,296  

Inventories

     7,530       9,128  

Deferred contract acquisition costs

     1,697       2,134  

Prepaid expenses and other current assets

     20,278       14,055  
  

 

 

   

 

 

 

Total current assets

     827,296       1,113,287  

Restricted cash

     795       —    

Property and equipment, net

     2,235       3,836  

Goodwill

     442,761       193,877  

Intangibles assets, net

     152,409       55,528  

Operating lease right-of-use asset

     16,422       6,609  

Deferred contract acquisition costs, net of current portion

     2,028       1,327  

Other assets

     1,722       1,430  

Investment in minority owned joint venture

     168       752  
  

 

 

   

 

 

 

Total assets

   $ 1,445,836     $ 1,376,646  
  

 

 

   

 

 

 

Liabilities and Stockholders’ Equity

    

Current liabilities:

    

Accounts payable

   $ 12,156     $ 5,797  

Accrued expenses and other current liabilities

     58,711       42,135  

Operating lease liability, current

     1,918       6,357  

Deferred revenue ($1,860 and $14,421 from related parties, respectively)

     68,841       66,693  
  

 

 

   

 

 

 

Total current liabilities

     141,626       120,982  

Other long-term liabilities

     5,136       64  

Contingent consideration liabilities, net of current portion

     16,450       —    

Operating lease liability, net of current portion

     14,694       1,296  

Deferred revenue, net of current portion ($22 and $486 from related parties, respectively)

     7,055       8,107  
  

 

 

   

 

 

 

Total liabilities

     184,961       130,449  
  

 

 

   

 

 

 

Commitments and contingencies

    

Stockholders’ equity:

    

Preferred stock, $0.01 par value; 100,000,000 shares authorized, no shares issued or outstanding as of December 31, 2021 and as of December 31, 2020

     —         —    

Common stock, $0.01 par value; 1,000,000,000 Class A shares authorized, 229,402,453 and 201,488,097 shares issued, and 229,402,453 and 200,751,168 shares outstanding, respectively; 100,000,000 Class B shares authorized, 26,913,579 and 30,427,128 shares issued, and 26,913,579 and 29,297,382 shares outstanding, respectively; 200,000,000 Class C shares authorized 5,555,555 issued and outstanding as of December 31, 2021 and December 31, 2020

     2,620       2,357  

Treasury stock, no shares and 1,866,675 shares as of December 31, 2021 and December 31, 2020, respectively

     —         (37,568

Additional paid-in capital

     2,054,275       1,841,405  

Accumulated other comprehensive income

     (6,353     297  

Accumulated deficit

     (811,284     (582,359
  

 

 

   

 

 

 

Total American Well Corporation stockholders’ equity

     1,239,258       1,224,132  

Non-controlling interest

     21,617       22,065  
  

 

 

   

 

 

 

Total stockholders’ equity

     1,260,875       1,246,197  
  

 

 

   

 

 

 

Total liabilities and stockholders’ equity

   $ 1,445,836     $ 1,376,646  
  

 

 

   

 

 

 


CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS

(in thousands, except share and per share amounts)

(unaudited)

 

     Three Months Ended December 31     Years Ended December 31,  
     2021     2020     2021     2020  

Revenue

   $ 72,750     $ 60,432     $ 252,789     $ 245,265  

Costs and operating expenses:

        

Costs of revenue, excluding depreciation and amortization of intangible assets

     43,696       37,821       148,474       156,790  

Research and development

     33,777       26,564       106,594       84,412  

Sales and marketing

     21,263       15,117       66,154       55,095  

General and administrative

     14,678       27,709       94,624       166,246  

Depreciation and amortization expense

     6,759       2,782       16,089       10,153  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total costs and operating expenses

     120,173       109,993       431,935       472,696  
  

 

 

   

 

 

   

 

 

   

 

 

 

Loss from operations

     (47,423     (49,561     (179,146     (227,431

Interest income and other income (expense), net

     217       222       120       1,632  
  

 

 

   

 

 

   

 

 

   

 

 

 

Loss before benefit (expense) from income taxes and loss from equity method investment

     (47,206     (49,339     (179,026     (225,799

Benefit (expense) from income taxes

     334       (309     5,376       (639

Loss from equity method investment

     (1,037     (938     (3,132     (2,188
  

 

 

   

 

 

   

 

 

   

 

 

 

Net loss

     (47,909     (50,586     (176,782     (228,626
  

 

 

   

 

 

   

 

 

   

 

 

 

Net (loss) income attributable to non-controlling interest

     (116     (274     (448     (4,194
  

 

 

   

 

 

   

 

 

   

 

 

 

Net loss attributable to American Well Corporation

   $ (47,793)     $ (50,312)     $ (176,334)     $ (224,432)  

Net loss per share attributable to common stockholders, basic and diluted(1)

   $ (0.18)     $ (0.21)     $ (0.69)     $ (2.27)  

Weighted-average common shares outstanding, basic and diluted

     266,034,717       240,664,561       254,068,942       99,044,312  


CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(in thousands, except share and per share amounts)

(unaudited)

 

     Years Ended December 31,  
     2021     2020     2019  

Cash flows from operating activities:

      

Net loss

   $ (176,782   $ (228,626   $ (88,366

Adjustments to reconcile net loss to net cash used in operating activities:

      

Depreciation and amortization expense

     16,089       10,153       7,761  

Provisions for credit losses

     714       1,646       717  

Amortization of deferred contract acquisition costs

     1,971       1,410       1,062  

Amortization of deferred contract fulfillment costs

     737       852       707  

Noncash compensation costs incurred by selling shareholders

     2,753       —          —     

Stock-based compensation expense

     43,809       118,358       12,135  

Loss on equity method investment

     3,132       2,188       —     

Deferred income taxes

     (6,245     —          (1,388

Changes in operating assets and liabilities, net of acquisition:

      

Accounts receivable

     (512     (14,212     803  

Inventories

     1,598       (6,024     (592

Deferred contract acquisition costs

     (2,235     (2,102     (1,217

Prepaid expenses and other current assets

     (5,775     (5,990     (2,698

Other assets

     117       122       (977

Accounts payable

     5,546       (707     1,158  

Accrued expenses and other current liabilities

     (380     12,887       5,851  

Other long-term liabilities

     (16,705     (245     (699

Deferred revenue

     (9,369     (2,174     (16,149
  

 

 

   

 

 

   

 

 

 

Net cash used in operating activities

     (141,537     (112,464     (81,892
  

 

 

   

 

 

   

 

 

 

Cash flows from investing activities:

      

Purchases of property and equipment

     (559     (3,318     (1,338

Investment in less than majority owned joint venture

     (2,548     (2,940     —     

Purchases of investments

     —          (159,608     (78,946

Proceeds from sales and maturities of investments

     100,000       99,109       246,033  

Acquisitions of business, net of cash acquired

     (156,526     —          (45,750
  

 

 

   

 

 

   

 

 

 

Net cash (used in) provided by investing activities

     (59,633     (66,757     119,999  
  

 

 

   

 

 

   

 

 

 

Cash flows from financing activities:

      

Proceeds from issuance of Series C convertible preferred stock, net of issuance costs

     —          146,014       45,761  

Proceeds from exercise of common stock options

     20,806       5,932       1,036  

Proceeds from employee stock purchase plan

     1,599       —          —     

Payments for the purchase of treasury stock

     (15,038     (37,568     (158

Proceeds from issuance of common stock in initial public offering, net of underwriting costs and commissions

     —          772,931       —     

Proceeds from the issuance of common stock to Google, net of issuance costs

     —          99,100       —     

Payment of deferred offering costs

     (1,613     (3,293     —     
  

 

 

   

 

 

   

 

 

 

Net cash provided by financing activities

     5,754       983,116       46,639  
  

 

 

   

 

 

   

 

 

 

Effect of exchange rates changes on cash, cash equivalents, and restricted cash

     (84     —          —     
  

 

 

   

 

 

   

 

 

 

Net (decrease) increase in cash, cash equivalents, and restricted cash

     (195,500     803,895       84,746  

Cash, cash equivalents, and restricted cash at beginning of period

     942,711       138,816       54,070  
  

 

 

   

 

 

   

 

 

 

Cash, cash equivalents, and restricted cash at end of period

   $ 747,211     $ 942,711     $ 138,816  
  

 

 

   

 

 

   

 

 

 

Cash, cash equivalents, and restricted cash at end of period:

      

Cash and cash equivalents

     746,416       941,616       137,673  

Restricted cash

     795       1,095       1,143  
  

 

 

   

 

 

   

 

 

 

Total cash, cash equivalents, and restricted cash at end of period

   $ 747,211     $ 942,711     $ 138,816  
  

 

 

   

 

 

   

 

 

 

Supplemental disclosure of cash flow information:

      

Cash paid for income taxes

   $ 1,587     $ 713     $ 193  

Supplemental disclosure of non-cash investing and financing activities:

      

Series C preferred stock issued in connection with Aligned acquisition

   $ —        $ —        $ 34,250  

Issuance of common stock in acquisitions

   $ 144,107     $ —        $ —     

Unsettled issuance of Series C preferred stock

   $ —        $ —        $ 75  

Receivable related to exercise of common stock options

   $ 74     $ —        $ —     

Common stock issuance costs in accrued expenses

   $ —        $ 1,613     $ —     


Non-GAAP Financial Measures:

To supplement our financial information presented in accordance with generally accepted accounting principles in the United States, of US GAAP, we use adjusted EBITDA, which is a non-U.S GAAP financial measure to clarify and enhance an understanding of past performance. We believe that the presentation of adjusted EBITDA enhances an investor’s understanding of our financial performance. We further believe that adjusted EBITDA is a 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. We utilize adjusted EBITDA as the primary measure of our performance.

We calculate adjusted EBITDA as net loss adjusted to exclude (i) interest income and other income, net, (ii) tax benefit and expense, (iii) depreciation and amortization, (iv) stock-based compensation expense, (v) public offering expenses, (vi) acquisition-related income and expenses, (vii) litigation expenses related to the defense of our patents in the patent infringement claim filed by Teladoc and (viii) other items affecting our results that we do not view as representative of our ongoing operations, including direct and incremental expenses associated with the COVID-19 pandemic.

We believe adjusted EBITDA is a commonly used by investors to evaluate our performance and that of our competitors. However, our use of the term adjusted EBITDA may vary from that of others in our industry. Adjusted EBITDA should not be considered as an alternative to net loss before taxes, net loss, loss per share or any other performance measures derived in accordance with U.S. GAAP as measures of performance.

Adjusted EBITDA has important limitations as an analytical tool and you should not consider it in isolation or as a substitute for analysis of our results as reported under U.S. GAAP. Some of the limitations of adjusted EBITDA include (i) adjusted EBITDA does not properly reflect capital commitments to be paid in the future, and (ii) although depreciation and amortization are non-cash charges, the underlying assets may need to be replaced and adjusted EBITDA does not reflect these capital expenditures. Our public offering and acquisition-related expenses, including legal, accounting and other professional expenses, reflect cash expenditures and we expect such expenditures to recur from time to time. Our adjusted EBITDA may not be comparable to similarly titled measures of other companies because they may not calculate adjusted EBITDA in the same manner as we calculate the measure, limiting its usefulness as a comparative measure.

In evaluating adjusted EBITDA, you should be aware that in the future we will incur expenses similar to the adjustments in this presentation. Our presentation of adjusted EBITDA should not be construed as an inference that our future results will be unaffected by these expenses or any unusual or non-recurring items. Adjusted EBITDA should not be considered as an alternative to loss before benefit from income taxes, net loss, earnings per share, or any other performance measures derived in accordance with U.S. GAAP. When evaluating our performance, you should consider adjusted EBITDA alongside other financial performance measures, including our net loss and other GAAP results.

Other than with respect to GAAP Revenue, the Company only provides guidance on a non-GAAP basis. The Company does not provide a reconciliation of forward-looking Adjusted EBITDA (non-GAAP) to GAAP net income (loss), due to the inherent difficulty in forecasting and quantifying certain amounts that are necessary for such reconciliation because other deductions (such as COVID expenses and acquisition related expenses) used to calculate projected net income (loss) vary dramatically based on actual events, the Company is not able to forecast on a GAAP basis with reasonable certainty all deductions needed in order to provide a GAAP calculation of projected net income (loss) at this time. The amount of these deductions may be material and, therefore, could result in projected GAAP net income (loss) being materially less than projected Adjusted EBITDA (non-GAAP).


The following table presents a reconciliation of adjusted EBITDA from the most comparable GAAP measure, net loss, for the three months ended and full year ended December 31, 2021 and 2020:

 

     Three Months Ended
December 31
    Years Ended
December 31,
 

(in thousands)

     2021       2020       2021       2020  
  

 

 

   

 

 

   

 

 

   

 

 

 

Net loss

   $ (47,909)     $ (50,586   $ (176,782   $ (228,626

Add:

        

Depreciation and amortization

     6,759       2,782       16,089       10,153  

Interest and other income, net

     (217     (222     (120     (1,632

Benefit (expense) from income taxes

     (334     309       (5,376     639  

Stock-based compensation

     12,053       11,842       43,809       118,358  

Public offering expenses(2)

     —          —          1,223       2,039  

Acquisition-related (income) expenses

     —          —          7,289       (48

Noncash expenses and contingent consideration adjustments(3)

     (11,704     —          (10,987     —     

COVID-19-related expenses(1)

     —          143             6,076  

Litigation expense

     264       352       2,182       352  
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA

   $ (41,088)     $ (35,380   $ (122,673   $ (92,689
  

 

 

   

 

 

   

 

 

   

 

 

 

 

(1)

COVID-19-related expenses include non-recurring provider bonus payments, emergency hosting licensing fees and non-medical provider temporary labor costs related to on-boarding non-AMG providers incurred in response to the initial outbreak of the COVID-19 virus as Amwell attempted to scale quickly to meet unusually high patient and non-AMG provider demand.

(2)

Public offering expenses include non-recurring expenses incurred in relation to our initial public offering for the year ended December 31, 2020, and our secondary offering for the year ended December 31, 2021.

(3)

Noncash expenses and contingent consideration adjustments include, noncash compensation costs incurred by selling shareholders and adjustments made to the contingent consideration.