RadNet (RDNT) 10-Q 10 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	May 06, 2019
Document and Entity Information
Entity Registrant Name	RadNet, Inc.
Entity Central Index Key	0000790526
Document Type	10-Q
Trading Symbol	RDNT
Document Period End Date	Mar. 31, 2019
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Current Reporting Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		50,079,978
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2019

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
CURRENT ASSETS
Cash and cash equivalents	$ 10,428	$ 10,389
Accounts receivable	156,767	148,919
Due from affiliates	619	595
Prepaid expenses and other current assets	46,276	46,288
Assets held for sale	2,041	2,499
Total current assets	216,131	208,690
PROPERTY, EQUIPMENT AND RIGHT-OF-USE ASSETS
Property and equipment, net	343,964	345,729
Operating lease right-of-use assets	403,066
Total property, equipment and right-of-use assets	747,030	345,729
OTHER ASSETS
Goodwill	424,308	418,093
Other intangible assets	40,872	40,593
Deferred financing costs	1,218	1,354
Investment in joint ventures	39,712	37,973
Deferred tax assets, net of current portion	31,952	31,506
Deposits and other	24,845	25,392
Total assets	1,526,068	1,109,330
CURRENT LIABILITIES
Accounts payable, accrued expenses and other	177,659	181,028
Due to affiliates	17,583	13,089
Deferred revenue	1,958	2,398
Current portion of deferred rent	0	3,735
Current finance lease liability	4,936
Current operating lease liability	64,538
Current portion of notes payable	33,912	33,653
Current portion of obligations under capital leases	0	5,614
Total current liabilities	300,586	239,517
LONG-TERM LIABILITIES
Deferred rent, net of current portion	0	31,542
Long-term finance lease liability	5,663
Long-term operating lease liability	375,363
Notes payable, net of current portion	630,874	626,507
Obligations under capital lease, net of current portion	0	6,505
Other non-current liabilities	44	5,006
Total liabilities	1,312,530	909,077
EQUITY
Common stock - $.0001 par value, 200,000,000 shares authorized; 50,081,478 and 48,977,485 shares issued and outstanding at March 31, 2019 and December 31, 2018, respectively	5	5
Additional paid-in-capital	256,488	242,835
Accumulated other comprehensive income	1,055	2,259
Accumulated deficit	(121,648)	(117,915)
Total RadNet, Inc.'s stockholders' equity	135,900	127,184
Noncontrolling interests	77,638	73,069
Total equity	213,538	200,253
Total liabilities and equity	$ 1,526,068	$ 1,109,330

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - $ / shares	Mar. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Common stock - par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock - shares authorized (in shares)	200,000,000	200,000,000
Common stock - shares issued (in shares)	50,081,478	48,977,485
Common stock - shares outstanding (in shares)	50,081,478	48,977,485

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
REVENUE
Total revenue	$ 271,549	$ 231,392
OPERATING EXPENSES
Cost of operations, excluding depreciation and amortization	243,057	215,634
Depreciation and amortization	19,620	17,856
Loss (gain) on sale and disposal of equipment	971	(1,936)
Severance costs	631	726
Total operating expenses	264,279	232,280
INCOME (LOSS) FROM OPERATIONS	7,270	(888)
OTHER INCOME AND EXPENSES
Interest expense	12,295	10,039
Equity in earnings of joint ventures	(1,873)	(2,977)
Other expenses	0	1
Total other expenses	10,422	7,063
LOSS BEFORE INCOME TAXES	(3,152)	(7,951)
Benefit from income taxes	1,230	2,497
NET LOSS	(1,922)	(5,454)
Net income attributable to noncontrolling interests	1,811	1,884
NET LOSS ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS	$ (3,733)	$ (7,338)
BASIC NET INCOME PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS (in dollars per share)	$ (0.08)	$ (0.15)
DILUTED NET INCOME PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS (in dollars per share)	$ (0.08)	$ (0.15)
WEIGHTED AVERAGE SHARES OUTSTANDING Basic and Diluted (in shares)	49,553,694	47,822,618
Service fee revenue
REVENUE
Service fee revenue, net of contractual allowances and discounts	$ 242,672	$ 204,168
Revenue under capitation arrangements
REVENUE
Service fee revenue, net of contractual allowances and discounts	$ 28,877	$ 27,224

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Statement of Comprehensive Income [Abstract]
Net loss	$ (1,922)	$ (5,454)
Foreign currency translation adjustments	(8)	22
Change in fair value of cash flow hedge, net of taxes	(1,196)
Change in fair value of cash flow hedge, net of taxes		3,095
COMPREHENSIVE LOSS	(3,126)	(2,337)
Less comprehensive income attributable to noncontrolling interests	1,811	1,884
COMPREHENSIVE LOSS ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS	$ (4,937)	$ (4,221)

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENT OF STOCKHOLDERS' EQUITY (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit	Total Radnet, Inc.'s Equity	Noncontrolling Interests
Beginning balance (in shares) at Dec. 31, 2017		47,723,915
Beginning balance, value at Dec. 31, 2017	$ 69,925	$ 5	$ 212,261	$ (548)	$ (150,158)	$ 61,560	$ 8,365
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation (in shares)		0
Stock-based compensation	3,643		3,643			3,643
Issuance of restricted stock and other awards (in shares)		512,701
Sale of noncontrolling interests, net of taxes	45,895		18,663			18,663	27,232
Distributions paid to noncontrolling interests	(759)						(759)
Change in cumulative foreign currency translation adjustment	22			22		22
Change in fair value of cash flow hedge, net of taxes	3,095			3,095		3,095
Net loss	(5,454)				(7,338)	(7,338)	1,884
Ending balance (in shares) at Mar. 31, 2018		48,236,616
Ending balance, value at Mar. 31, 2018	116,367	$ 5	234,567	2,569	(157,496)	79,645	36,722
Beginning balance (in shares) at Dec. 31, 2017		47,723,915
Beginning balance, value at Dec. 31, 2017	69,925	$ 5	212,261	(548)	(150,158)	61,560	8,365
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Change in fair value of cash flow hedge, net of taxes	2,876
Ending balance (in shares) at Dec. 31, 2018		48,977,485
Ending balance, value at Dec. 31, 2018	200,253	$ 5	242,835	2,259	(117,915)	127,184	73,069
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock upon exercise of options (in shares)		10,000
Issuance of common stock upon exercise of options	50		50			50
Stock-based compensation (in shares)		586,000
Stock-based compensation	4,514		4,514			4,514
Issuance of restricted stock and other awards (in shares)		67,786
Issuance of common stock for purchase of membership interest (in shares)		440,207
Issuance of common stock for purchase of membership interest in HVRA	6,000		6,000			6,000
Sale of noncontrolling interests, net of taxes	5,097		3,089			3,089	2,008
Contribution from noncontrolling partner	750						750
Change in cumulative foreign currency translation adjustment	(8)			(8)		(8)
Change in fair value of cash flow hedge, net of taxes	(1,196)			(1,196)		(1,196)
Net loss	(1,922)				(3,733)	(3,733)	1,811
Ending balance (in shares) at Mar. 31, 2019		50,081,478
Ending balance, value at Mar. 31, 2019	$ 213,538	$ 5	$ 256,488	$ 1,055	$ (121,648)	$ 135,900	$ 77,638

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)	Feb. 27, 2019	Jan. 06, 2017	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Feb. 28, 2019
CASH FLOWS FROM OPERATING ACTIVITIES
Net loss			$ (1,922,000)	$ (5,454,000)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization			19,620,000	17,856,000
Amortization of operating lease right-of-use assets			16,000,000	0
Equity in earnings of joint ventures			(1,873,000)	(2,977,000)
Distributions from joint ventures			0	2,821,000
Amortization deferred financing costs and loan discount			975,000	974,000
Loss (gain) on sale and disposal of equipment			971,000	(1,936,000)
Stock-based compensation			4,538,000	3,745,000
Noncash items included in cost of operations			(559,000)	0
Change in fair value of contingent consideration			(639,000)	0
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:
Accounts receivable			(9,486,000)	(6,132,000)
Other current assets			(1,184,000)	1,003,000
Other assets			1,254,000	(2,715,000)
Deferred taxes			(1,481,000)	(2,759,000)
Operating lease liability			(15,863,000)
Deferred rent			0	1,302,000
Deferred revenue			(440,000)	105,000
Accounts payable, accrued expenses and other			16,989,000	18,480,000
Net cash provided by operating activities			26,900,000	24,313,000
CASH FLOWS FROM INVESTING ACTIVITIES
Purchase of imaging facilities			(3,000,000)	(5,819,000)
Equity investments at fair value			(143,000)	(2,200,000)
Purchase of property and equipment			(32,940,000)	(23,946,000)
Proceeds from sale of equipment			756,000	2,116,000
Proceeds from the sale of equity interests in a joint venture			132,000
Proceeds from the sale of equity interests in a joint venture				0
Net cash used in investing activities			(35,195,000)	(29,849,000)
CASH FLOWS FROM FINANCING ACTIVITIES
Principal payments on notes and leases payable			(1,713,000)	(1,736,000)
Payments on Term Loan Debt			(9,020,000)	(8,270,000)
Distributions paid to noncontrolling interests			0	(759,000)
Proceeds from sale of noncontrolling interest			5,275,000	0
Contribution from noncontrolling partner			750,000	0
Proceeds from revolving credit facility			144,900,000	0
Payments on revolving credit facility			(131,900,000)	0
Proceeds from issuance of common stock upon exercise of options			50,000	0
Net cash provided by (used in) financing activities			8,342,000	(10,765,000)
EFFECT OF EXCHANGE RATE CHANGES ON CASH			(8,000)	22,000
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS			39,000	(16,279,000)
CASH AND CASH EQUIVALENTS, beginning of period			10,389,000	51,322,000	$ 51,322,000
CASH AND CASH EQUIVALENTS, end of period			10,428,000	35,043,000	10,389,000
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid during the period for interest			10,296,000	9,050,000
Equipment acquired and leasehold improvements			32,600,000	36,100,000
Capital lease debt			0	$ 4,000,000
Investment in joint venture, ScriptSender, LLC		$ 3,000,000			$ 268,000
Ventura County Imaging Group, LLC
Fixed assets acquired			$ 4,300,000
Hudson Valley Radiology Associates
Equity interest issued, value assigned						$ 6,000,000
Variable Interest Entity, Not Primary Beneficiary
Shares issues (in shares)	440,207
Variable Interest Entity, Not Primary Beneficiary | Hudson Valley Radiology Associates
Equity interest issued, value assigned	$ 6,000,000

NATURE OF BUSINESS AND BASIS OF

NATURE OF BUSINESS AND BASIS OF PRESENTATION	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
NATURE OF BUSINESS AND BASIS OF PRESENTATION	NOTE 1 – NATURE OF BUSINESS AND BASIS OF PRESENTATION We are a national provider of freestanding, fixed-site outpatient diagnostic imaging services in the United States based on number of locations and annual imaging revenue. At March 31, 2019 , we operated directly or indirectly through joint ventures with hospitals, 335 centers located in California, Delaware, Florida, Maryland, New Jersey, and New York. Our centers provide physicians with imaging capabilities to facilitate the diagnosis and treatment of diseases and disorders. Our services include magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), nuclear medicine, mammography, ultrasound, diagnostic radiology (X-ray), fluoroscopy and other related procedures. The vast majority of our centers offer multi-modality imaging services. Our multi-modality strategy diversifies revenue streams, reduces exposure to reimbursement changes and provides patients and referring physicians one location to serve the needs of multiple procedures. The consolidated financial statements include the accounts of Radnet Management, Inc. (or “Radnet Management”) and Beverly Radiology Medical Group III, a professional partnership (“BRMG”). BRMG is a partnership of ProNet Imaging Medical Group, Inc., Beverly Radiology Medical Group, Inc. and Breastlink Medical Group, Inc. (formerly known as Westchester Medical Group Inc.). The consolidated financial statements also include Radnet Management I, Inc., Radnet Management II, Inc., Radiologix, Inc., Radnet Managed Imaging Services, Inc., Delaware Imaging Partners, Inc., New Jersey Imaging Partners, Inc. and Diagnostic Imaging Services, Inc., all wholly owned subsidiaries of Radnet Management. All of these affiliated entities are referred to collectively as “RadNet”, “we”, “us”, “our” or the “Company” in this report. The Financial Accounting Standards Board (FASB) Accounting Standards Codification (“ASC”) 810-10-15-14, Consolidation, stipulates that generally any entity with a) insufficient equity to finance its activities without additional subordinated financial support provided by any parties, or b) equity holders that, as a group, lack the characteristics specified in the ASC which evidence a controlling financial interest, is considered a Variable Interest Entity (“VIE”). We consolidate all VIEs in which we are the primary beneficiary. We determine whether we are the primary beneficiary of a VIE through a qualitative analysis that identifies which variable interest holder has the controlling financial interest in the VIE. The variable interest holder who has both of the following has the controlling financial interest and is the primary beneficiary: (1) the power to direct the activities of the VIE that most significantly impact the VIE’s economic performance and (2) the obligation to absorb losses of, or the right to receive benefits from, the VIE that could potentially be significant to the VIE. In performing our analysis, we consider all relevant facts and circumstances, including: the design and activities of the VIE, the terms of the contracts the VIE has entered into, the nature of the VIE’s variable interests issued and how they were negotiated with or marketed to potential investors, and which parties participated significantly in the design or redesign of the entity. Howard G. Berger, M.D., is our President and Chief Executive Officer, a member of our Board of Directors, and also owns, indirectly, 99% of the equity interests in BRMG. BRMG is responsible for all of the professional medical services at nearly all of our facilities located in California under a management agreement with us, and employs physicians or contracts with various other independent physicians and physician groups to provide the professional medical services at most of our California facilities. We generally obtain professional medical services from BRMG in California, rather than provide such services directly or through subsidiaries, in order to comply with California’s prohibition against the corporate practice of medicine. However, as a result of our close relationship with Dr. Berger and BRMG, we believe that we are able to better ensure that medical service is provided at our California facilities in a manner consistent with our needs and expectations and those of our referring physicians, patients and payors than if we obtained these services from unaffiliated physician groups. As of February 28, 2019, we contract with seven medical groups which provide professional medical services at all of our facilities in Manhattan and Brooklyn, New York (“the NY Groups”). These contracts are similar to our contract with BRMG. Five of the NY Groups are owned or controlled by John V. Crues, III, M.D., RadNet’s Medical Director, a member of our Board of Directors, and a 1% owner of BRMG. Dr Berger owns a controlling interest in two of the NY Groups which provide professional medical services at one of our Manhattan facilities. On February 28, 2019, one of our NY Group entities, Lenox Hill Radiology and Medical Imaging Associates, P.C. ("LHR"), purchased the membership interest of Hudson Valley Radiology Associates, P.L.L.C. ("HVRA") for $6.0 million of RadNet common stock and contingent consideration valued at $680,000 to guarantee the share value issued for a period of six months post acquisition date. LHR has performed a preliminary purchase price allocation and recorded equipment of $10,000 , a covenant not to compete of $700,000 , trade name of $70,000 and goodwill of $3.1 million from the transaction. In connection with the acquisition, RadNet also settled against the purchase consideration, $2.8 million , net of taxes, of an unfavorable vendor contract with HVRA stemming from the previous acquisition of Radiologix, Inc. in November 2006. RadNet provides non-medical, technical and administrative services to BRMG and the NY Groups for which it receives a management fee, pursuant to the related management agreements. Through the management agreements we have exclusive authority over all non-medical decision making related to the ongoing business operations of BRMG and the NY Groups and we determine the annual budget of BRMG and the NY Groups. BRMG and the NY Groups both have insignificant operating assets and liabilities, and de minimis equity. Through management agreements with us, substantially all cash flows of BRMG and the NY Groups after expenses including professional salaries are transferred to us. We have determined that BRMG and the NY Groups are VIEs, that we are the primary beneficiary, and consequently, we consolidate the revenue and expenses, assets and liabilities of each. BRMG and the NY Groups on a combined basis recognized $37.4 million and $34.0 million of revenue, net of management service fees to RadNet, for the three months ended March 31, 2019 and 2018 , respectively, and $37.4 million and $34.0 million of operating expenses for the three months ended March 31, 2019 and 2018 , respectively. RadNet recognized in its condensed consolidated statement of operations $142.3 million and $118.6 million of net revenues for the three months ended March 31, 2019 , and 2018 respectively, for management services provided to BRMG and the NY Groups relating primarily to the technical portion of total billed revenue. The cash flows of BRMG and the NY Groups are included in the accompanying consolidated statements of cash flows. All intercompany balances and transactions have been eliminated in consolidation. In our consolidated balance sheets at March 31, 2019 and December 31, 2018 , we have included approximately $98.7 million and $88.9 million , respectively, of accounts receivable and approximately $6.3 million and $5.6 million , respectively, of accounts payable and accrued liabilities related to BRMG and the NY Groups. Also in our consolidated balance sheets at March 31, 2019 we have included $2.7 million in intangible assets related to the purchase of membership interest of a New York Group VIE. The creditors of BRMG and the NY Groups do not have recourse to our general credit and there are no other arrangements that could expose us to losses on behalf of BRMG and the NY Groups. However, RadNet may be required to provide financial support to cover any operating expenses in excess of operating revenues. We also own a 49% economic interest in ScriptSender, LLC, which provides secure data transmission services of medical information. Through a management agreement, RadNet provides management and accounting services and receives an agreed upon fee. ScriptSender LLC is dependent on the Company to finance its own activities, and as such we determined that it is a VIE but we are not a primary beneficiary since we do not have the power to direct the activities of the entity that most significantly impact the entity’s economic performance. At all of our centers we have entered into long-term contracts with radiology groups in the area to provide physician services at those facilities. These radiology practices provide professional services, including supervision and interpretation of diagnostic imaging procedures, in our diagnostic imaging centers. The radiology practices maintain full control over the provision of professional services. In these facilities we enter into long-term agreements with radiology practice groups (typically 40 years). Under these arrangements, in addition to obtaining technical fees for the use of our diagnostic imaging equipment and the provision of technical services, we provide management services and receive a fee based on the value of the services we provide. Except in New York City, the fee is based on the practice group’s professional revenue, including revenue derived outside of our diagnostic imaging centers. In New York City we are paid a fixed fee set in advance for our services. We own the diagnostic imaging equipment and, therefore, receive 100% of the technical reimbursements associated with imaging procedures. The radiology practice groups retain the professional reimbursements associated with imaging procedures after deducting management service fees paid to us and we have no financial controlling interest in the radiology practices. The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X and, therefore, do not include all information and footnotes necessary for conformity with U.S. generally accepted accounting principles for complete financial statements; however, in the opinion of our management, all adjustments consisting of normal recurring adjustments necessary for a fair presentation of the financial position, results of operations and cash flows for the interim periods ended March 31, 2019 and 2018 have been made. The results of operations for any interim period are not necessarily indicative of the results for a full year. These interim condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and related notes thereto contained in our annual report on Form 10-K for the year ended December 31, 2018 .

SIGNIFICANT ACCOUNTING POLICIES

SIGNIFICANT ACCOUNTING POLICIES	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
SIGNIFICANT ACCOUNTING POLICIES	NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES During the period covered in this report, we adopted a new significant accounting policy on Leases as described in Note 5 below. Except for the policy on Leases, there have been no material changes to the significant accounting policies we use and have explained, in our annual report on Form 10-K for the fiscal year ended December 31, 2018 . The information below is intended only to supplement the disclosure in our annual report on Form 10-K for the fiscal year ended December 31, 2018 . REVENUES - Our revenues generally relate to net patient fees received from various payers and patients themselves under contracts in which our performance obligations are to provide diagnostic services to the patients. Revenues are recorded during the period our obligations to provide diagnostic services are satisfied. Our performance obligations for diagnostic services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges and generally provide for payments based upon predetermined rates per diagnostic services or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. As it relates to BRMG centers, this service fee revenue includes payments for both the professional medical interpretation revenue recognized by BRMG as well as the payment for all other aspects related to our providing the imaging services, for which we earn management fees from BRMG. As it relates to non-BRMG centers, this service fee revenue is earned through providing the use of our diagnostic imaging equipment and the provision of technical services as well as providing administration services such as clerical and administrative personnel, bookkeeping and accounting services, billing and collection, provision of medical and office supplies, secretarial, reception and transcription services, maintenance of medical records, and advertising, marketing and promotional activities. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Under capitation arrangements with various health plans, we earn a per-enrollee amount each month for making available diagnostic imaging services to all plan enrollees under the capitation arrangement. Revenue under capitation arrangements is recognized in the period in which we are obligated to provide services to plan enrollees under contracts with various health plans. The Company’s total net revenues during the three months ended March 31, 2019 and 2018 are presented in the table below based on an allocation of the estimated transaction price with the patient between the primary patient classification of insurance coverage (in thousands): Three Months Ended 2019 2018 Commercial insurance $ 151,678 $ 126,225 Medicare 54,199 44,076 Medicaid 7,120 6,048 Workers' compensation/personal injury 11,027 8,431 Other patient revenue 5,835 5,606 Management fee revenue 2,117 3,677 Teleradiology and Software revenue 4,386 3,816 Other 6,310 6,289 Service fee revenue 242,672 204,168 Revenue under capitation arrangements 28,877 27,224 Total revenue $ 271,549 $ 231,392 RECLASSIFICATION – We have reclassified certain amounts within our table of income allocation for 2018 to conform to our 2019 presentation. ACCOUNTS RECEIVABLE - Substantially all of our accounts receivable are due under fee-for-service contracts from third party payors, such as insurance companies and government-sponsored healthcare programs, or directly from patients. Services are generally provided pursuant to one-year contracts with healthcare providers. We continuously monitor collections from our payors and maintain an allowance for bad debts based upon specific payor collection issues that we have identified and our historical experience. In 2018 we entered into factoring agreements with various institutions and sold certain accounts receivable under non-recourse agreements. These transactions are accounted for as a reduction in accounts receivable as the agreements transfer effective control over and risk related to the receivables to the buyers. The aggregate gross amount factored under these facilities was $20.5 million for the year ended December 31, 2018 and the cost of factoring such accounts receivable for the year ended December 31, 2018 was $440,000 . Proceeds will be received as a combination of cash and payments on notes receivable and will be reflected as operating activities on our statement of cash flows and on our balance sheet as prepaid expenses and other current assets for the current portion and deposits and other for the long term portion. At March 31, 2019 we have $17.8 million remaining to be collected on these agreements. We do not utilize factoring arrangements as an integral part of our financing for working capital. DEFERRED FINANCING COSTS - Costs of financing are deferred and amortized using the effective interest rate method. Deferred financing costs, net of accumulated amortization, were $1.2 million and $1.4 million , as of March 31, 2019 and December 31, 2018 , respectively and related to our line of credit. See Note 6, Revolving Credit Facility and Notes Payable, for more information. INVENTORIES - Inventories, consisting mainly of medical supplies, are stated at the lower of cost or net realizable value with cost determined by the first-in, first-out method. PROPERTY AND EQUIPMENT - Property and equipment are stated at cost, less accumulated depreciation and amortization. Depreciation of property and equipment is performed using the straight-line method over the estimated useful lives of the assets acquired, which range from 3 to 15 years. Leasehold improvements are amortized at the lesser of lease term or their estimated useful lives, which range from 3 to 15 years. Maintenance and repairs are charged to expense as incurred. BUSINESS COMBINATION - When the qualifications for business combination accounting treatment are met, it requires us to recognize separately from goodwill the assets acquired and the liabilities assumed at their acquisition date fair values. Goodwill as of the acquisition date is measured as the excess of consideration transferred over the net of the acquisition date fair values of the assets acquired and the liabilities assumed. While we use our best estimates and assumptions to accurately value assets acquired and liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we record adjustments to the assets acquired and liabilities assumed with the corresponding offset to goodwill. Upon the conclusion of the measurement period or final determination of the values of assets acquired or liabilities assumed, whichever comes first, any subsequent adjustments are recorded to our consolidated statements of operations. GOODWILL AND INDEFINITE LIVED INTANGIBLES- Goodwill at March 31, 2019 totaled $424.3 million . Indefinite lived intangible assets at March 31, 2019 were $9.9 million . Goodwill and Indefinite Lived Intangibles are recorded as a result of business combinations. When we determine the carrying value of goodwill exceeds its fair value an impairment charge would be recognized and should not exceed the total amount of goodwill allocated to that reporting unit. We tested goodwill and indefinite lived intangibles for impairment on October 1, 2018. During the review we noted our Teleradiology unit, Imaging On Call, (IOC), experienced a reduction of professional medical group clients and a contract with a major local health provider during 2018. This affected its estimated fair value and resulted in impairment charges to our the reporting unit of $3.9 million for the twelve months ended December 31, 2018 , with goodwill representing $3.8 million of the total and the remainder being its trade name of approximately $100,000 . We have not identified any indicators of impairment through March 31, 2019 . Activity in goodwill for the three months ended March 31, 2019 is provided below (in thousands): Balance as of December 31, 2018 $ 418,093 Adjustments to our preliminary allocation of the purchase price of Medical Arts Radiological Group, P.C. 722 Goodwill acquired through the acquisition of certain assets of Dignity Health 1 Goodwill acquired through the acquisition of certain assets of West Valley Imaging Center, LLC 2,490 Goodwill disposed through sale of assets (123 ) Goodwill acquired by Lenox Hill Radiology through the membership purchase of HVRA 3,125 Balance as of March 31, 2019 $ 424,308 INCOME TAXES - Income tax expense is computed using an asset and liability method and using expected annual effective tax rates. Under this method, deferred income tax assets and liabilities result from temporary differences in the financial reporting bases and the income tax reporting bases of assets and liabilities. The measurement of deferred tax assets is reduced, if necessary, by the amount of any tax benefit that, based on available evidence, is not expected to be realized. When it appears more likely than not that deferred taxes will not be realized, a valuation allowance is recorded to reduce the deferred tax asset to its estimated realizable value. For net deferred tax assets we consider estimates of future taxable income in determining whether our net deferred tax assets are more likely than not to be realized. We recorded an income tax benefit of $1.2 million , or an effective tax rate of 39.0% , for the three months ended March 31, 2019 compared to income tax benefit for the three months ended March 31, 2018 of $2.5 million , or an effective tax rate of 22.4% . The income tax rates for the three months ended March 31, 2019 diverge from the federal statutory rate due to (i) noncontrolling interests due to the controlled partnerships; (ii) effects of state income taxes; (iii) excess tax benefits attributable to share-based compensation; and adjustment associated with uncertain tax positions. U.S. GAAP requires that the impact of tax legislation be recognized in the period in which the law was enacted. As a result, we recorded provisional amounts due to the revaluation of deferred tax assets and liabilities and the transition tax on deemed repatriation of accumulated foreign income during the year ended December 31, 2018 . Both of these tax charges represent provisional amounts and our current best estimates. Any adjustments recorded to the provisional amounts will be included as an adjustment to tax expense. The provisional amounts incorporate assumptions made based upon our current interpretation of the Tax Reform Act and may change as we receive additional clarification and implementation guidance. We are not under examination in any jurisdiction and the years ended December 31, 2018 , 2017 , and 2016 remain subject to examination. We believe no significant changes in the unrecognized tax benefits will occur within the next 12 months. LEASES - We determine if an arrangement is a lease at inception. Operating leases are included in operating lease right-of-use (“ROU”) assets, current operating lease liabilities, and long term operating lease liability in our consolidated balance sheets. Finance leases are included in property and equipment, current finance lease liability, and long-term finance lease liability in our consolidated balance sheets. ROU assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease ROU assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. We use the implicit rate when readily determinable. We include options to extend a lease when it is reasonably certain that we will exercise that option. Lease expense for lease payments is recognized on a straight-line basis over the lease term. For a contract in which we are a lessee that contains fixed payments for both lease and non-lease components, we have elected to account for the components as a single lease component, as permitted. For finance leases, interest expense on the lease liability is recognized using the effective interest method and amortization of the right-of-use asset is recognized on a straight-line basis over the shorter of the estimated useful life of the asset or the lease term. See Note 5, Leases, for more information. EQUITY BASED COMPENSATION – We have one long-term incentive plan that we adopted in 2006 and which we first amended and restated as of April 20, 2015, and again on March 9, 2017 (the “Restated Plan”). The Restated Plan was approved by our stockholders at our annual stockholders meeting on June 8, 2017. We have reserved for issuance under the Restated Plan 14,000,000 shares of common stock. We can issue options, stock awards, stock appreciation rights, stock units and cash awards under the Restated Plan. Certain options granted under the Restated Plan to employees are intended to qualify as incentive stock options under existing tax regulations. Stock options and warrants generally vest over three to five years and expire five to ten years from date of grant. The compensation expense recognized for all equity-based awards is recognized over the awards’ service periods. Equity-based compensation is classified in operating expenses within the same line item as the majority of the cash compensation paid to employees. See Note 7, Stock-Based Compensation, for more information. COMPREHENSIVE INCOME - ASC 220, Comprehensive Income, establishes rules for reporting and displaying comprehensive income or loss and its components. Our unrealized gains or losses on foreign currency translation adjustments and our interest rate cap agreement are included in comprehensive income. The components of comprehensive loss for the three months ended March 31, 2019 are included in the consolidated statements of comprehensive loss. DERIVATIVE INSTRUMENTS - In the fourth quarter of 2016, we entered into two forward interest rate cap agreements ("2016 Caps"). The 2016 Caps will mature in September and October 2020. The 2016 Caps had notional amounts of $150,000,000 and $350,000,000 , respectively, which were designated at inception as cash flow hedges of future cash interest payments associated with portions of the our variable rate bank debt. Under these arrangements, the Company purchased a cap on 3 month LIBOR at 2.0% . We are liable for a $5.3 million premium to enter into the caps which is being accrued over the life of the agreements. At inception, we designated our 2016 Caps as cash flow hedges of floating-rate borrowings. In accordance with ASC Topic 815, derivatives that have been designated and qualify as cash flow hedging instruments are reported at fair value. The gain or loss of the hedge (i.e. change in fair value) is reported as a component of comprehensive loss in the consolidated statement of equity. See Fair Value Measurements section below for the fair value of the 2016 Caps at March 31, 2019 . A tabular presentation of the effect of derivative instruments on our consolidated statement of comprehensive loss is as follows (amounts in thousands): For the three months ended March 31, 2019 Account January 1, 2019 Balance Amount of comprehensive loss recognized on derivative March 31, 2019 Balance Location Accumulated Other Comprehensive Income (Loss) 2,506 (1,196 ) 1,310 Current Assets & Equity For the twelve months ended December 31, 2018 Account January 1, 2018 Balance Amount of comprehensive gain recognized on derivative December 31, 2018 Balance Location Accumulated Other Comprehensive (Loss) Income (370 ) 2,876 2,506 Current Assets & Equity FAIR VALUE MEASUREMENTS – Assets and liabilities subject to fair value measurements are required to be disclosed within a fair value hierarchy. The fair value hierarchy ranks the quality and reliability of inputs used to determine fair value. Accordingly, assets and liabilities carried at, or permitted to be carried at, fair value are classified within the fair value hierarchy in one of the following categories based on the lowest level input that is significant to a fair value measurement: Level 1—Fair value is determined by using unadjusted quoted prices that are available in active markets for identical assets and liabilities. Level 2—Fair value is determined by using inputs other than Level 1 quoted prices that are directly or indirectly observable. Inputs can include quoted prices for similar assets and liabilities in active markets or quoted prices for identical assets and liabilities in inactive markets. Related inputs can also include those used in valuation or other pricing models such as interest rates and yield curves that can be corroborated by observable market data. Level 3—Fair value is determined by using inputs that are unobservable and not corroborated by market data. Use of these inputs involves significant and subjective judgment. The table below summarizes the estimated fair values of certain of our financial assets that are subject to fair value measurements, and the classification of these assets on our consolidated balance sheets, as follows (in thousands): As of March 31, 2019 Level 1 Level 2 Level 3 Total Current assets Interest Rate Contracts $ — $ 1,690 $ — $ 1,690 As of December 31, 2018 Level 1 Level 2 Level 3 Total Current assets Interest Rate Contracts $ — $ 3,316 $ — $ 3,316 The estimated fair value of these contracts was determined using Level 2 inputs. More specifically, the fair value was determined by calculating the value of the difference between the fixed interest rate of the interest rate swaps and the counterparty’s forward LIBOR curve. The forward LIBOR curve is readily available in the public markets or can be derived from information available in the public markets. The table below summarizes the estimated fair value compared to our face value of our long-term debt as follows (in thousands): As of March 31, 2019 Level 1 Level 2 Level 3 Total Fair Value Total Face Value First Lien Term Loans and SunTrust Term Loan $ — $ 638,144 $ — $ 638,144 $ 637,420 As of December 31, 2018 Level 1 Level 2 Level 3 Total Total Face Value First Lien Term Loans and SunTrust Term Loan $ — $ 633,229 $ — $ 633,229 $ 646,441 As of March 31, 2019 and December 31, 2018 , our Barclays revolving credit facility had $41.0 million and $28.0 million aggregate principal amount outstanding, respectively. Our SunTrust revolving credit facility had no principal amount outstanding at March 31, 2019. The estimated fair value of our long-term debt, which is discussed in Note 6, was determined using Level 2 inputs primarily related to comparable market prices. We consider the carrying amounts of cash and cash equivalents, receivables, other current assets, current liabilities and other notes payables to approximate their fair value because of the relatively short period of time between the origination of these instruments and their expected realization or payment. Additionally, we consider the carrying amount of our capital lease obligations to approximate their fair value because the weighted average interest rate used to formulate the carrying amounts approximates current market rates. EARNINGS PER SHARE - Earnings per share is based upon the weighted average number of shares of common stock and common stock equivalents outstanding, net of common stock held in treasury, as follows (in thousands except share and per share data): Three Months Ended March 31, 2019 2018 Net loss attributable to RadNet, Inc.'s common stockholders $ (3,733 ) $ (7,338 ) BASIC AND DILUTED NET LOSS PER SHARE ATTRIBUTABLE TO RADNET, INC.'S COMMON STOCKHOLDERS Weighted average number of common shares outstanding during the period 49,553,694 47,822,618 Basic and diluted net loss per share attributable to RadNet, Inc.'s common stockholders $ (0.08 ) $ (0.15 ) For the three months ended March 31, 2019 and 2018 we excluded all outstanding options and restricted stock awards in the calculation of diluted earnings per share because their effect would be antidilutive. EQUITY INVESTMENTS AT FAIR VALUE–Accounting guidance requires entities to measure equity investments at fair value, with any changes in fair value recognized in net income. If there is no readily determinable fair value, the guidance allows entities the ability to measure investments at cost less impairment. As of March 31, 2019 , we have two equity investments for which a fair value is not readily determinable and therefore the total amounts invested are recognized at cost as follows: Medic Vision: Medic Vision, based in Israel, specializes in software packages that provide compliant radiation dose structured reporting and enhanced images from reduced dose CT scans. On March 24, 2017, we acquired an initial 12.5% equity interest in Medic Vision – Imaging Solutions Ltd for $1.0 million . We also received an option to exercise warrants to acquire up to an additional 12.5% equity interest for $1.4 million within one year from the initial share purchase date, if exercised in full. On March 1, 2018 we exercised our warrant in part and acquired an additional 1.96% for $200,000 . Our initial equity interest has been diluted to 12.25% and our total equity investment stands at 14.21% . In accordance with accounting guidance , as we exercise no significant influence over Medic Vision’s operations, the investment is recorded at its cost of $1.2 million , given that the fair value is not readily determinable. No impairment in our investment was identified as of the three months ended March 31, 2019 . Turner Imaging: Turner Imaging Systems, based in Utah, develops and markets portable X-ray imaging systems that provide a user the ability to acquire X-ray images wherever and whenever they are needed. On February 1, 2018, we purchased 2.1 million preferred shares in Turner Imaging Systems for $2.0 million . On January 1, 2019 we funded a convertible promissory note in the amount of $143,000 that will convert to additional preferred shares no later than December 21, 2019. No impairment in our investment was identified for the three months ended March 31, 2019 . INVESTMENT IN JOINT VENTURES – We have 14 unconsolidated joint ventures with ownership interests ranging from 25% to 55% . These joint ventures represent partnerships with hospitals, health systems or radiology practices and were formed for the purpose of owning and operating diagnostic imaging centers. Professional services at the joint venture diagnostic imaging centers are performed by contracted radiology practices or a radiology practice that participates in the joint venture. Our investment in these joint ventures is accounted for under the equity method, since RadNet does not have a controlling financial interest in such ventures. We evaluate our investment in joint ventures, including cost in excess of book value (equity method goodwill) for impairment whenever indicators of impairment exist. No indicators of impairment existed as of March 31, 2019 . Sale of joint venture interest: On April 1, 2017, we formed in conjuncture with Cedars Sinai Medical Center (“CSMC”) the Santa Monica Imaging Group, LLC (“SMIG”), consisting of two multi-modality imaging centers located in Santa Monica, CA with RadNet holding a 40% economic interest and CSMC holding a 60% economic interest. RadNet accounts for our share of the venture under the equity method. On January 1, 2019, CSMC purchased from the company, an additional five percent economic interest in SMIG valued at $134,000 . As a result of the transaction, our economic interest in SMIG has been reduced to 35% . We recorded a loss of $2,000 on the transaction. Joint venture investment and financial information The following table is a summary of our investment in joint ventures during the three months ended March 31, 2019 (in thousands): Balance as of December 31, 2018 $ 37,973 Equity in earnings in these joint ventures 1,873 Sale of ownership interest (134 ) Balance as of March 31, 2019 $ 39,712 We charged management service fees from the centers underlying these joint ventures of approximately $2.1 million and $3.4 million for the quarters ended March 31, 2019 and 2018 , respectively. We eliminate any unrealized portion of our management service fees with our equity in earnings of joint ventures. The following table is a summary of key balance sheet data for these joint ventures as of March 31, 2019 and December 31, 2018 and income statement data for the three months ended March 31, 2019 and 2018 (in thousands): Balance Sheet Data: March 31, 2019 December 31, 2018 Current assets $ 33,301 $ 28,317 Noncurrent assets 59,804 45,912 Current liabilities (8,244 ) (4,300 ) Noncurrent liabilities (15,881 ) (4,898 ) Total net assets $ 68,980 $ 65,031 Book value of RadNet joint venture interests $ 31,738 $ 30,030 Cost in excess of book value of acquired joint venture interests 7,974 7,943 Total value of Radnet joint venture interests $ 39,712 $ 37,973 Total book value of other joint venture partner interests $ 37,242 $ 35,001 Income statement data for the three months ended March 31, 2019 2018 Net revenue $ 27,254 $ 44,546 Net income $ 3,952 $ 6,250

RECENT ACCOUNTING AND REPORTING

RECENT ACCOUNTING AND REPORTING STANDARDS	3 Months Ended
	Mar. 31, 2019
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
RECENT ACCOUNTING AND REPORTING STANDARDS	RECENT ACCOUNTING AND REPORTING STANDARDS Accounting standards adopted In February 2016, the FASB issued Accounting Standard Update ("ASU") No. 2016-02, Leases (Topic 842) (ASU 2016-02), which amends the existing accounting standards for leases. In September 2017, the FASB issued ASU No. 2017-13 which provides additional clarification and implementation guidance on the previously issued ASU No. 2016-02. Subsequently, in July 2018, the FASB issued ASU No 2018-10, Codification Improvements to Topic 842, Leases, and ASU No. 2018-11, Targeted Improvement, to clarify and amend the guidance in ASU No. 2016-02. The amendments in this update were effective for fiscal years (and interim reporting periods within fiscal years) beginning after December 15, 2018, with early adoption permitted for all entities. Under the new guidance, a lessee is required to recognize a lease liability and right-of-use asset for all leases with terms in excess of twelve months. The new guidance also requires additional disclosures to enable users of financial statements to understand the amount, timing, and potential uncertainty of cash flows arising from leases. Consistent with current guidance, a lessee’s recognition, measurement, and presentation of expenses and cash flows arising from a lease will continue to depend primarily on its classification. The accounting standard is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. We have elected the optional transition method to apply the standard as of the effective date and therefore, we will not apply the standard to the comparative periods presented in the consolidated financial statements. We elected the transition package of three practical expedients permitted within the standard, which eliminates the requirements to reassess prior conclusions about lease identification, lease classification, and initial direct costs. For facility and equipment operating leases, the effect of the adoption amounted to a lease liability of approximately $455.5 million . Operating lease right-of-use assets were recorded in the amount of approximately $419.0 million . Inclusive in the adoption was the transfer of approximately $35.3 million in deferred rent liability and $792,000 in unfavorable rental contract liabilities to operating lease right of use assets. For finance leases, the effect of the adoption amounted to a finance lease liability of approximately $12.1 million , which was transfered from capital lease debt. Equipment leased under the finance arrangements, amounting to $14.1 million , remained in property, plant and equipment. The transition adjustment did not have a material impact on the statement of operations or cash flows. See Note 5, Leases, for more information. In February 2018, the FASB issued ASU No. 2018-02 (“ASU 2018-02”), Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income . ASU 2018-02 allows for the reclassification of certain income tax effects related to the Tax Cuts and Jobs Act between “Accumulated other comprehensive income” and “Retained earnings.” This ASU relates to the requirement that adjustments to deferred tax liabilities and assets related to a change in tax laws or rates to be included in “Income from continuing operations”, even in situations where the related items were originally recognized in “Other comprehensive income” (rather than in “Income from continuing operations”). Subsequently, in March 2018, the FASB issued ASU No. 2018-05, Income Taxes, to clarify and amend guidance in ASU 2018-02. ASU 2018-02 and ASU 2018-05 are effective for all entities for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. Adoption of this ASU is to be applied either in the period of adoption or retrospectively to each period in which the effect of the change in the tax laws or rates were recognized. The adoption had no significant impact on the our results of operations, financial position and cash flows. Accounting standards not yet adopted In June 2016, the FASB issued ASU No. 2016-13 ("ASU 2016-13), Financial Instruments - Credit Losses. ASU 2016-13 replaces the incurred loss impairment methodology under current GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. The standard will be effective for us beginning December 15, 2020, with early adoption permitted. We are currently evaluating the impact of this standard on our consolidated financial statements, including accounting policies, processes, and systems. In August 2018, the FASB issued ASU No. 2018-15 (“ASU 2018-15”), Intangibles-Goodwill and Other-Internal-Use Software. ASU 2018-15 aligns the requirements for deferring implementation costs incurred in a cloud computing arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. This ASU is effective in the first quarter of 2020 with early adoption permitted and can be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. We are currently assessing the impact of the adoption of this ASU on the Company’s results of operations, financial position and cash flows.

FACILITY ACQUISITIONS AND ASSET

FACILITY ACQUISITIONS AND ASSETS HELD FOR SALE	3 Months Ended
	Mar. 31, 2019
Business Combinations [Abstract]
FACILITY ACQUISITIONS AND ASSETS HELD FOR SALE	FACILITY ACQUISITIONS AND ASSETS HELD FOR SALE Acquisitions On February 1, 2019 our majority owned subsidiary, West Valley Imaging Group, LLC ("WVIG") completed its acquisition of certain assets of West Valley Imaging Center, LLC ("West Valley"), consisting of a single multi-modality imaging center located in West Hills, CA for purchase consideration of $3.0 million all of which was initially funded by the Company. We have made a preliminary fair value determination of the acquired assets and approximately $300,000 in equipment and fixed assets, $7,000 in other assets, $200,000 in intangible assets and $2.5 million in goodwill were recorded. Subsequent to the transaction, our partner in WVIG, Cedars Sinai Medical Center, contributed $750,000 in cash to maintain its 25% economic interest in the venture. On February 28, 2019, one of our NY Group entities, Lenox Hill Radiology and Medical Imaging Associates, P.C., purchased the membership interest of Hudson Valley Radiology Associates, P.L.L.C. See note 1, Nature of Business, for further information. Joint venture formations On February 13, 2019 we formed a wholly owned subsidiary, Ventura County Imaging Group, LLC ("VCIG"). On March 1, 2019, Dignity Health joined as a venture partner. Total agreed contribution of both parties was $10.4 million of cash and assets with RadNet contributing net assets with a book value of $4.3 million for a 60% economic interest and Dignity Health contributing $6.1 million in cash and assets for a 40% economic interest. For its contribution, RadNet transferred net assets of three wholly owned multi-modality imaging centers. Dignity Health contributed approximately $800,000 in assets to acquire 5% economic interest and paid RadNet $5.3 million for an additional 35% economic interest. RadNet maintains controlling economic interest in VCIG and fully consolidates the results into our financial statements. Assets held for sale: Effective January 1, 2018 we agreed to sell certain assets of four women’s imaging centers to MemorialCare Medical Foundation. The sale is anticipated within the next 12 months. The following table summarizes the major categories of assets which remain classified as held for sale in the accompanying condensed consolidated balance sheets at March 31, 2019 : Property and equipment, net $ 1,049 Goodwill 992 Total assets held for sale $ 2,041

LEASES (Notes)

LEASES (Notes)	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
LEASES	LEASES Adoption of Standard In February 2016, the FASB issued a new standard related to leases to increase transparency and comparability among organizations by requiring the recognition of right-of-use (“ROU”) assets and lease liabilities on the balance sheet for all leases with terms in excess of twelve months. Sufficient disclosures are required to meet the objective of enabling users of financial statements to assess the amount, timing, and uncertainty of cash flows arising from leases. The standard was effective for us beginning January 1, 2019. We have elected the optional transition method to apply the standard as of the effective date and therefore, we will not apply the standard to the comparative periods presented in the consolidated financial statements. We also elected the transition package of three practical expedients permitted within the standard, which eliminates the requirements to reassess prior conclusions about lease identification, lease classification, and initial direct costs. In preparation for adoption of the standard, we have implemented internal control procedures and key system functionality to enable the preparation of financial information. The adoption of the standard had a material impact on our condensed consolidated balance sheets, but did not have material impact on our condensed consolidated income statements or cash flows. Adoption of the standard resulted in the recognition an operating lease liability of $455.5 million . Operating lease ROU assets were recorded in the amount of $419.0 million . Inclusive in the adoption was the transfer of $35.3 million in deferred rent liability and $792,000 in unfavorable rental contract liabilities to operating lease ROU assets. For finance leases, the effect of the adoption amounted to a finance lease liability of $12.1 million , which was transfered from capital lease debt and a finance right of use assets in the amount of $14.1 million which remained in property, plant and equipment. Lease Liability We have operating leases for medical facilities, administrative offices, warehouse space and major medical equipment. We lease the premises at which these facilities are located and do not have options to purchase the facilities we rent. Our most common initial term varies in length from 5 to 15 years. Including renewal options negotiated with the landlord, we can have a total span of 10 to 35 years at the facilities we lease. We also lease smaller satellite X-Ray locations on mutually renewable terms, usually lasting one year. Additionally, we have operating and finance leases for certain medical and office equipment, with lease terms generally lasting from 5 to 8 years. Our Incremental Borrowing Rate ("IBR") used to discount the stream of lease payments is closely related to the interest rates charged on our collateralized debt obligations and our IBR is adjusted when those rates experience a substantial change. The components of lease expense were as follows: Three months ended (In thousands) March 31, 2019 Operating lease cost $ 22,792 Finance lease cost: Depreciation of leased equipment $ 783 Interest on lease liabilities 123 Total finance lease cost $ 905 Supplemental cash flow information related to leases was as follows: Three months ended (In thousands) March 31, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 22,921 Operating cash flows from financing leases 123 Financing cash flows from financing leases 1,522 Right-of-use & Equipment assets obtained in exchange for lease obligations: Operating leases (1) 412,695 Financing leases 14,056 (1) Amounts for the three months ended March 31, 2019 include the transition adjustment for the adoption of Topic 842 discussed in Note 2, Significant Accounting Policies for further information. Supplemental balance sheet information related to leases was as follows: (In thousands, except lease term and discount rates) March 31, 2019 Operating Leases Operating lease right-of-use assets $ 403,066 Current portion of operating lease liability $ 64,538 Operating lease liabilities 375,363 Total operating lease liabilities $ 439,901 Finance Leases Property and Equipment, at cost $ 14,056 Accumulated depreciation (783 ) Equipment, net $ 13,273 Current portion of finance lease $ 4,936 Finance lease liabilities 5,663 Total finance lease liabilities $ 10,599 Weighted Average Remaining Lease Term Operating leases - years 8.4 Finance leases - years 2.4 Weighted Average Discount Rate Operating leases 6.4 % Finance leases 4.4 % Maturities of lease liabilities were as follows: (In thousands) Operating Financing Year Ending December 31, Leases Leases 2019 (excluding the three months ended March 31, 2019) $ 67,927 $ 4,374 2020 84,334 3,481 2021 77,688 2,614 2022 67,351 692 2023 56,487 — Thereafter 225,101 — Total Lease Payments 578,888 11,161 Less imputed interest (138,987 ) (562 ) Total $ 439,901 $ 10,599 As of March 31, 2019 , we have additional operating leases for facilities and medical equipment that have not yet commenced of approximately $19.7 million . These operating leases will commence in 2019 with lease terms of 1 to 14 years. As previously disclosed in our 2018 Annual Report on Form 10-K and under the previous lease accounting, maturities of operating lease liabilities were as follows as of December 31, 2018 (in thousands): Facilities Equipment Total 2019 $ 75,588 $ 14,924 $ 90,512 2020 66,116 14,385 80,501 2021 57,826 12,966 70,792 2022 48,542 10,264 58,806 2023 38,800 7,095 45,895 Thereafter 160,327 5,144 165,471 $ 447,199 $ 64,778 $ 511,977
LEASES	LEASES Adoption of Standard In February 2016, the FASB issued a new standard related to leases to increase transparency and comparability among organizations by requiring the recognition of right-of-use (“ROU”) assets and lease liabilities on the balance sheet for all leases with terms in excess of twelve months. Sufficient disclosures are required to meet the objective of enabling users of financial statements to assess the amount, timing, and uncertainty of cash flows arising from leases. The standard was effective for us beginning January 1, 2019. We have elected the optional transition method to apply the standard as of the effective date and therefore, we will not apply the standard to the comparative periods presented in the consolidated financial statements. We also elected the transition package of three practical expedients permitted within the standard, which eliminates the requirements to reassess prior conclusions about lease identification, lease classification, and initial direct costs. In preparation for adoption of the standard, we have implemented internal control procedures and key system functionality to enable the preparation of financial information. The adoption of the standard had a material impact on our condensed consolidated balance sheets, but did not have material impact on our condensed consolidated income statements or cash flows. Adoption of the standard resulted in the recognition an operating lease liability of $455.5 million . Operating lease ROU assets were recorded in the amount of $419.0 million . Inclusive in the adoption was the transfer of $35.3 million in deferred rent liability and $792,000 in unfavorable rental contract liabilities to operating lease ROU assets. For finance leases, the effect of the adoption amounted to a finance lease liability of $12.1 million , which was transfered from capital lease debt and a finance right of use assets in the amount of $14.1 million which remained in property, plant and equipment. Lease Liability We have operating leases for medical facilities, administrative offices, warehouse space and major medical equipment. We lease the premises at which these facilities are located and do not have options to purchase the facilities we rent. Our most common initial term varies in length from 5 to 15 years. Including renewal options negotiated with the landlord, we can have a total span of 10 to 35 years at the facilities we lease. We also lease smaller satellite X-Ray locations on mutually renewable terms, usually lasting one year. Additionally, we have operating and finance leases for certain medical and office equipment, with lease terms generally lasting from 5 to 8 years. Our Incremental Borrowing Rate ("IBR") used to discount the stream of lease payments is closely related to the interest rates charged on our collateralized debt obligations and our IBR is adjusted when those rates experience a substantial change. The components of lease expense were as follows: Three months ended (In thousands) March 31, 2019 Operating lease cost $ 22,792 Finance lease cost: Depreciation of leased equipment $ 783 Interest on lease liabilities 123 Total finance lease cost $ 905 Supplemental cash flow information related to leases was as follows: Three months ended (In thousands) March 31, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 22,921 Operating cash flows from financing leases 123 Financing cash flows from financing leases 1,522 Right-of-use & Equipment assets obtained in exchange for lease obligations: Operating leases (1) 412,695 Financing leases 14,056 (1) Amounts for the three months ended March 31, 2019 include the transition adjustment for the adoption of Topic 842 discussed in Note 2, Significant Accounting Policies for further information. Supplemental balance sheet information related to leases was as follows: (In thousands, except lease term and discount rates) March 31, 2019 Operating Leases Operating lease right-of-use assets $ 403,066 Current portion of operating lease liability $ 64,538 Operating lease liabilities 375,363 Total operating lease liabilities $ 439,901 Finance Leases Property and Equipment, at cost $ 14,056 Accumulated depreciation (783 ) Equipment, net $ 13,273 Current portion of finance lease $ 4,936 Finance lease liabilities 5,663 Total finance lease liabilities $ 10,599 Weighted Average Remaining Lease Term Operating leases - years 8.4 Finance leases - years 2.4 Weighted Average Discount Rate Operating leases 6.4 % Finance leases 4.4 % Maturities of lease liabilities were as follows: (In thousands) Operating Financing Year Ending December 31, Leases Leases 2019 (excluding the three months ended March 31, 2019) $ 67,927 $ 4,374 2020 84,334 3,481 2021 77,688 2,614 2022 67,351 692 2023 56,487 — Thereafter 225,101 — Total Lease Payments 578,888 11,161 Less imputed interest (138,987 ) (562 ) Total $ 439,901 $ 10,599 As of March 31, 2019 , we have additional operating leases for facilities and medical equipment that have not yet commenced of approximately $19.7 million . These operating leases will commence in 2019 with lease terms of 1 to 14 years. As previously disclosed in our 2018 Annual Report on Form 10-K and under the previous lease accounting, maturities of operating lease liabilities were as follows as of December 31, 2018 (in thousands): Facilities Equipment Total 2019 $ 75,588 $ 14,924 $ 90,512 2020 66,116 14,385 80,501 2021 57,826 12,966 70,792 2022 48,542 10,264 58,806 2023 38,800 7,095 45,895 Thereafter 160,327 5,144 165,471 $ 447,199 $ 64,778 $ 511,977

CREDIT FACILITY, NOTES PAYABLE

CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS	5.50x 4.50% 3.50% > 4.00x but ≤ 5.50x 3.75% 2.75% >3.50x but ≤ 4.00x 3.50% 2.50% ≤ 3.50x 3.25% 2.25% At March 31, 2019 the effective Adjusted Eurodollar Rate and the Base Rate for the First Lien Term Loans was 2.75% and 5.50% , respectively and the applicable margin for Adjusted Eurodollar Rate and Base Rate borrowings was 3.75% and 2.75% , respectively. Pursuant to the Fifth Amendment, the First Lien Credit Agreement was amended so that we can elect to request 1) an increase to the existing Barclays Revolving Credit Facility and/or 2) additional First Lien Term Loans, provided that the aggregate amount of such increases and additions does not exceed (a) $100.0 million and (b) as long as the First Lien Leverage Ratio (as defined in the First Lien Credit Agreement) would not exceed 4.00 :1.00 after giving effect to such incremental facilities, an uncapped amount of incremental facilities, in each case subject to the conditions and limitations set forth in the First Lien Credit Agreement. Each lender approached to provide all or a portion of any incremental facility may elect or decline, in its sole discretion, to provide an incremental commitment or loan. Pursuant to the Fifth Amendment, the First Lien Credit Agreement was also amended to (i) provide for quarterly payments of principal of the First Lien Term Loans in the amount of approximately $ 8.3 million , as compared to approximately $6.1 million prior to the Fifth Amendment, (ii) extend the call protection provided to the holders of the First Lien Term Loans for a period of twelve months following the date of the Fifth Amendment and (iii) provide us with additional operating flexibility, including the ability to incur certain additional debt and to make certain additional restricted payments, investments and dispositions, in each case as more fully set forth in the Fifth Amendment. Total issue costs for the Fifth Amendment aggregated to approximately $4.7 million . Of this amount, $4.1 million was identified and capitalized as discount on debt, $350,000 was capitalized as deferred financing costs and the remaining $235,000 was expensed. Amounts capitalized will be amortized over the remaining term of the agreement. Fourth Amendment to First Lien Credit Agreement On February 2, 2017, we entered into Amendment No. 4 to Credit and Guaranty Agreement (the “Fourth Amendment”) with respect to our First Lien Credit Agreement. Pursuant to the Fourth Amendment, the interest rate margin per annum on the First Lien Term Loans and the Barclays Revolving Credit Facility was reduced by 50 basis points, from 3.75% to 3.25% . Except for such reduction in the interest rate on credit extensions, the Fourth Amendment did not result in any other material modifications to the First Lien Credit Agreement. RadNet incurred expenses for the transaction in the amount of $543,000 , which was recorded to discount on debt and will be amortized over the remaining term of the agreement. The following describes our applicable financing prior to giving effect to the Fourth Amendment and Fifth Amendment discussed above. First Lien Credit Agreement On July 1, 2016, we entered into the First Lien Credit Agreement pursuant to which we amended and restated our then existing first lien credit facilities. Pursuant to the First Lien Credit Agreement, we originally issued $485 million of First Lien Term Loans and established the $117.5 million Barclays Revolving Credit Facility. Proceeds from the First Lien Credit Agreement were used to repay the previously outstanding first lien loans under the First Lien Credit Agreement, make a $12.0 million principal payment of the Second Lien Term Loans, pay costs and expenses related to the First Lien Credit Agreement and provide approximately $10.0 million for general corporate purposes. Interest: Prior to the Fourth Amendment and Fifth Amendment, the interest rates payable on the First Lien Term Loans were (a) the Adjusted Eurodollar Rate (as defined in the First Lien Credit Agreement) plus 3.75% per annum or (b) the Base Rate (as defined in the First Lien Credit Agreement) plus 2.75% per annum. As applied to the First Lien Term Loans, the Adjusted Eurodollar Rate has a minimum floor of 1.0% . Payments: Prior to the Fourth Amendment and Fifth Amendment, the scheduled quarterly principal payment of the First Lien Term Loans was approximately $6.1 million , with the balance due at maturity. Maturity Date: The maturity date for the First Lien Term Loans shall be on the earlier to occur of (i) July 1, 2023 and (ii) the date on which all First Lien Term Loans shall become due and payable in full under the First Lien Credit Agreement, whether by acceleration or otherwise. Barclays Revolving Credit Facility: The First Lien Credit Agreement provides for a $117.5 million Barclays revolving credit facility. Revolving loans borrowed under the Barclays Revolving Credit Facility bear interest at either an Adjusted Eurodollar Rate or a Base Rate (in each case, as more fully defined in the First Lien Credit Agreement), plus an applicable margin. Pursuant to the Fifth Amendment, the applicable margin was amended to vary based on our leverage ratio in accordance with the following schedule: First Lien Leverage Ratio Eurodollar Rate Spread Base Rate Spread > 5.50x 4.50% 3.50% > 4.00x but ≤ 5.50x 3.75% 2.75% >3.50x but ≤ 4.00x 3.50% 2.50% ≤ 3.50x 3.25% 2.25% For letters of credit issued under the Barclays Revolving Credit Facility, letter of credit fees accrue at the applicable margin (see table above) for Adjusted Eurodollar Rate revolving loans and fronting fees accrue at 0.25% per annum, in each case on the average aggregate daily maximum amount available to be drawn under all letters of credit issued under the First Lien Credit Agreement. In addition a commitment fee of 0.5% per annum accrues on the unused revolver commitments under the Barclays Revolving Credit Facility. As of March 31, 2019 , the interest rate payable on revolving loans was 8.25% . With amounts borrowed of $41.0 million and a reserve for letters of credit of $6.9 million as of March 31, 2019 , the amount available to borrow under the Barclays Revolving Credit Facility at March 31, 2019 was $69.6 million . The Barclays Revolving Credit Facility will terminate on the earliest to occur of (i) July 1, 2021 , (ii) the date we voluntarily agree to permanently reduce the Barclays Revolving Credit Facility to zero pursuant to section 2.13(b) of the First Lien Credit Agreement, and (iii) the date the Barclays Revolving Credit Facility is terminated due to specific events of default pursuant to section 8.01 of the First Lien Credit Agreement. The following describes our financing activities with respect to our SunTrust credit facilities: Amended and Restated Revolving Credit and Term Loan Agreement On August 31, 2018, our subsidiary, New Jersey Imaging Networks ("NJIN"), entered into the Amended and Restated Revolving Credit and Term Loan Agreement (as amended, the "SunTrust Restated Credit Agreement) as borrower with SunTrust Bank and other financial institutions as lenders to restate the SunTrust Original Credit Agreement (as described below) and to provide NJIN additional aggregate credit facilities of $48.1 million as categorized below: SunTrust Revolving Credit Facility: The SunTrust Restated Credit Agreement establishes a $30.0 million revolving credit facility available to NJIN for funding requirements. This represents an increase of $20.0 million over the revolving facility of $ 10.0 million made available to NJIN under the SunTrust Original Credit Agreement. The SunTrust Revolving Credit Facility terminates on the earliest of (i) August 31, 2023 (ii) the voluntary termination thereof by NJIN pursuant to Section 2.8 of the SunTrust Restated Credit Agreement, or (iii) the date on which all amounts outstanding under the SunTrust Restated Credit Agreement have been declared or have automatically become due and payable (whether by acceleration or otherwise). NJIN has not borrowed against the revolving credit line. SunTrust Term Loan: Pursuant to the SunTrust Restated Credit Agreement, the lenders thereunder made a term loan to NJIN in the amount of $60.0 million . This represents an increase of $28.1 million over the outstanding amount of the term loan under the SunTrust Original Credit Agreement and extends the term of the loan from September 30, 2020 to August 31, 2023. The SunTrust Term Loan is repayable in scheduled quarterly amounts (as described below) and has a maturity date of the earlier of (a) August 31, 2023 and (b) the date on which the principal amount of the SunTrust Term Loan has been declared or automatically has become due and payable (whether by acceleration or otherwise).. Interest: For the period from August 31, 2018, through the date NJIN delivered its financial statements and compliance certificate for the fiscal quarter ending September 30, 2018, the interest rates and fees applicable to the SunTrust Revolving Credit Facility and the SunTrust Term Loan were (i) for Eurodollar Loans (as defined in the SunTrust Restated Credit Agreement), the Adjusted LIBOR (as defined in the SunTrust Restated Credit Agreement) plus 2.75% per annum, (ii) for Base Rate Loans (as defined in the SunTrust Restated Credit Agreement), the Base Rate (as defined in the SunTrust Restated Credit Agreement) plus 1.75% per annum, (iii) for letters of credit, 2.75% per annum, and (iv) for the unused commitment fee on the SunTrust Revolving Credit Facility, 0.45% per annum. Thereafter, the rates of the applicable margin for borrowing under the SunTrust Restated Credit Agreement will adjust depending on our leverage ratio, according to the following table: Pricing Level Leverage Ratio Applicable Margin for Eurodollar Loans Applicable Margin for Base Rate Loans Applicable Margin for Letter of Credit Fees Applicable Percentage for Commitment Fee I Greater than or equal to 3.00:1.00 2.75% per annum 1.75% per annum 2.75% per annum 0.45% per annum II Less than 3.00:1.00 but greater than or equal to 2.50:1.00 2.25% per annum 1.25% per annum 2.25% per annum 0.40% per annum III Less than 2.50:1.00 but greater than or equal to 2.00:1.00 2.00% per annum 1.00% per annum 2.00% per annum 0.35% per annum IV Less than 2.00:1.00 but greater than or equal to 1.50:1.00 1.75% per annum 0.75% per annum 1.75% per annum 0.30% per annum V Less than 1.50:1.00 1.50% per annum 0.50% per annum 1.50% per annum 0.30% per annum The loans and other obligations outstanding under the SunTrust Restated Credit Agreement currently bear interest and fees based on Pricing Level I described above.The loans outstanding under the SunTrust Restated Credit Agreement currently bear interest based on a one month Eurodollar election. Payments: The scheduled amortization of the SunTrust Term Loan began December 31, 2018 with quarterly payments of $750,000 , representing annual amortization equal to 5% of the original principal amount of the SunTrust Term Loan. At scheduled intervals, the quarterly amortization increases by $375,000 , with the remaining balance to be paid at maturity. Revolving Credit and Term Loan Agreement On September 30, 2015, NJIN entered into the Revolving Credit and Term Loan Agreement (the "SunTrust Original Credit Agreement") as borrower with SunTrust Bank and other financial institutions as lenders, pursuant to which the lenders made available to NJIN credit facilities in an aggregate amount of $50.0 million as categorized below: Original Revolving Credit Facility: The SunTrust Original Credit Agreement established a $10.0 million revolving credit facility available to NJIN for needed funding requirements. The Original Revolving Credit Facility terminates on the earliest of (i) September 30, 2020, (ii) the voluntary termination thereof by NJIN pursuant to Section 2.8 of the SunTrust Original Credit Agreement, or (iii) the date on which all amounts outstanding under the SunTrust Original Credit Agreement have been declared or have automatically become due and payable (whether by acceleration or otherwise). Original Term Loan: Pursuant to the SunTrust Original Credit Agreement, the lenders thereunder made a term loan to NJIN in the amount of $40.0 million . The Original Term Loan is repayable in scheduled quarterly amounts (as described below) and has a maturity date of the earlier of (a) September 30, 2020 and (b) the date on which the principal amount of the Original Term Loan has been declared or automatically has become due and payable (whether by acceleration or otherwise). Interest: For the period from September 30, 2015, through the date NJIN delivered its financial statements and compliance certificate for the fiscal quarter ending December 31, 2015, the interest rates and fees applicable to the SunTrust Original Credit Agreement were (i) for Eurodollar Loans (as defined in the SunTrust Original Credit Agreement), the Adjusted LIBOR (as defined in the SunTrust Original Credit Agreement) plus 3.00% per annum, (ii) for Base Rate Loans (as defined in the SunTrust Original Credit Agreement), the Base Rate (as defined in the SunTrust Original Credit Agreement) plus 2.00% per annum, (iii) for letters of credit, 3.00% per annum, and (iv) for the unused commitment fee on the Original Revolving Credit Facility, 0.45% per annum. Thereafter, the rates of the applicable margin for borrowing under the SunTrust Original Credit Agreement adjusted depending on our leverage ratio, according to the following table: Pricing Level Leverage Ratio Applicable Margin for Eurodollar Loans Applicable Margin for Base Rate Loans Applicable Margin for Letter of Credit Fees Applicable Percentage for Commitment Fee I Greater than or equal to 3.00:1.00 3.00% per annum 2.00% per annum 3.00% per annum 0.45% per annum II Less than 3.00:1.00 but greater than or equal to 2.50:1.00 2.50% per annum 1.50% per annum 2.50% per annum 0.40% per annum III Less than 2.50:1.00 but greater than or equal to 2.00:1.00 2.25% per annum 1.25% per annum 2.25% per annum 0.35% per annum IV Less than 2.00:1.00 but greater than or equal to 1.50:1.00 2.00% per annum 1.00% per annum 2.00% per annum 0.30% per annum V Less than 1.50:1.00 1.75% per annum 0.75% per annum 1.75% per annum 0.30% per annum Payments: The scheduled amortization of the term loans under the SunTrust Original Credit Agreement began December 31, 2015 with quarterly payments of $500,000 , representing annual amortization equal to 5% of the original principal amount of the term loans under the SunTrust Original Credit Agreement. Each December 31, the scheduled quarterly amortization increased by a certain amount, with the remaining balance to be paid at maturity." id="sjs-B4">CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS As of the three months ended March 31, 2019 our debt obligations consist of the following (in thousands): March 31, December 31, First Lien Term Loans collateralized by RadNet's tangible and intangible assets $ 578,920 $ 587,191 Discounts on First Lien Term Loans (14,272 ) (15,112 ) Term Loan Agreement collateralized by NJIN's tangible and intangible assets 58,500 59,250 Revolving Credit Facilities 41,000 28,000 Promissory note payable to the former owner of a practice acquired at an interest rate of 1.5% due through 2019 100 199 Equipment notes payable at interest rates ranging from 3.3% to 5.6%, due through 2020, collateralized by medical equipment 538 632 Obligations under capital leases at interest rates ranging from 4.3% to 11.2%, due through 2022, collateralized by medical and office equipment (1) — 12,119 Total debt obligations 664,786 672,279 Less: current portion (33,912 ) (39,267 ) Long term portion debt obligations $ 630,874 $ 633,012 (1) Obligations under capital leases were transferred to Finance Lease Liability at January 1, 2019 in accordance with the adoption of Accounting Standards Update No 2016-02, Leases (Topic 842) . See Footnote 5, Leases, for more information. Senior Secured Credit Facilities At March 31, 2019 , our Barclays credit facilities were comprised of one tranche of term loans (“First Lien Term Loans”) and a revolving credit facility of $117.5 million (the “Barclays Revolving Credit Facility”), both of which are provided pursuant to the Amended and Restated First Lien Credit and Guaranty Agreement dated as of July 1, 2016 (as amended, the “First Lien Credit Agreement”). At March 31, 2019 , our SunTrust credit facilities were comprised of one term loan (the "SunTrust Term Loan") and a revolving credit facility of $30.0 million (the "SunTrust Revolving Credit Facility") both of which are provided pursuant to the SunTrust Restated Credit Agreement (as described below). As of March 31, 2019 , we were in compliance with all covenants under our credit facilities. Deferred financing costs at March 31, 2019 , net of accumulated amortization, was $1.2 million and is specifically related to our Barclays Revolving Credit Facility. Included in our condensed consolidated balance sheets at March 31, 2019 are $623.1 million of senior secured term loan debt (net of unamortized discounts of $14.3 million ) in thousands: Face Value Discount Total Carrying First Lien Term Loans 578,920 (14,272 ) 564,648 SunTrust Term Loan 58,500 — 58,500 Total Term Loans 637,420 (14,272 ) 623,148 We had a balance of $41.0 million under our $117.5 million Barclays Revolving Credit Facility at March 31, 2019 and have reserved an additional $6.9 million for certain letters of credit. The remaining $69.6 million of our Barclays Revolving Credit Facility was available to draw upon as of March 31, 2019 . We had no balance under our $30.0 million SunTrust Revolving Credit Facility at March 31, 2019 . The following describes our financing activities related to our Barclays credit facilities: Amendment No. 5, Consent and Incremental Joinder Agreement to Credit and Guaranty Agreement On August 22, 2017, we entered into Amendment No. 5, Consent and Incremental Joinder Agreement to Credit and Guaranty Agreement (the “Fifth Amendment”) with respect to our First Lien Credit Agreement. Pursuant to the Fifth Amendment, we issued $170.0 million in incremental First Lien Term Loans, the proceeds of which were used to repay in full previously outstanding second lien term loans. Pursuant to the Fifth Amendment, we also changed the interest rate margin applicable to borrowings under the First Lien Credit Agreement. While borrowings under the First Lien Credit Agreement continue to bear interest at either an Adjusted Eurodollar Rate or a Base Rate (in each case, as more fully defined in the First Lien Credit Agreement) or a combination of both, at the election of the Company, plus an applicable margin. Applicable margin for Adjusted Eurodollar Rate borrowings and Base Rate borrowings was changed from 3.25% and 2.25% , respectively, to 3.75% and 2.75% , respectively, through an initial period which ended when financial reporting was delivered for the period ended September 30, 2017. Thereafter, the rates of the applicable margin for borrowing under the First Lien Credit Agreement adjust depending on our leverage ratio, according to the following schedule: First Lien Leverage Ratio Eurodollar Rate Spread Base Rate Spread > 5.50x 4.50% 3.50% > 4.00x but ≤ 5.50x 3.75% 2.75% >3.50x but ≤ 4.00x 3.50% 2.50% ≤ 3.50x 3.25% 2.25% At March 31, 2019 the effective Adjusted Eurodollar Rate and the Base Rate for the First Lien Term Loans was 2.75% and 5.50% , respectively and the applicable margin for Adjusted Eurodollar Rate and Base Rate borrowings was 3.75% and 2.75% , respectively. Pursuant to the Fifth Amendment, the First Lien Credit Agreement was amended so that we can elect to request 1) an increase to the existing Barclays Revolving Credit Facility and/or 2) additional First Lien Term Loans, provided that the aggregate amount of such increases and additions does not exceed (a) $100.0 million and (b) as long as the First Lien Leverage Ratio (as defined in the First Lien Credit Agreement) would not exceed 4.00 :1.00 after giving effect to such incremental facilities, an uncapped amount of incremental facilities, in each case subject to the conditions and limitations set forth in the First Lien Credit Agreement. Each lender approached to provide all or a portion of any incremental facility may elect or decline, in its sole discretion, to provide an incremental commitment or loan. Pursuant to the Fifth Amendment, the First Lien Credit Agreement was also amended to (i) provide for quarterly payments of principal of the First Lien Term Loans in the amount of approximately $ 8.3 million , as compared to approximately $6.1 million prior to the Fifth Amendment, (ii) extend the call protection provided to the holders of the First Lien Term Loans for a period of twelve months following the date of the Fifth Amendment and (iii) provide us with additional operating flexibility, including the ability to incur certain additional debt and to make certain additional restricted payments, investments and dispositions, in each case as more fully set forth in the Fifth Amendment. Total issue costs for the Fifth Amendment aggregated to approximately $4.7 million . Of this amount, $4.1 million was identified and capitalized as discount on debt, $350,000 was capitalized as deferred financing costs and the remaining $235,000 was expensed. Amounts capitalized will be amortized over the remaining term of the agreement. Fourth Amendment to First Lien Credit Agreement On February 2, 2017, we entered into Amendment No. 4 to Credit and Guaranty Agreement (the “Fourth Amendment”) with respect to our First Lien Credit Agreement. Pursuant to the Fourth Amendment, the interest rate margin per annum on the First Lien Term Loans and the Barclays Revolving Credit Facility was reduced by 50 basis points, from 3.75% to 3.25% . Except for such reduction in the interest rate on credit extensions, the Fourth Amendment did not result in any other material modifications to the First Lien Credit Agreement. RadNet incurred expenses for the transaction in the amount of $543,000 , which was recorded to discount on debt and will be amortized over the remaining term of the agreement. The following describes our applicable financing prior to giving effect to the Fourth Amendment and Fifth Amendment discussed above. First Lien Credit Agreement On July 1, 2016, we entered into the First Lien Credit Agreement pursuant to which we amended and restated our then existing first lien credit facilities. Pursuant to the First Lien Credit Agreement, we originally issued $485 million of First Lien Term Loans and established the $117.5 million Barclays Revolving Credit Facility. Proceeds from the First Lien Credit Agreement were used to repay the previously outstanding first lien loans under the First Lien Credit Agreement, make a $12.0 million principal payment of the Second Lien Term Loans, pay costs and expenses related to the First Lien Credit Agreement and provide approximately $10.0 million for general corporate purposes. Interest: Prior to the Fourth Amendment and Fifth Amendment, the interest rates payable on the First Lien Term Loans were (a) the Adjusted Eurodollar Rate (as defined in the First Lien Credit Agreement) plus 3.75% per annum or (b) the Base Rate (as defined in the First Lien Credit Agreement) plus 2.75% per annum. As applied to the First Lien Term Loans, the Adjusted Eurodollar Rate has a minimum floor of 1.0% . Payments: Prior to the Fourth Amendment and Fifth Amendment, the scheduled quarterly principal payment of the First Lien Term Loans was approximately $6.1 million , with the balance due at maturity. Maturity Date: The maturity date for the First Lien Term Loans shall be on the earlier to occur of (i) July 1, 2023 and (ii) the date on which all First Lien Term Loans shall become due and payable in full under the First Lien Credit Agreement, whether by acceleration or otherwise. Barclays Revolving Credit Facility: The First Lien Credit Agreement provides for a $117.5 million Barclays revolving credit facility. Revolving loans borrowed under the Barclays Revolving Credit Facility bear interest at either an Adjusted Eurodollar Rate or a Base Rate (in each case, as more fully defined in the First Lien Credit Agreement), plus an applicable margin. Pursuant to the Fifth Amendment, the applicable margin was amended to vary based on our leverage ratio in accordance with the following schedule: First Lien Leverage Ratio Eurodollar Rate Spread Base Rate Spread > 5.50x 4.50% 3.50% > 4.00x but ≤ 5.50x 3.75% 2.75% >3.50x but ≤ 4.00x 3.50% 2.50% ≤ 3.50x 3.25% 2.25% For letters of credit issued under the Barclays Revolving Credit Facility, letter of credit fees accrue at the applicable margin (see table above) for Adjusted Eurodollar Rate revolving loans and fronting fees accrue at 0.25% per annum, in each case on the average aggregate daily maximum amount available to be drawn under all letters of credit issued under the First Lien Credit Agreement. In addition a commitment fee of 0.5% per annum accrues on the unused revolver commitments under the Barclays Revolving Credit Facility. As of March 31, 2019 , the interest rate payable on revolving loans was 8.25% . With amounts borrowed of $41.0 million and a reserve for letters of credit of $6.9 million as of March 31, 2019 , the amount available to borrow under the Barclays Revolving Credit Facility at March 31, 2019 was $69.6 million . The Barclays Revolving Credit Facility will terminate on the earliest to occur of (i) July 1, 2021 , (ii) the date we voluntarily agree to permanently reduce the Barclays Revolving Credit Facility to zero pursuant to section 2.13(b) of the First Lien Credit Agreement, and (iii) the date the Barclays Revolving Credit Facility is terminated due to specific events of default pursuant to section 8.01 of the First Lien Credit Agreement. The following describes our financing activities with respect to our SunTrust credit facilities: Amended and Restated Revolving Credit and Term Loan Agreement On August 31, 2018, our subsidiary, New Jersey Imaging Networks ("NJIN"), entered into the Amended and Restated Revolving Credit and Term Loan Agreement (as amended, the "SunTrust Restated Credit Agreement) as borrower with SunTrust Bank and other financial institutions as lenders to restate the SunTrust Original Credit Agreement (as described below) and to provide NJIN additional aggregate credit facilities of $48.1 million as categorized below: SunTrust Revolving Credit Facility: The SunTrust Restated Credit Agreement establishes a $30.0 million revolving credit facility available to NJIN for funding requirements. This represents an increase of $20.0 million over the revolving facility of $ 10.0 million made available to NJIN under the SunTrust Original Credit Agreement. The SunTrust Revolving Credit Facility terminates on the earliest of (i) August 31, 2023 (ii) the voluntary termination thereof by NJIN pursuant to Section 2.8 of the SunTrust Restated Credit Agreement, or (iii) the date on which all amounts outstanding under the SunTrust Restated Credit Agreement have been declared or have automatically become due and payable (whether by acceleration or otherwise). NJIN has not borrowed against the revolving credit line. SunTrust Term Loan: Pursuant to the SunTrust Restated Credit Agreement, the lenders thereunder made a term loan to NJIN in the amount of $60.0 million . This represents an increase of $28.1 million over the outstanding amount of the term loan under the SunTrust Original Credit Agreement and extends the term of the loan from September 30, 2020 to August 31, 2023. The SunTrust Term Loan is repayable in scheduled quarterly amounts (as described below) and has a maturity date of the earlier of (a) August 31, 2023 and (b) the date on which the principal amount of the SunTrust Term Loan has been declared or automatically has become due and payable (whether by acceleration or otherwise).. Interest: For the period from August 31, 2018, through the date NJIN delivered its financial statements and compliance certificate for the fiscal quarter ending September 30, 2018, the interest rates and fees applicable to the SunTrust Revolving Credit Facility and the SunTrust Term Loan were (i) for Eurodollar Loans (as defined in the SunTrust Restated Credit Agreement), the Adjusted LIBOR (as defined in the SunTrust Restated Credit Agreement) plus 2.75% per annum, (ii) for Base Rate Loans (as defined in the SunTrust Restated Credit Agreement), the Base Rate (as defined in the SunTrust Restated Credit Agreement) plus 1.75% per annum, (iii) for letters of credit, 2.75% per annum, and (iv) for the unused commitment fee on the SunTrust Revolving Credit Facility, 0.45% per annum. Thereafter, the rates of the applicable margin for borrowing under the SunTrust Restated Credit Agreement will adjust depending on our leverage ratio, according to the following table: Pricing Level Leverage Ratio Applicable Margin for Eurodollar Loans Applicable Margin for Base Rate Loans Applicable Margin for Letter of Credit Fees Applicable Percentage for Commitment Fee I Greater than or equal to 3.00:1.00 2.75% per annum 1.75% per annum 2.75% per annum 0.45% per annum II Less than 3.00:1.00 but greater than or equal to 2.50:1.00 2.25% per annum 1.25% per annum 2.25% per annum 0.40% per annum III Less than 2.50:1.00 but greater than or equal to 2.00:1.00 2.00% per annum 1.00% per annum 2.00% per annum 0.35% per annum IV Less than 2.00:1.00 but greater than or equal to 1.50:1.00 1.75% per annum 0.75% per annum 1.75% per annum 0.30% per annum V Less than 1.50:1.00 1.50% per annum 0.50% per annum 1.50% per annum 0.30% per annum The loans and other obligations outstanding under the SunTrust Restated Credit Agreement currently bear interest and fees based on Pricing Level I described above.The loans outstanding under the SunTrust Restated Credit Agreement currently bear interest based on a one month Eurodollar election. Payments: The scheduled amortization of the SunTrust Term Loan began December 31, 2018 with quarterly payments of $750,000 , representing annual amortization equal to 5% of the original principal amount of the SunTrust Term Loan. At scheduled intervals, the quarterly amortization increases by $375,000 , with the remaining balance to be paid at maturity. Revolving Credit and Term Loan Agreement On September 30, 2015, NJIN entered into the Revolving Credit and Term Loan Agreement (the "SunTrust Original Credit Agreement") as borrower with SunTrust Bank and other financial institutions as lenders, pursuant to which the lenders made available to NJIN credit facilities in an aggregate amount of $50.0 million as categorized below: Original Revolving Credit Facility: The SunTrust Original Credit Agreement established a $10.0 million revolving credit facility available to NJIN for needed funding requirements. The Original Revolving Credit Facility terminates on the earliest of (i) September 30, 2020, (ii) the voluntary termination thereof by NJIN pursuant to Section 2.8 of the SunTrust Original Credit Agreement, or (iii) the date on which all amounts outstanding under the SunTrust Original Credit Agreement have been declared or have automatically become due and payable (whether by acceleration or otherwise). Original Term Loan: Pursuant to the SunTrust Original Credit Agreement, the lenders thereunder made a term loan to NJIN in the amount of $40.0 million . The Original Term Loan is repayable in scheduled quarterly amounts (as described below) and has a maturity date of the earlier of (a) September 30, 2020 and (b) the date on which the principal amount of the Original Term Loan has been declared or automatically has become due and payable (whether by acceleration or otherwise). Interest: For the period from September 30, 2015, through the date NJIN delivered its financial statements and compliance certificate for the fiscal quarter ending December 31, 2015, the interest rates and fees applicable to the SunTrust Original Credit Agreement were (i) for Eurodollar Loans (as defined in the SunTrust Original Credit Agreement), the Adjusted LIBOR (as defined in the SunTrust Original Credit Agreement) plus 3.00% per annum, (ii) for Base Rate Loans (as defined in the SunTrust Original Credit Agreement), the Base Rate (as defined in the SunTrust Original Credit Agreement) plus 2.00% per annum, (iii) for letters of credit, 3.00% per annum, and (iv) for the unused commitment fee on the Original Revolving Credit Facility, 0.45% per annum. Thereafter, the rates of the applicable margin for borrowing under the SunTrust Original Credit Agreement adjusted depending on our leverage ratio, according to the following table: Pricing Level Leverage Ratio Applicable Margin for Eurodollar Loans Applicable Margin for Base Rate Loans Applicable Margin for Letter of Credit Fees Applicable Percentage for Commitment Fee I Greater than or equal to 3.00:1.00 3.00% per annum 2.00% per annum 3.00% per annum 0.45% per annum II Less than 3.00:1.00 but greater than or equal to 2.50:1.00 2.50% per annum 1.50% per annum 2.50% per annum 0.40% per annum III Less than 2.50:1.00 but greater than or equal to 2.00:1.00 2.25% per annum 1.25% per annum 2.25% per annum 0.35% per annum IV Less than 2.00:1.00 but greater than or equal to 1.50:1.00 2.00% per annum 1.00% per annum 2.00% per annum 0.30% per annum V Less than 1.50:1.00 1.75% per annum 0.75% per annum 1.75% per annum 0.30% per annum Payments: The scheduled amortization of the term loans under the SunTrust Original Credit Agreement began December 31, 2015 with quarterly payments of $500,000 , representing annual amortization equal to 5% of the original principal amount of the term loans under the SunTrust Original Credit Agreement. Each December 31, the scheduled quarterly amortization increased by a certain amount, with the remaining balance to be paid at maturity.

STOCK-BASED COMPENSATION

STOCK-BASED COMPENSATION	3 Months Ended
	Mar. 31, 2019
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
STOCK-BASED COMPENSATION	STOCK-BASED COMPENSATION Stock Incentive Plans We have one long-term equity incentive plan which we refer to as the 2006 Equity Incentive Plan, which we first amended and restated as of April 20, 2015 and again on March 9, 2017 (the "Restated Plan”). The Restated Plan was approved by our stockholders at our annual stockholders meeting on June 8, 2017. We have reserved for issuance under the Restated Plan 14,000,000 shares of common stock. We can issue options, stock awards, stock appreciation rights, stock units and cash awards under the Restated Plan. Options Certain options granted under the Restated Plan to employees are intended to qualify as incentive stock options under existing tax regulations. Stock options generally vest over 3 to 5 years and expire 5 to 10 years from the date of grant. As of March 31, 2019 , we had outstanding options to acquire 481,451 shares of our common stock, of which options to acquire 129,290 shares were exercisable. The following summarizes all of our option transactions for the three months ended March 31, 2019 : Outstanding Options Under the 2006 Plan Shares Weighted Average Exercise price Per Common Share Weighted Average Remaining Contractual Life (in years) Aggregate Intrinsic Value Balance,December 31, 2018 513,282 $ 7.44 Granted 89,200 10.93 Exercised (10,000 ) 4.97 Canceled, forfeited or expired (111,031 ) 0.08 Balance, March 31, 2019 481,451 8.22 8.06 $ 2,007,986 Exercisable at March 31, 2019 129,290 6.66 7.06 740,955 Aggregate intrinsic value in the table above represents the total pretax intrinsic value (the difference between our closing stock price on March 31, 2019 and the exercise price, multiplied by the number of in-the-money options as applicable) that would have been received by the holder had all holders exercised their options on March 31, 2019 . Options exercised amounted to 10,000 shares during the three months ended March 31, 2019 . As of March 31, 2019 , total unrecognized stock-based compensation expense related to non-vested employee awards was $1.1 million which is expected to be recognized over a weighted average period of approximately 2 years. Restricted Stock Awards (“RSA’s”) The Restated Plan permits the award of restricted stock awards (“RSA’s”). As of March 31, 2019 , we have issued a total of 6,043,620 RSA’s of which 392,644 were unvested at March 31, 2019 . The following summarizes all unvested RSA’s activities during the three months ended March 31, 2019 : RSA's Weighted-Average Remaining Contractual Term (Years) Weighted-Average Fair Value RSA's unvested at December 31, 2018 277,504 $ 9.77 Changes during the period Granted 586,000 $ 11.83 Vested (470,860 ) $ 10.62 RSA's unvested at March 31, 2019 392,644 1.92 $ 11.51 We determine the fair value of all RSA’s based on the closing price of our common stock on award date. Other stock bonus awards The Restated Plan also permits the award of stock bonuses not subject to any future service period. These awards are valued and expensed based on the closing price of our common stock on the date of award. During the three months ended March 31, 2019 no awards of such nature were granted. Plan summary In summary, of the 14,000,000 shares of common stock reserved for issuance under the Restated Plan, at March 31, 2019 , we had issued 14,734,438 total shares between options, RSA’s and other stock awards. With options cancelled and RSA’s forfeited amounting to 3,281,040 and 60,203 shares, respectively, there remain 2,606,805 shares available under the Restated Plan for future issuance.

SUBSEQUENT EVENTS

SUBSEQUENT EVENTS	3 Months Ended
	Mar. 31, 2019
Subsequent Events [Abstract]
SUBSEQUENT EVENTS	SUBSEQUENT EVENTS Acquisitions: On April 1, 2019 we completed our acquisition of certain assets of Kern Radiology Imaging Systems, Inc., consisting of 4 multi-modality imaging centers located in Bakersfield, CA for purchase consideration of $19.3 million . On April 1, 2019 we completed our acquisition of certain assets of Zilkha Radiology consisting of a single multi-modality imaging center located in West Islip, NY for purchase consideration of $4.5 million . 2019 Amendments to the First Lien Credit Agreement: The following relates only to our financing activities related to our Barclays credit facilities: On April 18, 2019 we entered into the following two new amendments to the First Lien Credit Agreement: (i) Amendment No. 6, Consent and Incremental Joinder Agreement to Credit and Guaranty Agreement dated as of April 18, 2019 by and among Radnet Management, Inc., RadNet, Inc., certain subsidiaries and affiliates of RadNet, Inc., the lenders party thereto from time to time, and Barclays Bank PLC, as administrative agent and collateral agent (the “Sixth Amendment”); and (ii) Amendment No. 7 to Credit and Guaranty Agreement dated as of April 18, 2019 by and among Radnet Management, Inc., RadNet, Inc., certain subsidiaries and affiliates of RadNet, Inc., the lenders party thereto from time to time, and Barclays Bank PLC, as administrative agent and collateral agent (the “Seventh Amendment”). The Sixth Amendment amended the First Lien Credit Agreement to issue $100.0 million in incremental First Lien Term Loans and to add an additional $20.0 million of revolving commitments. Under the First Lien Credit Agreement, we now have approximately $679.0 million in First Lien Term Loans outstanding and capacity to borrow up to $137.5 million under our Barclays Revolving Credit Facility. The proceeds of the incremental First Lien Term Loans have been used to repay revolving loans outstanding under the Revolving Credit Facility and the fees, costs and expenses associated with the Sixth Amendment and the Seventh Amendment. The Seventh Amendment amends the First Lien Credit Agreement to extend the maturity date of the Barclays Revolving Credit Facility by an additional two years to July 1, 2023, unless sooner terminated in accordance with the terms of the First Lien Credit Agreement. The First Lien Credit Agreement, as amended by the Sixth Amendment, provides for quarterly payments of principal under the First Lien Term Loans in the amount of approximately $9.7 million , as compared to approximately $8.3 million under the First Lien Credit Agreement prior to the Sixth Amendment.

SIGNIFICANT ACCOUNTING POLICI_2

SIGNIFICANT ACCOUNTING POLICIES (Policies)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
REVENUES	REVENUES - Our revenues generally relate to net patient fees received from various payers and patients themselves under contracts in which our performance obligations are to provide diagnostic services to the patients. Revenues are recorded during the period our obligations to provide diagnostic services are satisfied. Our performance obligations for diagnostic services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges and generally provide for payments based upon predetermined rates per diagnostic services or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. As it relates to BRMG centers, this service fee revenue includes payments for both the professional medical interpretation revenue recognized by BRMG as well as the payment for all other aspects related to our providing the imaging services, for which we earn management fees from BRMG. As it relates to non-BRMG centers, this service fee revenue is earned through providing the use of our diagnostic imaging equipment and the provision of technical services as well as providing administration services such as clerical and administrative personnel, bookkeeping and accounting services, billing and collection, provision of medical and office supplies, secretarial, reception and transcription services, maintenance of medical records, and advertising, marketing and promotional activities. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Under capitation arrangements with various health plans, we earn a per-enrollee amount each month for making available diagnostic imaging services to all plan enrollees under the capitation arrangement. Revenue under capitation arrangements is recognized in the period in which we are obligated to provide services to plan enrollees under contracts with various health plans. The Company’s total net revenues during the three months ended March 31, 2019 and 2018 are presented in the table below based on an allocation of the estimated transaction price with the patient between the primary patient classification of insurance coverage (in thousands): Three Months Ended 2019 2018 Commercial insurance $ 151,678 $ 126,225 Medicare 54,199 44,076 Medicaid 7,120 6,048 Workers' compensation/personal injury 11,027 8,431 Other patient revenue 5,835 5,606 Management fee revenue 2,117 3,677 Teleradiology and Software revenue 4,386 3,816 Other 6,310 6,289 Service fee revenue 242,672 204,168 Revenue under capitation arrangements 28,877 27,224 Total revenue $ 271,549 $ 231,392
RECLASSIFICATION	RECLASSIFICATION – We have reclassified certain amounts within our table of income allocation for 2018 to conform to our 2019 presentation.
ACCOUNTS RECEIVABLE	ACCOUNTS RECEIVABLE - Substantially all of our accounts receivable are due under fee-for-service contracts from third party payors, such as insurance companies and government-sponsored healthcare programs, or directly from patients. Services are generally provided pursuant to one-year contracts with healthcare providers. We continuously monitor collections from our payors and maintain an allowance for bad debts based upon specific payor collection issues that we have identified and our historical experience. In 2018 we entered into factoring agreements with various institutions and sold certain accounts receivable under non-recourse agreements. These transactions are accounted for as a reduction in accounts receivable as the agreements transfer effective control over and risk related to the receivables to the buyers. The aggregate gross amount factored under these facilities was $20.5 million for the year ended December 31, 2018 and the cost of factoring such accounts receivable for the year ended December 31, 2018 was $440,000 . Proceeds will be received as a combination of cash and payments on notes receivable and will be reflected as operating activities on our statement of cash flows and on our balance sheet as prepaid expenses and other current assets for the current portion and deposits and other for the long term portion. At March 31, 2019 we have $17.8 million remaining to be collected on these agreements. We do not utilize factoring arrangements as an integral part of our financing for working capital.
DEFERRED FINANCING COSTS	DEFERRED FINANCING COSTS - Costs of financing are deferred and amortized using the effective interest rate method. Deferred financing costs, net of accumulated amortization, were $1.2 million and $1.4 million , as of March 31, 2019 and December 31, 2018 , respectively and related to our line of credit. See Note 6, Revolving Credit Facility and Notes Payable, for more information.
INVENTORIES	INVENTORIES - Inventories, consisting mainly of medical supplies, are stated at the lower of cost or net realizable value with cost determined by the first-in, first-out method.
PROPERTY AND EQUIPMENT	PROPERTY AND EQUIPMENT - Property and equipment are stated at cost, less accumulated depreciation and amortization. Depreciation of property and equipment is performed using the straight-line method over the estimated useful lives of the assets acquired, which range from 3 to 15 years. Leasehold improvements are amortized at the lesser of lease term or their estimated useful lives, which range from 3 to 15 years. Maintenance and repairs are charged to expense as incurred.
BUSINESS COMBINATION	BUSINESS COMBINATION - When the qualifications for business combination accounting treatment are met, it requires us to recognize separately from goodwill the assets acquired and the liabilities assumed at their acquisition date fair values. Goodwill as of the acquisition date is measured as the excess of consideration transferred over the net of the acquisition date fair values of the assets acquired and the liabilities assumed. While we use our best estimates and assumptions to accurately value assets acquired and liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we record adjustments to the assets acquired and liabilities assumed with the corresponding offset to goodwill. Upon the conclusion of the measurement period or final determination of the values of assets acquired or liabilities assumed, whichever comes first, any subsequent adjustments are recorded to our consolidated statements of operations.
GOODWILL AND INDEFINITE LIVED INTANGIBLES	GOODWILL AND INDEFINITE LIVED INTANGIBLES- Goodwill at March 31, 2019 totaled $424.3 million . Indefinite lived intangible assets at March 31, 2019 were $9.9 million . Goodwill and Indefinite Lived Intangibles are recorded as a result of business combinations. When we determine the carrying value of goodwill exceeds its fair value an impairment charge would be recognized and should not exceed the total amount of goodwill allocated to that reporting unit. We tested goodwill and indefinite lived intangibles for impairment on October 1, 2018. During the review we noted our Teleradiology unit, Imaging On Call, (IOC), experienced a reduction of professional medical group clients and a contract with a major local health provider during 2018. This affected its estimated fair value and resulted in impairment charges to our the reporting unit of $3.9 million for the twelve months ended December 31, 2018 , with goodwill representing $3.8 million of the total and the remainder being its trade name of approximately $100,000 . We have not identified any indicators of impairment through March 31, 2019 . Activity in goodwill for the three months ended March 31, 2019 is provided below (in thousands): Balance as of December 31, 2018 $ 418,093 Adjustments to our preliminary allocation of the purchase price of Medical Arts Radiological Group, P.C. 722 Goodwill acquired through the acquisition of certain assets of Dignity Health 1 Goodwill acquired through the acquisition of certain assets of West Valley Imaging Center, LLC 2,490 Goodwill disposed through sale of assets (123 ) Goodwill acquired by Lenox Hill Radiology through the membership purchase of HVRA 3,125 Balance as of March 31, 2019 $ 424,308
INCOME TAXES	INCOME TAXES - Income tax expense is computed using an asset and liability method and using expected annual effective tax rates. Under this method, deferred income tax assets and liabilities result from temporary differences in the financial reporting bases and the income tax reporting bases of assets and liabilities. The measurement of deferred tax assets is reduced, if necessary, by the amount of any tax benefit that, based on available evidence, is not expected to be realized. When it appears more likely than not that deferred taxes will not be realized, a valuation allowance is recorded to reduce the deferred tax asset to its estimated realizable value. For net deferred tax assets we consider estimates of future taxable income in determining whether our net deferred tax assets are more likely than not to be realized. We recorded an income tax benefit of $1.2 million , or an effective tax rate of 39.0% , for the three months ended March 31, 2019 compared to income tax benefit for the three months ended March 31, 2018 of $2.5 million , or an effective tax rate of 22.4% . The income tax rates for the three months ended March 31, 2019 diverge from the federal statutory rate due to (i) noncontrolling interests due to the controlled partnerships; (ii) effects of state income taxes; (iii) excess tax benefits attributable to share-based compensation; and adjustment associated with uncertain tax positions. U.S. GAAP requires that the impact of tax legislation be recognized in the period in which the law was enacted. As a result, we recorded provisional amounts due to the revaluation of deferred tax assets and liabilities and the transition tax on deemed repatriation of accumulated foreign income during the year ended December 31, 2018 . Both of these tax charges represent provisional amounts and our current best estimates. Any adjustments recorded to the provisional amounts will be included as an adjustment to tax expense. The provisional amounts incorporate assumptions made based upon our current interpretation of the Tax Reform Act and may change as we receive additional clarification and implementation guidance. We are not under examination in any jurisdiction and the years ended December 31, 2018 , 2017 , and 2016 remain subject to examination. We believe no significant changes in the unrecognized tax benefits will occur within the next 12 months.
EQUITY BASED COMPENSATION	EQUITY BASED COMPENSATION – We have one long-term incentive plan that we adopted in 2006 and which we first amended and restated as of April 20, 2015, and again on March 9, 2017 (the “Restated Plan”). The Restated Plan was approved by our stockholders at our annual stockholders meeting on June 8, 2017. We have reserved for issuance under the Restated Plan 14,000,000 shares of common stock. We can issue options, stock awards, stock appreciation rights, stock units and cash awards under the Restated Plan. Certain options granted under the Restated Plan to employees are intended to qualify as incentive stock options under existing tax regulations. Stock options and warrants generally vest over three to five years and expire five to ten years from date of grant. The compensation expense recognized for all equity-based awards is recognized over the awards’ service periods. Equity-based compensation is classified in operating expenses within the same line item as the majority of the cash compensation paid to employees. See Note 7, Stock-Based Compensation, for more information.
COMPREHENSIVE INCOME	COMPREHENSIVE INCOME - ASC 220, Comprehensive Income, establishes rules for reporting and displaying comprehensive income or loss and its components. Our unrealized gains or losses on foreign currency translation adjustments and our interest rate cap agreement are included in comprehensive income. The components of comprehensive loss for the three months ended March 31, 2019 are included in the consolidated statements of comprehensive loss.
DERIVATIVE INSTRUMENTS	DERIVATIVE INSTRUMENTS - In the fourth quarter of 2016, we entered into two forward interest rate cap agreements ("2016 Caps"). The 2016 Caps will mature in September and October 2020. The 2016 Caps had notional amounts of $150,000,000 and $350,000,000 , respectively, which were designated at inception as cash flow hedges of future cash interest payments associated with portions of the our variable rate bank debt. Under these arrangements, the Company purchased a cap on 3 month LIBOR at 2.0% . We are liable for a $5.3 million premium to enter into the caps which is being accrued over the life of the agreements. At inception, we designated our 2016 Caps as cash flow hedges of floating-rate borrowings. In accordance with ASC Topic 815, derivatives that have been designated and qualify as cash flow hedging instruments are reported at fair value. The gain or loss of the hedge (i.e. change in fair value) is reported as a component of comprehensive loss in the consolidated statement of equity. See Fair Value Measurements section below for the fair value of the 2016 Caps at March 31, 2019 . A tabular presentation of the effect of derivative instruments on our consolidated statement of comprehensive loss is as follows (amounts in thousands): For the three months ended March 31, 2019 Account January 1, 2019 Balance Amount of comprehensive loss recognized on derivative March 31, 2019 Balance Location Accumulated Other Comprehensive Income (Loss) 2,506 (1,196 ) 1,310 Current Assets & Equity For the twelve months ended December 31, 2018 Account January 1, 2018 Balance Amount of comprehensive gain recognized on derivative December 31, 2018 Balance Location Accumulated Other Comprehensive (Loss) Income (370 ) 2,876 2,506 Current Assets & Equity
FAIR VALUE MEASUREMENTS	FAIR VALUE MEASUREMENTS – Assets and liabilities subject to fair value measurements are required to be disclosed within a fair value hierarchy. The fair value hierarchy ranks the quality and reliability of inputs used to determine fair value. Accordingly, assets and liabilities carried at, or permitted to be carried at, fair value are classified within the fair value hierarchy in one of the following categories based on the lowest level input that is significant to a fair value measurement: Level 1—Fair value is determined by using unadjusted quoted prices that are available in active markets for identical assets and liabilities. Level 2—Fair value is determined by using inputs other than Level 1 quoted prices that are directly or indirectly observable. Inputs can include quoted prices for similar assets and liabilities in active markets or quoted prices for identical assets and liabilities in inactive markets. Related inputs can also include those used in valuation or other pricing models such as interest rates and yield curves that can be corroborated by observable market data. Level 3—Fair value is determined by using inputs that are unobservable and not corroborated by market data. Use of these inputs involves significant and subjective judgment. The table below summarizes the estimated fair values of certain of our financial assets that are subject to fair value measurements, and the classification of these assets on our consolidated balance sheets, as follows (in thousands): As of March 31, 2019 Level 1 Level 2 Level 3 Total Current assets Interest Rate Contracts $ — $ 1,690 $ — $ 1,690 As of December 31, 2018 Level 1 Level 2 Level 3 Total Current assets Interest Rate Contracts $ — $ 3,316 $ — $ 3,316 The estimated fair value of these contracts was determined using Level 2 inputs. More specifically, the fair value was determined by calculating the value of the difference between the fixed interest rate of the interest rate swaps and the counterparty’s forward LIBOR curve. The forward LIBOR curve is readily available in the public markets or can be derived from information available in the public markets. The table below summarizes the estimated fair value compared to our face value of our long-term debt as follows (in thousands): As of March 31, 2019 Level 1 Level 2 Level 3 Total Fair Value Total Face Value First Lien Term Loans and SunTrust Term Loan $ — $ 638,144 $ — $ 638,144 $ 637,420 As of December 31, 2018 Level 1 Level 2 Level 3 Total Total Face Value First Lien Term Loans and SunTrust Term Loan $ — $ 633,229 $ — $ 633,229 $ 646,441 As of March 31, 2019 and December 31, 2018 , our Barclays revolving credit facility had $41.0 million and $28.0 million aggregate principal amount outstanding, respectively. Our SunTrust revolving credit facility had no principal amount outstanding at March 31, 2019. The estimated fair value of our long-term debt, which is discussed in Note 6, was determined using Level 2 inputs primarily related to comparable market prices. We consider the carrying amounts of cash and cash equivalents, receivables, other current assets, current liabilities and other notes payables to approximate their fair value because of the relatively short period of time between the origination of these instruments and their expected realization or payment. Additionally, we consider the carrying amount of our capital lease obligations to approximate their fair value because the weighted average interest rate used to formulate the carrying amounts approximates current market rates.
EARNINGS PER SHARE	EARNINGS PER SHARE - Earnings per share is based upon the weighted average number of shares of common stock and common stock equivalents outstanding, net of common stock held in treasury, as follows (in thousands except share and per share data): Three Months Ended March 31, 2019 2018 Net loss attributable to RadNet, Inc.'s common stockholders $ (3,733 ) $ (7,338 ) BASIC AND DILUTED NET LOSS PER SHARE ATTRIBUTABLE TO RADNET, INC.'S COMMON STOCKHOLDERS Weighted average number of common shares outstanding during the period 49,553,694 47,822,618 Basic and diluted net loss per share attributable to RadNet, Inc.'s common stockholders $ (0.08 ) $ (0.15 )
EQUITY INVESTMENTS AT FAIR VALUE	EQUITY INVESTMENTS AT FAIR VALUE–Accounting guidance requires entities to measure equity investments at fair value, with any changes in fair value recognized in net income. If there is no readily determinable fair value, the guidance allows entities the ability to measure investments at cost less impairment. As of March 31, 2019 , we have two equity investments for which a fair value is not readily determinable and therefore the total amounts invested are recognized at cost as follows: Medic Vision: Medic Vision, based in Israel, specializes in software packages that provide compliant radiation dose structured reporting and enhanced images from reduced dose CT scans. On March 24, 2017, we acquired an initial 12.5% equity interest in Medic Vision – Imaging Solutions Ltd for $1.0 million . We also received an option to exercise warrants to acquire up to an additional 12.5% equity interest for $1.4 million within one year from the initial share purchase date, if exercised in full. On March 1, 2018 we exercised our warrant in part and acquired an additional 1.96% for $200,000 . Our initial equity interest has been diluted to 12.25% and our total equity investment stands at 14.21% . In accordance with accounting guidance , as we exercise no significant influence over Medic Vision’s operations, the investment is recorded at its cost of $1.2 million , given that the fair value is not readily determinable. No impairment in our investment was identified as of the three months ended March 31, 2019 . Turner Imaging: Turner Imaging Systems, based in Utah, develops and markets portable X-ray imaging systems that provide a user the ability to acquire X-ray images wherever and whenever they are needed. On February 1, 2018, we purchased 2.1 million preferred shares in Turner Imaging Systems for $2.0 million . On January 1, 2019 we funded a convertible promissory note in the amount of $143,000 that will convert to additional preferred shares no later than December 21, 2019. No impairment in our investment was identified for the three months ended March 31, 2019 .
INVESTMENTS IN JOINT VENTURES	INVESTMENT IN JOINT VENTURES – We have 14 unconsolidated joint ventures with ownership interests ranging from 25% to 55% . These joint ventures represent partnerships with hospitals, health systems or radiology practices and were formed for the purpose of owning and operating diagnostic imaging centers. Professional services at the joint venture diagnostic imaging centers are performed by contracted radiology practices or a radiology practice that participates in the joint venture. Our investment in these joint ventures is accounted for under the equity method, since RadNet does not have a controlling financial interest in such ventures. We evaluate our investment in joint ventures, including cost in excess of book value (equity method goodwill) for impairment whenever indicators of impairment exist. No indicators of impairment existed as of March 31, 2019 . Sale of joint venture interest: On April 1, 2017, we formed in conjuncture with Cedars Sinai Medical Center (“CSMC”) the Santa Monica Imaging Group, LLC (“SMIG”), consisting of two multi-modality imaging centers located in Santa Monica, CA with RadNet holding a 40% economic interest and CSMC holding a 60% economic interest. RadNet accounts for our share of the venture under the equity method. On January 1, 2019, CSMC purchased from the company, an additional five percent economic interest in SMIG valued at $134,000 . As a result of the transaction, our economic interest in SMIG has been reduced to 35% . We recorded a loss of $2,000 on the transaction. Joint venture investment and financial information The following table is a summary of our investment in joint ventures during the three months ended March 31, 2019 (in thousands): Balance as of December 31, 2018 $ 37,973 Equity in earnings in these joint ventures 1,873 Sale of ownership interest (134 ) Balance as of March 31, 2019 $ 39,712 We charged management service fees from the centers underlying these joint ventures of approximately $2.1 million and $3.4 million for the quarters ended March 31, 2019 and 2018 , respectively. We eliminate any unrealized portion of our management service fees with our equity in earnings of joint ventures. The following table is a summary of key balance sheet data for these joint ventures as of March 31, 2019 and December 31, 2018 and income statement data for the three months ended March 31, 2019 and 2018 (in thousands): Balance Sheet Data: March 31, 2019 December 31, 2018 Current assets $ 33,301 $ 28,317 Noncurrent assets 59,804 45,912 Current liabilities (8,244 ) (4,300 ) Noncurrent liabilities (15,881 ) (4,898 ) Total net assets $ 68,980 $ 65,031 Book value of RadNet joint venture interests $ 31,738 $ 30,030 Cost in excess of book value of acquired joint venture interests 7,974 7,943 Total value of Radnet joint venture interests $ 39,712 $ 37,973 Total book value of other joint venture partner interests $ 37,242 $ 35,001 Income statement data for the three months ended March 31, 2019 2018 Net revenue $ 27,254 $ 44,546 Net income $ 3,952 $ 6,250
RECENT ACCOUNTING AND REPORTING STANDARDS	Accounting standards adopted In February 2016, the FASB issued Accounting Standard Update ("ASU") No. 2016-02, Leases (Topic 842) (ASU 2016-02), which amends the existing accounting standards for leases. In September 2017, the FASB issued ASU No. 2017-13 which provides additional clarification and implementation guidance on the previously issued ASU No. 2016-02. Subsequently, in July 2018, the FASB issued ASU No 2018-10, Codification Improvements to Topic 842, Leases, and ASU No. 2018-11, Targeted Improvement, to clarify and amend the guidance in ASU No. 2016-02. The amendments in this update were effective for fiscal years (and interim reporting periods within fiscal years) beginning after December 15, 2018, with early adoption permitted for all entities. Under the new guidance, a lessee is required to recognize a lease liability and right-of-use asset for all leases with terms in excess of twelve months. The new guidance also requires additional disclosures to enable users of financial statements to understand the amount, timing, and potential uncertainty of cash flows arising from leases. Consistent with current guidance, a lessee’s recognition, measurement, and presentation of expenses and cash flows arising from a lease will continue to depend primarily on its classification. The accounting standard is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. We have elected the optional transition method to apply the standard as of the effective date and therefore, we will not apply the standard to the comparative periods presented in the consolidated financial statements. We elected the transition package of three practical expedients permitted within the standard, which eliminates the requirements to reassess prior conclusions about lease identification, lease classification, and initial direct costs. For facility and equipment operating leases, the effect of the adoption amounted to a lease liability of approximately $455.5 million . Operating lease right-of-use assets were recorded in the amount of approximately $419.0 million . Inclusive in the adoption was the transfer of approximately $35.3 million in deferred rent liability and $792,000 in unfavorable rental contract liabilities to operating lease right of use assets. For finance leases, the effect of the adoption amounted to a finance lease liability of approximately $12.1 million , which was transfered from capital lease debt. Equipment leased under the finance arrangements, amounting to $14.1 million , remained in property, plant and equipment. The transition adjustment did not have a material impact on the statement of operations or cash flows. See Note 5, Leases, for more information. In February 2018, the FASB issued ASU No. 2018-02 (“ASU 2018-02”), Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income . ASU 2018-02 allows for the reclassification of certain income tax effects related to the Tax Cuts and Jobs Act between “Accumulated other comprehensive income” and “Retained earnings.” This ASU relates to the requirement that adjustments to deferred tax liabilities and assets related to a change in tax laws or rates to be included in “Income from continuing operations”, even in situations where the related items were originally recognized in “Other comprehensive income” (rather than in “Income from continuing operations”). Subsequently, in March 2018, the FASB issued ASU No. 2018-05, Income Taxes, to clarify and amend guidance in ASU 2018-02. ASU 2018-02 and ASU 2018-05 are effective for all entities for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. Adoption of this ASU is to be applied either in the period of adoption or retrospectively to each period in which the effect of the change in the tax laws or rates were recognized. The adoption had no significant impact on the our results of operations, financial position and cash flows. Accounting standards not yet adopted In June 2016, the FASB issued ASU No. 2016-13 ("ASU 2016-13), Financial Instruments - Credit Losses. ASU 2016-13 replaces the incurred loss impairment methodology under current GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. The standard will be effective for us beginning December 15, 2020, with early adoption permitted. We are currently evaluating the impact of this standard on our consolidated financial statements, including accounting policies, processes, and systems. In August 2018, the FASB issued ASU No. 2018-15 (“ASU 2018-15”), Intangibles-Goodwill and Other-Internal-Use Software. ASU 2018-15 aligns the requirements for deferring implementation costs incurred in a cloud computing arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. This ASU is effective in the first quarter of 2020 with early adoption permitted and can be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. We are currently assessing the impact of the adoption of this ASU on the Company’s results of operations, financial position and cash flows.

SIGNIFICANT ACCOUNTING POLICI_3

SIGNIFICANT ACCOUNTING POLICIES (Tables)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Service Fee Revenue	The Company’s total net revenues during the three months ended March 31, 2019 and 2018 are presented in the table below based on an allocation of the estimated transaction price with the patient between the primary patient classification of insurance coverage (in thousands): Three Months Ended 2019 2018 Commercial insurance $ 151,678 $ 126,225 Medicare 54,199 44,076 Medicaid 7,120 6,048 Workers' compensation/personal injury 11,027 8,431 Other patient revenue 5,835 5,606 Management fee revenue 2,117 3,677 Teleradiology and Software revenue 4,386 3,816 Other 6,310 6,289 Service fee revenue 242,672 204,168 Revenue under capitation arrangements 28,877 27,224 Total revenue $ 271,549 $ 231,392
Schedule of goodwill and other intangible assets	Activity in goodwill for the three months ended March 31, 2019 is provided below (in thousands): Balance as of December 31, 2018 $ 418,093 Adjustments to our preliminary allocation of the purchase price of Medical Arts Radiological Group, P.C. 722 Goodwill acquired through the acquisition of certain assets of Dignity Health 1 Goodwill acquired through the acquisition of certain assets of West Valley Imaging Center, LLC 2,490 Goodwill disposed through sale of assets (123 ) Goodwill acquired by Lenox Hill Radiology through the membership purchase of HVRA 3,125 Balance as of March 31, 2019 $ 424,308
Effect of derivative instruments on comprehensive income	A tabular presentation of the effect of derivative instruments on our consolidated statement of comprehensive loss is as follows (amounts in thousands): For the three months ended March 31, 2019 Account January 1, 2019 Balance Amount of comprehensive loss recognized on derivative March 31, 2019 Balance Location Accumulated Other Comprehensive Income (Loss) 2,506 (1,196 ) 1,310 Current Assets & Equity For the twelve months ended December 31, 2018 Account January 1, 2018 Balance Amount of comprehensive gain recognized on derivative December 31, 2018 Balance Location Accumulated Other Comprehensive (Loss) Income (370 ) 2,876 2,506 Current Assets & Equity
Schedule of fair value of assets and liabilities	The table below summarizes the estimated fair value compared to our face value of our long-term debt as follows (in thousands): As of March 31, 2019 Level 1 Level 2 Level 3 Total Fair Value Total Face Value First Lien Term Loans and SunTrust Term Loan $ — $ 638,144 $ — $ 638,144 $ 637,420 As of December 31, 2018 Level 1 Level 2 Level 3 Total Total Face Value First Lien Term Loans and SunTrust Term Loan $ — $ 633,229 $ — $ 633,229 $ 646,441 The table below summarizes the estimated fair values of certain of our financial assets that are subject to fair value measurements, and the classification of these assets on our consolidated balance sheets, as follows (in thousands): As of March 31, 2019 Level 1 Level 2 Level 3 Total Current assets Interest Rate Contracts $ — $ 1,690 $ — $ 1,690 As of December 31, 2018 Level 1 Level 2 Level 3 Total Current assets Interest Rate Contracts $ — $ 3,316 $ — $ 3,316
Earnings per share	Earnings per share is based upon the weighted average number of shares of common stock and common stock equivalents outstanding, net of common stock held in treasury, as follows (in thousands except share and per share data): Three Months Ended March 31, 2019 2018 Net loss attributable to RadNet, Inc.'s common stockholders $ (3,733 ) $ (7,338 ) BASIC AND DILUTED NET LOSS PER SHARE ATTRIBUTABLE TO RADNET, INC.'S COMMON STOCKHOLDERS Weighted average number of common shares outstanding during the period 49,553,694 47,822,618 Basic and diluted net loss per share attributable to RadNet, Inc.'s common stockholders $ (0.08 ) $ (0.15 )
Investment in joint ventures	The following table is a summary of our investment in joint ventures during the three months ended March 31, 2019 (in thousands): Balance as of December 31, 2018 $ 37,973 Equity in earnings in these joint ventures 1,873 Sale of ownership interest (134 ) Balance as of March 31, 2019 $ 39,712
Joint venture investment and financial information	The following table is a summary of key balance sheet data for these joint ventures as of March 31, 2019 and December 31, 2018 and income statement data for the three months ended March 31, 2019 and 2018 (in thousands): Balance Sheet Data: March 31, 2019 December 31, 2018 Current assets $ 33,301 $ 28,317 Noncurrent assets 59,804 45,912 Current liabilities (8,244 ) (4,300 ) Noncurrent liabilities (15,881 ) (4,898 ) Total net assets $ 68,980 $ 65,031 Book value of RadNet joint venture interests $ 31,738 $ 30,030 Cost in excess of book value of acquired joint venture interests 7,974 7,943 Total value of Radnet joint venture interests $ 39,712 $ 37,973 Total book value of other joint venture partner interests $ 37,242 $ 35,001 Income statement data for the three months ended March 31, 2019 2018 Net revenue $ 27,254 $ 44,546 Net income $ 3,952 $ 6,250

FACILITY ACQUISITIONS AND ASS_2

FACILITY ACQUISITIONS AND ASSETS HELD FOR SALE (Tables)	3 Months Ended
	Mar. 31, 2019
Business Combinations [Abstract]
Schedule of assets held for sale	The following table summarizes the major categories of assets which remain classified as held for sale in the accompanying condensed consolidated balance sheets at March 31, 2019 : Property and equipment, net $ 1,049 Goodwill 992 Total assets held for sale $ 2,041

LEASES (Tables)

LEASES (Tables)	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Lease, Cost	Supplemental cash flow information related to leases was as follows: Three months ended (In thousands) March 31, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 22,921 Operating cash flows from financing leases 123 Financing cash flows from financing leases 1,522 Right-of-use & Equipment assets obtained in exchange for lease obligations: Operating leases (1) 412,695 Financing leases 14,056 (1) Amounts for the three months ended March 31, 2019 include the transition adjustment for the adoption of Topic 842 discussed in Note 2, Significant Accounting Policies for further information. The components of lease expense were as follows: Three months ended (In thousands) March 31, 2019 Operating lease cost $ 22,792 Finance lease cost: Depreciation of leased equipment $ 783 Interest on lease liabilities 123 Total finance lease cost $ 905
Supplemental Balance Sheet Information	Supplemental balance sheet information related to leases was as follows: (In thousands, except lease term and discount rates) March 31, 2019 Operating Leases Operating lease right-of-use assets $ 403,066 Current portion of operating lease liability $ 64,538 Operating lease liabilities 375,363 Total operating lease liabilities $ 439,901 Finance Leases Property and Equipment, at cost $ 14,056 Accumulated depreciation (783 ) Equipment, net $ 13,273 Current portion of finance lease $ 4,936 Finance lease liabilities 5,663 Total finance lease liabilities $ 10,599 Weighted Average Remaining Lease Term Operating leases - years 8.4 Finance leases - years 2.4 Weighted Average Discount Rate Operating leases 6.4 % Finance leases 4.4 %
Maturities of Operating Lease Liabilities	Maturities of lease liabilities were as follows: (In thousands) Operating Financing Year Ending December 31, Leases Leases 2019 (excluding the three months ended March 31, 2019) $ 67,927 $ 4,374 2020 84,334 3,481 2021 77,688 2,614 2022 67,351 692 2023 56,487 — Thereafter 225,101 — Total Lease Payments 578,888 11,161 Less imputed interest (138,987 ) (562 ) Total $ 439,901 $ 10,599 As previously disclosed in our 2018 Annual Report on Form 10-K and under the previous lease accounting, maturities of operating lease liabilities were as follows as of December 31, 2018 (in thousands): Facilities Equipment Total 2019 $ 75,588 $ 14,924 $ 90,512 2020 66,116 14,385 80,501 2021 57,826 12,966 70,792 2022 48,542 10,264 58,806 2023 38,800 7,095 45,895 Thereafter 160,327 5,144 165,471 $ 447,199 $ 64,778 $ 511,977
Maturities of Financing Lease Liabilities	Maturities of lease liabilities were as follows: (In thousands) Operating Financing Year Ending December 31, Leases Leases 2019 (excluding the three months ended March 31, 2019) $ 67,927 $ 4,374 2020 84,334 3,481 2021 77,688 2,614 2022 67,351 692 2023 56,487 — Thereafter 225,101 — Total Lease Payments 578,888 11,161 Less imputed interest (138,987 ) (562 ) Total $ 439,901 $ 10,599 As previously disclosed in our 2018 Annual Report on Form 10-K and under the previous lease accounting, maturities of operating lease liabilities were as follows as of December 31, 2018 (in thousands): Facilities Equipment Total 2019 $ 75,588 $ 14,924 $ 90,512 2020 66,116 14,385 80,501 2021 57,826 12,966 70,792 2022 48,542 10,264 58,806 2023 38,800 7,095 45,895 Thereafter 160,327 5,144 165,471 $ 447,199 $ 64,778 $ 511,977

CREDIT FACILITY, NOTES PAYABL_2

CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS (Tables)	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Schedule of notes payable, line of credit and capital lease obligations	As of the three months ended March 31, 2019 our debt obligations consist of the following (in thousands): March 31, December 31, First Lien Term Loans collateralized by RadNet's tangible and intangible assets $ 578,920 $ 587,191 Discounts on First Lien Term Loans (14,272 ) (15,112 ) Term Loan Agreement collateralized by NJIN's tangible and intangible assets 58,500 59,250 Revolving Credit Facilities 41,000 28,000 Promissory note payable to the former owner of a practice acquired at an interest rate of 1.5% due through 2019 100 199 Equipment notes payable at interest rates ranging from 3.3% to 5.6%, due through 2020, collateralized by medical equipment 538 632 Obligations under capital leases at interest rates ranging from 4.3% to 11.2%, due through 2022, collateralized by medical and office equipment (1) — 12,119 Total debt obligations 664,786 672,279 Less: current portion (33,912 ) (39,267 ) Long term portion debt obligations $ 630,874 $ 633,012
Schedule of First Lien Credit Agreement	Included in our condensed consolidated balance sheets at March 31, 2019 are $623.1 million of senior secured term loan debt (net of unamortized discounts of $14.3 million ) in thousands: Face Value Discount Total Carrying First Lien Term Loans 578,920 (14,272 ) 564,648 SunTrust Term Loan 58,500 — 58,500 Total Term Loans 637,420 (14,272 ) 623,148
Schedule of leverage ratio	Pursuant to the Fifth Amendment, the applicable margin was amended to vary based on our leverage ratio in accordance with the following schedule: First Lien Leverage Ratio Eurodollar Rate Spread Base Rate Spread > 5.50x 4.50% 3.50% > 4.00x but ≤ 5.50x 3.75% 2.75% >3.50x but ≤ 4.00x 3.50% 2.50% ≤ 3.50x 3.25% 2.25% Thereafter, the rates of the applicable margin for borrowing under the SunTrust Restated Credit Agreement will adjust depending on our leverage ratio, according to the following table: Pricing Level Leverage Ratio Applicable Margin for Eurodollar Loans Applicable Margin for Base Rate Loans Applicable Margin for Letter of Credit Fees Applicable Percentage for Commitment Fee I Greater than or equal to 3.00:1.00 2.75% per annum 1.75% per annum 2.75% per annum 0.45% per annum II Less than 3.00:1.00 but greater than or equal to 2.50:1.00 2.25% per annum 1.25% per annum 2.25% per annum 0.40% per annum III Less than 2.50:1.00 but greater than or equal to 2.00:1.00 2.00% per annum 1.00% per annum 2.00% per annum 0.35% per annum IV Less than 2.00:1.00 but greater than or equal to 1.50:1.00 1.75% per annum 0.75% per annum 1.75% per annum 0.30% per annum V Less than 1.50:1.00 1.50% per annum 0.50% per annum 1.50% per annum 0.30% per annum Thereafter, the rates of the applicable margin for borrowing under the SunTrust Original Credit Agreement adjusted depending on our leverage ratio, according to the following table: Pricing Level Leverage Ratio Applicable Margin for Eurodollar Loans Applicable Margin for Base Rate Loans Applicable Margin for Letter of Credit Fees Applicable Percentage for Commitment Fee I Greater than or equal to 3.00:1.00 3.00% per annum 2.00% per annum 3.00% per annum 0.45% per annum II Less than 3.00:1.00 but greater than or equal to 2.50:1.00 2.50% per annum 1.50% per annum 2.50% per annum 0.40% per annum III Less than 2.50:1.00 but greater than or equal to 2.00:1.00 2.25% per annum 1.25% per annum 2.25% per annum 0.35% per annum IV Less than 2.00:1.00 but greater than or equal to 1.50:1.00 2.00% per annum 1.00% per annum 2.00% per annum 0.30% per annum V Less than 1.50:1.00 1.75% per annum 0.75% per annum 1.75% per annum 0.30% per annum

STOCK-BASED COMPENSATION (Table

STOCK-BASED COMPENSATION (Tables)	3 Months Ended
	Mar. 31, 2019
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of options activity	The following summarizes all of our option transactions for the three months ended March 31, 2019 : Outstanding Options Under the 2006 Plan Shares Weighted Average Exercise price Per Common Share Weighted Average Remaining Contractual Life (in years) Aggregate Intrinsic Value Balance,December 31, 2018 513,282 $ 7.44 Granted 89,200 10.93 Exercised (10,000 ) 4.97 Canceled, forfeited or expired (111,031 ) 0.08 Balance, March 31, 2019 481,451 8.22 8.06 $ 2,007,986 Exercisable at March 31, 2019 129,290 6.66 7.06 740,955
Schedule of RSA activity	The following summarizes all unvested RSA’s activities during the three months ended March 31, 2019 : RSA's Weighted-Average Remaining Contractual Term (Years) Weighted-Average Fair Value RSA's unvested at December 31, 2018 277,504 $ 9.77 Changes during the period Granted 586,000 $ 11.83 Vested (470,860 ) $ 10.62 RSA's unvested at March 31, 2019 392,644 1.92 $ 11.51

NATURE OF BUSINESS (Details Nar

NATURE OF BUSINESS (Details Narrative) $ in Thousands	Feb. 28, 2019USD ($)	Mar. 31, 2019USD ($)Center	Mar. 31, 2018USD ($)	Dec. 31, 2018USD ($)
Business Acquisition [Line Items]
Number of centers | Center		335
Goodwill		$ 424,308		$ 418,093
BRMG and NY Groups revenues		37,400	$ 34,000
BRMG and NY Groups operating expenses		37,400	34,000
Management services provided to BRMG and NY Groups		142,300	$ 118,600
BRMG and NY Groups accounts receivable		98,700		88,900
BRMG and NY Groups accounts payable		6,300		$ 5,600
BRMG and NY Groups intangible assets		$ 2,700
ScriptSender LLC
Business Acquisition [Line Items]
Ownership percentage		49.00%
Chief Executive Officer | Beverly Radiology Medical Group III
Business Acquisition [Line Items]
Ownership percentage		99.00%
Board Member | Beverly Radiology Medical Group III
Business Acquisition [Line Items]
Ownership percentage		1.00%
Hudson Valley Radiology Associates
Business Acquisition [Line Items]
Purchase consideration	$ 680
Equipment	10
Goodwill	3,100
Hudson Valley Radiology Associates | Primedex Health Systems, Inc. and Radiologix
Business Acquisition [Line Items]
Unfavorable lease contracts	2,800
Noncompete Agreements | Hudson Valley Radiology Associates
Business Acquisition [Line Items]
Intangible assets acquired	700
Trade Names | Hudson Valley Radiology Associates
Business Acquisition [Line Items]
Intangible assets acquired	$ 70

SIGNIFICANT ACCOUNTING POLICI_4

SIGNIFICANT ACCOUNTING POLICIES (Details - Revenue) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue from External Customer [Line Items]
Total revenue	$ 271,549	$ 231,392
Commercial insurance
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	151,678	126,225
Medicare
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	54,199	44,076
Medicaid
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	7,120	6,048
Workers' compensation/personal injury
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	11,027	8,431
Other patient revenue
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	5,835	5,606
Management fee revenue
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	2,117	3,677
Teleradiology and Software revenue
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	4,386	3,816
Other
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	6,310	6,289
Service fee revenue
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	242,672	204,168
Revenue under capitation arrangements
Revenue from External Customer [Line Items]
Service fee revenue, net of contractual allowances and discounts	$ 28,877	$ 27,224

SUMMARY OF ACCOUNTING POLICIES

SUMMARY OF ACCOUNTING POLICIES (Details Narrative)	Jan. 01, 2019USD ($)	Mar. 01, 2018USD ($)	Feb. 01, 2018USD ($)shares	Mar. 31, 2019USD ($)shares	Mar. 31, 2018USD ($)	Dec. 31, 2018USD ($)joint_venture	Apr. 01, 2017	Mar. 24, 2017USD ($)
Property, Plant and Equipment [Line Items]
Contracts receivable, factored amount						$ 20,500,000
Contracts receivable, factoring expense						440,000
Contracts receivable, factoring receivable				$ 17,800,000
Deferred financing costs, net of accumulated amortization				1,200,000		1,400,000
Goodwill				424,308,000		418,093,000
Goodwill, impairment loss						3,800,000
Indefinite-lived intangible assets				9,900,000
Impairment of intangible assets						3,900,000
Indefinite-lived trade names						100,000
Income tax expense				$ 1,230,000	$ 2,497,000
Effective tax rate				39.00%	22.40%
Total credit facilities outstanding				$ 0
Investment at cost				31,738,000		30,030,000
Aggregate cost				68,980,000		$ 65,031,000
Number of unconsolidated joint ventures | joint_venture						14
Loss on economic interest transaction				(134,000)
Management service fees				$ 2,100,000	$ 3,400,000
Minimum
Property, Plant and Equipment [Line Items]
Share-based payment award, award vesting period				3 years
Share-based payment award, expiration period				5 years
Maximum
Property, Plant and Equipment [Line Items]
Share-based payment award, award vesting period				5 years
Share-based payment award, expiration period				10 years
Medic Vision
Property, Plant and Equipment [Line Items]
Ownership percentage		14.21%						12.50%
Investment at cost		$ 200,000						$ 1,000,000
Option to purchase additional equity method investment								$ 1,400,000
Additional equity interest acquired		1.96%
Initial qwnership percentage after dilution		12.25%
Aggregate cost				$ 1,200,000
Turner Imaging
Property, Plant and Equipment [Line Items]
Number of shares purchased (in shares) | shares			2,100,000
Number of shares purchased, value			$ 2,000,000
Restated Plan
Property, Plant and Equipment [Line Items]
Shares authorized (in shares) | shares				14,000,000
Restated Plan | Minimum
Property, Plant and Equipment [Line Items]
Share-based payment award, award vesting period				3 years
Share-based payment award, expiration period				5 years
Restated Plan | Maximum
Property, Plant and Equipment [Line Items]
Share-based payment award, award vesting period				5 years
Share-based payment award, expiration period				10 years
2016 Caps
Property, Plant and Equipment [Line Items]
Premium liability for 2016 Caps				$ 5,300,000
2016 Caps | September 2020
Property, Plant and Equipment [Line Items]
Notional amounts				150,000,000
2016 Caps | October 2020
Property, Plant and Equipment [Line Items]
Notional amounts				$ 350,000,000
Property and equipment, net | Minimum
Property, Plant and Equipment [Line Items]
PPE estimated useful lives				P3Y
Property and equipment, net | Maximum
Property, Plant and Equipment [Line Items]
PPE estimated useful lives				P15Y
Leasehold Improvements | Minimum
Property, Plant and Equipment [Line Items]
PPE estimated useful lives				P3Y
Leasehold Improvements | Maximum
Property, Plant and Equipment [Line Items]
PPE estimated useful lives				15
2016 Caps | London Interbank Offered Rate (LIBOR)
Property, Plant and Equipment [Line Items]
Basis spread on variable rate				2.00%
Revolving Credit Facility
Property, Plant and Equipment [Line Items]
Deferred financing costs, net of accumulated amortization				$ 1,200,000
Total credit facilities outstanding				41,000,000		$ 28,000,000
RadNet | Santa Monica Imaging Group
Property, Plant and Equipment [Line Items]
Ownership percentage	35.00%						40.00%
Loss on economic interest transaction	$ 2,000
Cedars Sinai Medical Center | Santa Monica Imaging Group
Property, Plant and Equipment [Line Items]
Ownership percentage							60.00%
Additional equity interest acquired	5.00%
Investment owned, value	$ 134,000
Dignity Health | Glendale Advanced Imaging | Joint Venture | Minimum
Property, Plant and Equipment [Line Items]
Variable interest entity, ownership percentage						25.00%
Dignity Health | Glendale Advanced Imaging | Joint Venture | Maximum
Property, Plant and Equipment [Line Items]
Variable interest entity, ownership percentage						55.00%
Promissory Note
Property, Plant and Equipment [Line Items]
Convertible promissory note				$ 100,000		$ 199,000
Promissory Note | Turner Imaging
Property, Plant and Equipment [Line Items]
Convertible promissory note	$ 143,000

SIGNIFICANT ACCOUNTING POLICI_5

SIGNIFICANT ACCOUNTING POLICIES (Details - Goodwill) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 418,093
Goodwill transferred to assets held for sale	(123)
Goodwill, ending balance	424,308
Medical Arts Radiological Group, PC
Goodwill [Roll Forward]
Goodwill, purchase accounting adjustments	722
Dignity Health
Goodwill [Roll Forward]
Goodwill acquired through acquisitions	1
West Valley Imaging Group, LLC
Goodwill [Roll Forward]
Goodwill acquired through acquisitions	2,490
Hudson Valley Radiology Associates
Goodwill [Roll Forward]
Goodwill acquired through acquisitions	$ 3,125

SIGNIFICANT ACCOUNTING POLICI_6

SIGNIFICANT ACCOUNTING POLICIES (Details - Gain on Derivative) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Accounting Policies [Abstract]
Derivative instrument, beginning balance	$ 2,506	$ (370)	$ (370)
Change in fair value of cash flow hedge, net of taxes	(1,196)
Change in fair value of cash flow hedge, net of taxes		$ 3,095	2,876
Derivative instrument, ending balance	$ 1,310		$ 2,506

SUMMARY OF ACCOUNTING POLICIE_2

SUMMARY OF ACCOUNTING POLICIES (Details - Fair Value Measurements) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest Rate Contracts	$ 1,690	$ 3,316
First Lien Term Loans and SunTrust Term Loan	637,420	646,441
Fair Value, Inputs, Level 1
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest Rate Contracts	0	0
Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest Rate Contracts	1,690	3,316
Fair Value, Inputs, Level 3
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest Rate Contracts	0	0
Estimate of Fair Value Measurement
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
First Lien Term Loans and SunTrust Term Loan	638,144	633,229
Estimate of Fair Value Measurement | Fair Value, Inputs, Level 1
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
First Lien Term Loans and SunTrust Term Loan	0	0
Estimate of Fair Value Measurement | Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
First Lien Term Loans and SunTrust Term Loan	638,144	633,229
Estimate of Fair Value Measurement | Fair Value, Inputs, Level 3
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
First Lien Term Loans and SunTrust Term Loan	$ 0	$ 0

SUMMARY OF ACCOUNTING POLICIE_3

SUMMARY OF ACCOUNTING POLICIES (Details - Earnings Per Share) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Accounting Policies [Abstract]
Net loss attributable to RadNet, Inc.'s common stockholders	$ (3,733)	$ (7,338)
BASIC AND DILUTED NET LOSS PER SHARE ATTRIBUTABLE TO RADNET, INC.'S COMMON STOCKHOLDERS
Weighted average number of common shares outstanding during the period (in shares)	49,553,694	47,822,618
Basic and diluted net loss per share attributable to RadNet, Inc.'s common stockholders (in dollars per share)	$ (0.08)	$ (0.15)

SUMMARY OF ACCOUNTING POLICIE_4

SUMMARY OF ACCOUNTING POLICIES (Details - Investment in Joint Ventures) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Accounting Policies [Abstract]
Beginning balance	$ 37,973
Equity in earnings in these joint ventures	1,873	$ 2,977
Sale of ownership interest	(134)
Ending balance	$ 39,712

SUMMARY OF ACCOUNTING POLICIE_5

SUMMARY OF ACCOUNTING POLICIES (Details - Key Financial Data on Joint Ventures) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Balance Sheet Data:
Current assets	$ 33,301		$ 28,317
Noncurrent assets	59,804		45,912
Noncurrent liabilities	(8,244)		(4,300)
Noncurrent liabilities	(15,881)		(4,898)
Total net assets	68,980		65,031
Book value of RadNet joint venture interests	31,738		30,030
Cost in excess of book value of acquired joint venture interests	7,974		7,943
Total value of Radnet joint venture interests	39,712		37,973
Total book value of other joint venture partner interests	37,242		$ 35,001
Net revenue	27,254	$ 44,546
Net income	$ 3,952	$ 6,250

RECENT ACCOUNTING AND REPORTI_2

RECENT ACCOUNTING AND REPORTING STANDARDS (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Jan. 01, 2019
Lessee, Lease, Description [Line Items]
Operating lease, liability	$ 439,901
Operating lease right-of-use assets	403,066
Finance lease, liability	10,599
Finance lease, right-of-use asset	$ 13,273
Accounting Standards Update 2016-02
Lessee, Lease, Description [Line Items]
Operating lease, liability		$ 455,500
Operating lease right-of-use assets		419,000
Finance lease, liability		12,100
Finance lease, right-of-use asset		14,100
Deferred rent		35,300
Contract liabilities		$ 792

FACILITY ACQUISITIONS AND ASS_3

FACILITY ACQUISITIONS AND ASSETS HELD FOR SALE (Details Narrative) - USD ($) $ in Thousands	Mar. 01, 2019	Feb. 02, 2019	Feb. 01, 2019	Mar. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill acquired				$ 424,308	$ 418,093
West Valley Imaging Group, LLC
Business Acquisition [Line Items]
Purchase consideration			$ 3,000
Fixed assets acquired			300
Other assets acquired			7
Intangible assets acquired			200
Goodwill acquired			$ 2,500
Payments to acquire equity method investments		$ 750
Noncontrolling interest, ownership percentage			25.00%
Ventura County Imaging Group, LLC
Business Acquisition [Line Items]
Payments to acquire equity method investments	$ 10,400
Ownership percentage	60.00%
Dignity Health | Partnership | Ventura County Imaging Group, LLC
Business Acquisition [Line Items]
Payments to acquire equity method investments	$ 6,100
Ownership percentage	40.00%
Payments to acquire equity method investments, Assets	$ 800
Ownership percentage in exchange for assets	5.00%
Payments to acquire equity method investments, Cash	$ 5,300
Ownership percentage in exchange for cash	35.00%

FACILITY ACQUISITIONS AND ASS_4

FACILITY ACQUISITIONS AND ASSETS HELD FOR SALE (Details - Assets held for sale) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Long Lived Assets Held-for-sale [Line Items]
Assets held for sale	$ 2,041	$ 2,499
Property and equipment, net
Long Lived Assets Held-for-sale [Line Items]
Assets held for sale	1,049
Goodwill
Long Lived Assets Held-for-sale [Line Items]
Assets held for sale	$ 992

LEASES (Details Narrative)

LEASES (Details Narrative) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Jan. 01, 2019
Lessee, Lease, Description [Line Items]
Operating lease, liability	$ 439,901
Operating lease right-of-use assets	403,066
Finance lease, liability	10,599
Finance lease, right-of-use asset	13,273
Operating lease, not yet commenced	$ 19,700
Minimum
Lessee, Lease, Description [Line Items]
Operating lease, term of contract	5 years
Operating lease, renewal term	10 years
Lease, term of contract	5 years
Operating lease, not yet commenced, term of contract	1 year
Maximum
Lessee, Lease, Description [Line Items]
Operating lease, term of contract	15 years
Operating lease, renewal term	35 years
Lease, term of contract	8 years
Operating lease, not yet commenced, term of contract	14 years
Accounting Standards Update 2016-02
Lessee, Lease, Description [Line Items]
Operating lease, liability		$ 455,500
Operating lease right-of-use assets		419,000
Deferred rent		35,300
Contract liabilities		792
Finance lease, liability		12,100
Finance lease, right-of-use asset		$ 14,100

LEASES (Details - Lease, Cost)

LEASES (Details - Lease, Cost) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Leases [Abstract]
Operating lease cost	$ 22,792
Depreciation of leased equipment	783
Interest on lease liabilities	123
Total finance lease cost	$ 905

LEASES (Details - Supplemental

LEASES (Details - Supplemental Cash Flows) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 22,921
Operating cash flows from financing leases	123
Financing cash flows from financing leases	1,522
Right-of-use & Equipment assets obtained in exchange for lease obligations:
Operating leases	412,695
Financing leases	$ 14,056

LEASES (Details - Supplementa_2

LEASES (Details - Supplemental Balance Sheet) $ in Thousands	Mar. 31, 2019USD ($)
Operating Leases
Operating lease right-of-use assets	$ 403,066
Current portion of operating lease liability	64,538
Operating lease liabilities	375,363
Total operating lease liabilities	439,901
Finance Leases
Property and Equipment, at cost	14,056
Accumulated depreciation	(783)
Finance lease, right-of-use asset	13,273
Current finance lease liability	4,936
Long-term finance lease liability	5,663
Total finance lease liabilities	$ 10,599
Weighted Average Remaining Lease Term
Operating leases - years	8 years 5 months
Finance leases - years	2 years 5 months
Weighted Average Discount Rate
Operating leases	6.40%
Finance leases	4.40%

LEASES (Details - Maturities of

LEASES (Details - Maturities of Operating and Financing Lease Liabilities) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Operating Leases, After Adoption of 842
Remainder of 2019	$ 67,927
2020	84,334
2021	77,688
2022	67,351
2023	56,487
Thereafter	225,101
Total Lease Payments	578,888
Less imputed interest	(138,987)
Total	439,901
Financing Leases, After Adoption of 842
Remainder of 2019	4,374
2020	3,481
2021	2,614
2022	692
2023	0
Thereafter	0
Total Lease Payments	11,161
Less imputed interest	(562)
Total	$ 10,599
Lessee, Lease, Description [Line Items]
2019		$ 90,512
2020		80,501
2021		70,792
2022		58,806
2023		45,895
Thereafter		165,471
Total		511,977
Equipment
Lessee, Lease, Description [Line Items]
2019		14,924
2020		14,385
2021		12,966
2022		10,264
2023		7,095
Thereafter		5,144
Total		64,778
Facilities
Lessee, Lease, Description [Line Items]
2019		75,588
2020		66,116
2021		57,826
2022		48,542
2023		38,800
Thereafter		160,327
Total		$ 447,199

CREDIT FACILITY, NOTES PAYABL_3

CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS (Details - Schedule of debt) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Equipment notes payable at interest rates ranging from 3.3% to 5.6%, due through 2020, collateralized by medical equipment	$ 538	$ 632
Obligations under capital leases at interest rates ranging from 4.3% to 11.2%, due through 2022, collateralized by medical and office equipment (1)	0	12,119
Total debt obligations	664,786	672,279
Less: current portion	(33,912)	(39,267)
Long term portion debt obligations	630,874	633,012
Term Loan | First Lien Term Loan
Debt Instrument [Line Items]
Debt	578,920	587,191
Discounts on First Lien Term Loans	(14,272)	(15,112)
Term Loan | Term Loan Agreement collateralized by NJIN's tangible and intangible assets
Debt Instrument [Line Items]
Debt	58,500	59,250
Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt	$ 41,000	28,000
Equipment Notes Payable
Debt Instrument [Line Items]
Maturity date	Dec. 31, 2020
Capital Lease Obligations
Debt Instrument [Line Items]
Maturity date	Dec. 31, 2022
Promissory Note
Debt Instrument [Line Items]
Promissory note payable to the former owner of a practice acquired at an interest rate of 1.5% due through 2019	$ 100	$ 199
Interest rate, stated percentage	1.50%
Maturity date	Dec. 31, 2019
Minimum | Equipment Notes Payable
Debt Instrument [Line Items]
Interest rate, stated percentage	3.30%
Minimum | Capital Lease Obligations
Debt Instrument [Line Items]
Interest rate, stated percentage	4.30%
Maximum | Equipment Notes Payable
Debt Instrument [Line Items]
Interest rate, stated percentage	5.60%
Maximum | Capital Lease Obligations
Debt Instrument [Line Items]
Interest rate, stated percentage	11.20%

CREDIT FACILITY, NOTES PAYABL_4

CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS (Details Narrative)	Aug. 31, 2018USD ($)	Aug. 22, 2017USD ($)	Feb. 02, 2017USD ($)	Jul. 01, 2016USD ($)	Sep. 30, 2015USD ($)	Sep. 30, 2017	Mar. 31, 2019USD ($)	Aug. 31, 2018USD ($)	Dec. 31, 2018USD ($)
Debt Instrument [Line Items]
Maximum borrowing capacity				$ 117,500,000			$ 117,500,000
Deferred financing costs, net of accumulated amortization							1,200,000		$ 1,400,000
Total credit facilities outstanding							0
Covenant, leverage ratio		4
First Lien Term Loans
Debt Instrument [Line Items]
Senior secured term loan							623,100,000
Discounts on term loans							14,300,000
Amendment No. 5 to Credit Agreement
Debt Instrument [Line Items]
Deferred financing costs, net of accumulated amortization		$ 350,000
Proceeds from term loans		170,000,000
Debt issuance costs		4,700,000
Debt discount		4,100,000
Amortization of deferred issuance costs		235,000
Term Loan
Debt Instrument [Line Items]
Face Value							637,420,000
Amendment No. 4 to Credit Agreement
Debt Instrument [Line Items]
Deferred financing costs, net of accumulated amortization			$ 543,000
Revolving Credit Facility
Debt Instrument [Line Items]
Maximum borrowing capacity							69,600,000
Deferred financing costs, net of accumulated amortization							1,200,000
Total credit facilities outstanding							41,000,000		28,000,000
Letters of credit outstanding							$ 6,900,000
Effective interest rate							8.25%
SunTrust | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity							$ 30,000,000
First Lien Term Loan | Term Loan
Debt Instrument [Line Items]
Discounts on term loans							14,272,000		$ 15,112,000
Face Value				485,000,000			578,920,000
Second Lien Term Loans | Term Loan
Debt Instrument [Line Items]
Repayments of long-term debt				12,000,000
General and administrative expense				10,000,000
First Lien Credit Agreement, Fifth Amendment | Medium-term Notes
Debt Instrument [Line Items]
Total credit facilities outstanding		100,000,000
First Lien Credit Agreement, Fifth Amendment | Term Loan
Debt Instrument [Line Items]
Covenant, increase to credit facility		100,000,000
First Lien Credit Agreement, Fifth Amendment | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Periodic payment, principal		$ 8,300,000
First Lien Credit Agreement, Fourth Amendment | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Periodic payment, principal			$ 6,100,000
First Lien Credit Agreement | Term Loan
Debt Instrument [Line Items]
Debt instrument, periodic payment				6,100,000
First Lien Credit Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity				$ 117,500,000
Commitment fee percentage				0.25%
Unused capacity, commitment fee percentage				0.50%
Restated Agreement
Debt Instrument [Line Items]
Increase (decrease) in line of credit, net								$ 48,100,000
Restated Agreement | Term Loan
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 60,000,000							60,000,000
Face Value							$ 58,500,000
Debt instrument, periodic payment	$ 750,000
Increase (decrease) in line of credit, net								28,100,000
Periodic payment, percent	5.00%
Periodic payment amortization increase	$ 375,000							375,000
Restated Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 30,000,000							30,000,000
Commitment fee percentage	2.75%
Unused capacity, commitment fee percentage	0.45%
Increase (decrease) in line of credit, net								20,000,000
Agreement
Debt Instrument [Line Items]
Maximum borrowing capacity					$ 50,000,000
Agreement | Term Loan
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 40,000,000							$ 40,000,000
Debt instrument, periodic payment	$ 500,000
Periodic payment, percent	5.00%
Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity					$ 10,000,000
Commitment fee percentage					3.00%
Unused capacity, commitment fee percentage					0.45%
Eurodollar | First Lien Term Loan
Debt Instrument [Line Items]
Basis spread on variable rate				3.75%
Basis spread on variable rate, increase (decrease)				50.00%
Eurodollar | First Lien Term Loan | Term Loan
Debt Instrument [Line Items]
Basis spread on variable rate				3.75%
Basis spread on variable rate, floor				1.00%
Eurodollar | First Lien Credit Agreement, Fifth Amendment | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate							3.75%
Effective interest rate							2.75%
Eurodollar | First Lien Credit Agreement, Fourth Amendment
Debt Instrument [Line Items]
Basis spread on variable rate			3.25%
Eurodollar | Restated Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate	2.75%
Eurodollar | Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate					3.00%
Eurodollar | ≤ 3.50x | First Lien Credit Agreement, Fifth Amendment | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate		3.25%				3.25%
Eurodollar | ≤ 3.50x | First Lien Credit Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate				3.25%
Eurodollar | 4.00x but ≤ 5.50x | First Lien Credit Agreement, Fifth Amendment | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate		3.75%				3.75%
Eurodollar | 4.00x but ≤ 5.50x | First Lien Credit Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate				3.75%
Base Rate | First Lien Term Loan | Term Loan
Debt Instrument [Line Items]
Basis spread on variable rate				2.75%
Base Rate | First Lien Credit Agreement, Fifth Amendment | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate							2.75%
Effective interest rate							5.50%
Base Rate | Restated Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate	1.75%
Base Rate | Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate					2.00%
Base Rate | ≤ 3.50x | First Lien Credit Agreement, Fifth Amendment | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate		2.25%				2.25%
Base Rate | ≤ 3.50x | First Lien Credit Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate				2.25%
Base Rate | 4.00x but ≤ 5.50x | First Lien Credit Agreement, Fifth Amendment | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate		2.75%				2.75%
Base Rate | 4.00x but ≤ 5.50x | First Lien Credit Agreement | Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Basis spread on variable rate				2.75%

CREDIT FACILITY, NOTES PAYABL_5

CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS (Details - Term Loans) - Term Loan - USD ($)	Mar. 31, 2019	Jul. 01, 2016
Debt Instrument [Line Items]
Face Value	$ 637,420,000
Discount	(14,272,000)
Total Carrying Value	623,148,000
First Lien Term Loan
Debt Instrument [Line Items]
Face Value	578,920,000	$ 485,000,000
Discount	(14,272,000)
Total Carrying Value	564,648,000
Restated Agreement
Debt Instrument [Line Items]
Face Value	58,500,000
Discount	0
Total Carrying Value	$ 58,500,000

CREDIT FACILITY, NOTES PAYABL_6

CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS (Details - Margin Spread Based on Leverage Ratio) - Line of Credit - Revolving Credit Facility	Aug. 22, 2017	Jul. 01, 2016	Sep. 30, 2017	Mar. 31, 2019
First Lien Credit Agreement, Fifth Amendment | Eurodollar
Line of Credit Facility [Line Items]
Basis spread on variable rate				3.75%
First Lien Credit Agreement, Fifth Amendment | Eurodollar | 5.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate	4.50%
First Lien Credit Agreement, Fifth Amendment | Eurodollar | 4.00x but ≤ 5.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate	3.75%		3.75%
First Lien Credit Agreement, Fifth Amendment | Eurodollar | 3.50x but ≤ 4.00x
Line of Credit Facility [Line Items]
Basis spread on variable rate	3.50%
First Lien Credit Agreement, Fifth Amendment | Eurodollar | ≤ 3.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate	3.25%		3.25%
First Lien Credit Agreement, Fifth Amendment | Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate				2.75%
First Lien Credit Agreement, Fifth Amendment | Base Rate | 5.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate	3.50%
First Lien Credit Agreement, Fifth Amendment | Base Rate | 4.00x but ≤ 5.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate	2.75%		2.75%
First Lien Credit Agreement, Fifth Amendment | Base Rate | 3.50x but ≤ 4.00x
Line of Credit Facility [Line Items]
Basis spread on variable rate	2.50%
First Lien Credit Agreement, Fifth Amendment | Base Rate | ≤ 3.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate	2.25%		2.25%
First Lien Credit Agreement | Eurodollar | 5.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate		4.50%
First Lien Credit Agreement | Eurodollar | 4.00x but ≤ 5.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate		3.75%
First Lien Credit Agreement | Eurodollar | 3.50x but ≤ 4.00x
Line of Credit Facility [Line Items]
Basis spread on variable rate		3.50%
First Lien Credit Agreement | Eurodollar | ≤ 3.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate		3.25%
First Lien Credit Agreement | Base Rate | 5.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate		3.50%
First Lien Credit Agreement | Base Rate | 4.00x but ≤ 5.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate		2.75%
First Lien Credit Agreement | Base Rate | 3.50x but ≤ 4.00x
Line of Credit Facility [Line Items]
Basis spread on variable rate		2.50%
First Lien Credit Agreement | Base Rate | ≤ 3.50x
Line of Credit Facility [Line Items]
Basis spread on variable rate		2.25%

CREDIT FACILITY, NOTES PAYABL_7

CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASE OBLIGATIONS (Details - Margin Spread Based on Leverage Ratio, Debt Instrument)	Aug. 31, 2018	Sep. 30, 2015
Pricing Level I | Restated Agreement
Debt Instrument [Line Items]
Leverage ratio, greater than	3	3
Pricing Level I | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage	2.75%
Unused capacity, commitment fee percentage	0.45%
Pricing Level I | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage		3.00%
Unused capacity, commitment fee percentage		0.45%
Pricing Level I | Eurodollar | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	2.75%
Pricing Level I | Eurodollar | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		3.00%
Pricing Level I | Base Rate | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	1.75%
Pricing Level I | Base Rate | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		2.00%
Pricing Level II | Restated Agreement
Debt Instrument [Line Items]
Leverage ratio, greater than	2.50	2.50
Leverage ratio, less than	3	3
Pricing Level II | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage	2.25%
Unused capacity, commitment fee percentage	0.40%
Pricing Level II | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage		2.50%
Unused capacity, commitment fee percentage		0.40%
Pricing Level II | Eurodollar | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	2.25%
Pricing Level II | Eurodollar | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		2.50%
Pricing Level II | Base Rate | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	1.25%
Pricing Level II | Base Rate | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		1.50%
Pricing Level III | Restated Agreement
Debt Instrument [Line Items]
Leverage ratio, greater than	2	2
Leverage ratio, less than	2.50	2.50
Pricing Level III | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage	2.00%
Unused capacity, commitment fee percentage	0.35%
Pricing Level III | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage		2.25%
Unused capacity, commitment fee percentage		0.35%
Pricing Level III | Eurodollar | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	2.00%
Pricing Level III | Eurodollar | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		2.25%
Pricing Level III | Base Rate | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	1.00%
Pricing Level III | Base Rate | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		1.25%
Pricing Level IV | Restated Agreement
Debt Instrument [Line Items]
Leverage ratio, greater than	1.50	1.50
Leverage ratio, less than	2	2
Pricing Level IV | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage	1.75%
Unused capacity, commitment fee percentage	0.30%
Pricing Level IV | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage		2.00%
Unused capacity, commitment fee percentage		0.30%
Pricing Level IV | Eurodollar | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	1.75%
Pricing Level IV | Eurodollar | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		2.00%
Pricing Level IV | Base Rate | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	0.75%
Pricing Level IV | Base Rate | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		1.00%
Pricing Level V | Restated Agreement
Debt Instrument [Line Items]
Leverage ratio, less than	1.50	1.50
Pricing Level V | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage	1.50%
Unused capacity, commitment fee percentage	0.30%
Pricing Level V | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Commitment fee percentage		1.75%
Unused capacity, commitment fee percentage		0.30%
Pricing Level V | Eurodollar | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	1.50%
Pricing Level V | Eurodollar | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		1.75%
Pricing Level V | Base Rate | Restated Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate	0.50%
Pricing Level V | Base Rate | Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Basis spread on variable rate		0.75%

STOCK-BASED COMPENSATION (Detai

STOCK-BASED COMPENSATION (Details Narrative) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation expense	$ 1.1
Unrecognized expense weighted average period	2 years
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment award, award vesting period	3 years
Share-based payment award, expiration period	5 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment award, award vesting period	5 years
Share-based payment award, expiration period	10 years
Equity Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options outstanding (in shares)	481,451	513,282
Exercisable shares (in shares)	129,290
Options exercised (in shares)	10,000
Options granted (in shares)	89,200
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards issued to date (in shares)	6,043,620
RSA's unvested (in shares)	392,644
Future Service
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)	0
Restated Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized (in shares)	14,000,000
Awards issued to date (in shares)	14,734,438
Options cancelled (in shares)	3,281,040
RSA's forfeited (in shares)	60,203
Shares available for future issuance, options, warrants, shares of restricted stock and other bonus awards (in shares)	2,606,805
Restated Plan | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment award, award vesting period	3 years
Share-based payment award, expiration period	5 years
Restated Plan | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment award, award vesting period	5 years
Share-based payment award, expiration period	10 years

STOCK-BASED COMPENSATION (Det_2

STOCK-BASED COMPENSATION (Details-Outstanding options and warrants) - Equity Option $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Begining Balance (in shares) | shares	513,282
Granted (in shares) | shares	89,200
Exercised (in shares) | shares	10,000
Canceled, forfeited or expired (in shares) | shares	(111,031)
Ending Balance (in shares) | shares	481,451
Exercisable at the end (in shares) | shares	129,290
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Begining Balance (in dollars per share) | $ / shares	$ 7.44
Granted (in dollars per share) | $ / shares	10.93
Exercised (in dollars per share) | $ / shares	4.97
Canceled, forfeited or expired (in dollars per share) | $ / shares	0.08
Ending Balance (in dollars per share) | $ / shares	8.22
Exercisable at the end (in dollars per share) | $ / shares	$ 6.66
Weighted Average Remaining Contractual Life
Balance at the end	8 years 22 days
Exercisable at the end	7 years 22 days
Aggregate Intrinsic Value
Aggregate value outstanding | $	$ 2,007,986
Aggregate value exercisable | $	$ 740,955

STOCK-BASED COMPENSATION (Det_3

STOCK-BASED COMPENSATION (Details - RSU's) - Restricted Stock	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award, Non-Option Equity Instruments, Outstanding [Roll Forward]
RSA's outstanding, beginning balance (in shares) | shares	277,504
RSA's granted (in shares) | shares	586,000
RSA's vested (in shares) | shares	(470,860)
RSA's outstanding, ending balance (in shares) | shares	392,644
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Weighted-average fair value, beginning balance (in dollars per share) | $ / shares	$ 9.77
Weighted-average fair value, granted (in dollars per share) | $ / shares	11.83
Weighted-average fair value, vested (in dollars per share) | $ / shares	10.62
Weighted-average fair value, ending balance (in dollars per share) | $ / shares	$ 11.51
Weighted-Average Remaining Contractual Term (Years)	1 year 11 months

SUBSEQUENT EVENTS (Details)

SUBSEQUENT EVENTS (Details) - USD ($)	Apr. 18, 2019	Apr. 01, 2019	Aug. 22, 2017	Mar. 31, 2019	Dec. 31, 2018	Jul. 01, 2016
Subsequent Event [Line Items]
Total credit facilities outstanding				$ 0
Maximum borrowing capacity				117,500,000		$ 117,500,000
Kern Radiology Imaging Systems, Inc. | Subsequent Event
Subsequent Event [Line Items]
Purchase consideration		$ 19,300,000
Zilkha Radiology | Subsequent Event
Subsequent Event [Line Items]
Purchase consideration		$ 4,500,000
Revolving Credit Facility
Subsequent Event [Line Items]
Total credit facilities outstanding				41,000,000	$ 28,000,000
Maximum borrowing capacity				$ 69,600,000
Line of Credit | Revolving Credit Facility | First Lien Credit Agreement, Fifth Amendment
Subsequent Event [Line Items]
Periodic payment, principal			$ 8,300,000
Line of Credit | Revolving Credit Facility | First Lien Credit Agreement, Sixth Amendment | Subsequent Event
Subsequent Event [Line Items]
Additional revolving commitments	$ 20,000,000
Maximum borrowing capacity	$ 137,500,000
Line of Credit | Revolving Credit Facility | First Lien Credit Agreement, Seventh Amendment | Subsequent Event
Subsequent Event [Line Items]
Term increase	2 years
Periodic payment, principal	$ 9,700,000
Medium-term Notes | First Lien Credit Agreement, Fifth Amendment
Subsequent Event [Line Items]
Total credit facilities outstanding			$ 100,000,000
Medium-term Notes | First Lien Credit Agreement, Sixth Amendment | Subsequent Event
Subsequent Event [Line Items]
Total credit facilities outstanding	$ 679,000,000