Segmented information (Tables)

12 Months Ended

Dec. 31, 2019

Segment Reporting [Abstract]

Summary of Revenues Relating to Geographic Segments

The revenues relating to geographic segments based on customer location, in United States dollars, for the years ended December 31, 2019 and 2018 are as follows

	2019		2018
Revenue:
Canada and other	$	225,807	$	271,803
United States		120,159,467		112,477,577
Total	$	120,385,274	$	112,749,380

Summary of Revenue from Contract with Customer

The Company’s revenues are disaggregated below into categories which differ in terms of the economic factors which impact the amount, timing and uncertainty of revenue and cash flows.

	2019		2018
Revenue:
Commercial Insurers	$	90,332,380	$	86,992,218
Federal Insurers		19,404,851		14,246,626
Physicians		10,078,843		10,959,215
Other		569,200		551,321
Total	$	120,385,274	$	112,749,380

Summary of Property and Equipment, Intangibles and Other Assets Located in Geographic Regions

The Company’s property and equipment, intangibles, other assets and total assets are located in the following geographic regions as at December 31, 2019 and 2018:

	2019		2018
Property and equipment:
Canada	$	210,386	$	276,621
United States	$	41,547		26,670
Total	$	251,933	$	303,291
Intangible assets:
Canada	$	30,478	$	32,735
United States	$	163,077,715		179,351,528
Total	$	163,108,193	$	179,384,263
Total assets:
Canada	$	3,231,845	$	9,293,796
United States	$	199,863,424		209,694,200
Total	$	203,095,269	$	218,987,996

Summary of Operating Segments

The financial measures reviewed by the Company’s Chief Operating Decision Maker are presented below for the years ended December 31, 2019 and 2018.  The Company does not allocate expenses related to corporate activities.  These expenses are presented within “Other” to allow for reconciliation to reported measures.

	2019
	Anesthesia services		Product sales		Other			Total
Revenue	$	110,306,431	$	10,078,843	$	—		$	120,385,274
Operating costs		94,506,039		4,647,719		6,549,321			105,703,079
Operating income (loss)	$	15,800,392	$	5,431,124	$	(6,549,321	)	$	14,682,195

	2018
	Anesthesia services		Product sales		Other			Total
Revenue	$	101,790,165	$	10,959,215	$	—		$	112,749,380
Operating costs		81,079,150		5,022,737		6,352,363			92,454,250
Operating income (loss)	$	20,711,015	$	5,936,478	$	(6,352,363	)	$	20,295,130

Additionally, the company incurs the following in each of its operating segments:

	2019
	Anesthesia services		Product sales		Other		Total
Finance expense	$	2,994,654	$	—	$	3,614,964	$	6,609,618
Depreciation and amortization expense	$	34,908,764	$	25,534	$	74,772	$	35,009,070

	2018
	Anesthesia services		Product sales		Other		Total
Finance expense	$	1,138,200	$	—	$	3,429,127	$	4,567,327
Depreciation and amortization expense	$	31,394,245	$	68,509	$	23,301	$	31,486,055