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SEGMENT REPORTING
 12 Months Ended
Dec. 31, 2024
Segment Reporting [Abstract]  
SEGMENT REPORTING SEGMENT REPORTING
Our chief operating decision maker ("CODM"), who is also our CEO, evaluates the financial performance of our segments based upon their respective revenue and segmented internal profit and loss statements prepared on a basis not consistent with GAAP. The CODM considers actual to budget and current year actual to prior year actual for revenue and other profit and loss measures on a monthly basis for evaluating performance of each segment and making decisions about allocating capital and other resources to each segment. We do not report balance sheet information by segment since it is not reviewed by our CODM to evaluate segment performance or to make resource allocation decisions.

In the first quarter of 2024, we revised our reportable segments to combine our eRad business, which was included in the Imaging Center segment, with our former AI segment to form a new Digital Health reportable segment. Prior period amounts were adjusted retrospectively to reflect the change in reportable segment. Accordingly, our reportable segments currently are our Imaging Center segment and our Digital Health segment.
Our Imaging Center segment provides physicians with imaging capabilities to facilitate the diagnosis and treatment of diseases and disorders. 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, a strategy that diversifies revenue streams, reduces exposure to reimbursement changes and provides patients and referring physicians one location to serve the needs of multiple procedures.
Our Digital Health segment develops and deploys clinical applications to enhance interpretation of medical images and improve patient outcomes with an emphasis on brain, breast, prostate, and pulmonary diagnostics. Included in the segment is our eRad subsidiary, which designs the underlying critical scheduling, data storage and retrieval systems necessary for imaging center operation.
In the normal course of business, our Imaging Center and Digital Health segments enter into transactions with each other. While intersegment transactions are treated like third-party transactions to determine segment performance, the revenues recognized by a segment and expenses incurred by the counterparty are eliminated in consolidation and do not affect consolidated results.

The following tables reflect certain financial data for each reportable segment:
Year Ended December 31, 2024
Imaging CenterDigital healthTotal
Revenues from external customers$1,792,319 $37,345 $1,829,664 
Intersegment revenues— 28,361 28,361 
$1,792,319 $65,706 $1,858,025 
Reconciliation of revenue
Elimination of intersegment revenues(28,361)
Total consolidated revenues$1,829,664 
Less:
Other segment items*$1,542,274 $40,753 $1,583,027 
Segment profit (loss)250,045 (3,408)246,637 
Reconciliation of segment profit
Depreciation and amortization(137,838)
Loss on sale and disposal of equipment and other(2,276)
Severance costs(1,902)
Interest expense(79,849)
Equity in earnings of joint ventures14,472 
Non-cash change in fair value of interest rate swaps(8,006)
Debt restructuring and extinguishment expenses(11,292)
Other income24,916 
Income before income taxes$44,862 

*Other segment items include operating expenses, inclusive of cost of operations and lease abandonment charges.
Year Ended December 31, 2023
Imaging CenterDigital healthTotal
Revenues from external customers$1,590,564 $26,066 $1,616,630 
Intersegment revenues— 23,510 23,510 
1,590,564 49,576 1,640,140 
Reconciliation of revenue
Elimination of intersegment revenues(23,510)
Total consolidated revenues$1,616,630 
Less:
Other segment items*$1,381,847 $18,538 $1,400,385 
Segment profit (loss)208,717 7,528 216,245 
Reconciliation of segment profit
Depreciation and amortization(128,391)
Loss on sale and disposal of equipment and other(2,187)
Severance costs(3,778)
Interest expense(64,483)
Equity in earnings of joint ventures6,427 
Non-cash change in fair value of interest rate swaps(8,185)
Debt restructuring and extinguishment expenses— 
Other income6,354 
Gain on contribution of imaging centers into joint venture16,808 
Income before income taxes$38,810 

*Other segment items include operating expenses, inclusive of cost of operations and lease abandonment charges.
Year Ended December 31, 2022
Imaging CenterDigital healthTotal
Revenues from external customers$1,413,419 $16,642 $1,430,061 
Intersegment revenues— 21,416 21,416 
1,413,419 38,058 1,451,477 
Reconciliation of revenue
Elimination of intersegment revenues(21,416)
Total consolidated revenues$1,430,061 
Less:
Other segment items*$1,246,701 $17,645 $1,264,346 
Segment profit (loss)166,718 (1,003)165,715 
Reconciliation of segment profit
Depreciation and amortization(115,877)
Loss on sale and disposal of equipment and other(2,529)
Severance costs(946)
Interest expense(50,841)
Equity in earnings of joint ventures10,390 
Non-cash change in fair value of interest rate swaps39,621 
Debt restructuring and extinguishment expenses(731)
Other income(1,833)
Income before income taxes$42,969 

*Other segment items include operating expenses, inclusive of cost of operations and lease abandonment charges.

Substantially all of our property, equipment and right-of-use assets were located in the United States as of December 31, 2024 and 2023.

Service revenue attributed to countries that represent a significant portion of consolidated service revenue are as follows (in thousands):

202420232022
United States$1,802,422 $1,599,745 $1,423,232 
United Kingdom24,359 14,245 4,432 
Other countries2,883 2,640 2,397 
Total$1,829,664 $1,616,630 $1,430,061