The following management's discussion and analysis should be read in conjunction with the financial statements and the related notes thereto contained in this Annual Report. In addition to historical information, this discussion and analysis contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, or the Securities Act, and section 21E of the Securities Exchange Act of 1934, as amended, or the Exchange Act. These forward-looking statements are subject to risks and uncertainties, including those under "Risk Factors" in this Annual Report that could cause actual results or events to differ materially from those expressed or implied by the forward-looking statements. See "Cautionary Note Regarding Forward-Looking Statements" in this Annual Report.

Unless otherwise indicated, references in this section to "ViewRay," "we," "us," "our," "the Company" and "our Company" refer to ViewRay, Inc. and its consolidated subsidiary, ViewRay Technologies, Inc.

The following discussion highlights our results of operations and the principal factors that have affected our financial condition as well as our liquidity and capital resources for the periods described, and provides information that management believes is relevant for an assessment and understanding of the statements of financial condition and results of operations presented herein. The following discussion and analysis are based on our consolidated financial statements contained in this Annual Report, which we have prepared in accordance with United States generally accepted accounting principles. You should read this discussion and analysis together with such consolidated financial statements and the related notes thereto.

A comparison of the results for the year ended December 31, 2022 and 2021 is provided below. Our Annual Report on Form 10-K for the year ended December 31, 2021 includes a discussion and analysis of our financial condition and results of operations for the year ended December 31, 2020 in Part II, Item 7 "Management's Discussion and Analysis of Financial Condition and Results of Operations."

Company Overview

We design, manufacture and market the MRIdian MRI-guided Radiation Therapy System. The MRIdian is built upon a proprietary high-definition magnetic resonance ("MR") imaging system designed from the ground up to address the unique


                                       59

--------------------------------------------------------------------------------

Table of Contents

challenges and clinical workflow for advanced radiation oncology. There are two generations of the MRIdian: the first generation MRIdian with radiation delivery using Cobalt-60 and the second generation MRIdian Linac, with more advanced linear accelerator or 'linac' to deliver the radiation beams. MRIdian with Cobalt-60 is no longer commercially available.

Both generations of the MRIdian have received 510(k) marketing clearance from the FDA and permission to affix the CE mark. Additionally, the newest version of MRIdian, MRIdian A3i, received 510(k) marketing clearance from the FDA in December 2021.

MRIdian is the first radiation therapy system that enables simultaneous radiation treatment delivery and real-time MRI imaging of a patient's internal anatomy. It generates high-quality images that differentiate between the targeted tumor, surrounding soft tissue and nearby critical organs. MRIdian also records the level of radiation dose that the treatment area has received, enabling physicians to adapt the prescription between treatments, as needed. We believe this improved visualization and accurate dose recording will enable better treatment, improve patient outcomes and reduce side effects. Key benefits to users and patients include: improved imaging and patient alignment; the ability to adapt the patient's radiation treatments to changes while the patient is still on the treatment table, or "on-table adaptive treatment planning"; MRI-based motion management; and an accurate recording of the delivered radiation dose. Physicians have already used MRIdian to treat a broad spectrum of radiation therapy patients with more than 45 different types of cancer, as well as patients for whom radiation therapy was previously not an option.

MRIdian A3i streamlines the on-table adaptive workflow by allowing clinicians to intelligently auto-contour, auto-adapt, and auto-gate. Enabling clinicians to collaborate simultaneously and connect remotely during patient treatment. The automated workflow steps and contouring tools are designed to minimize clinician time and increase patient throughput.

MRIdian A3i expands existing real-time tissue tracking and automated beam gating functionalities to include multiplanar tracking and gating in up to three planes. Our customers have the flexibility to select up to three different tracking targets in any combination of coronal, sagittal, or axial planes to automatically stop the beam when any single target exceeds the clinician-defined treatment boundaries.

At December 31, 2022, a total of 56 MRIdian systems, one MRIdian with Cobalt-60 system and 55 MRIdian Linac systems, are in operation worldwide (26 in the United States and 30 outside the United States). In addition, 16 MRIdian Linac systems have been delivered to customers that are in varying stages of deployment.

We currently market MRIdian through a direct sales force in the United States. In the rest of the world, we market MRIdian through a hybrid model of both a direct sales force and distribution network. We market MRIdian to a broad range of worldwide customers, including university research and teaching hospitals, community hospitals, private practices, government institutions and freestanding cancer centers. As with the traditional linac market, our sales and revenue cycles vary based on the particular customer and can be lengthy, sometimes lasting up to 18 to 24 months (or more) from initial customer contact to order contract execution. Following execution of an order contract, it generally takes nine to 15 months for a customer to customize an existing facility or construct a new vault. Upon the commencement of installation at a customer's facility, it typically takes approximately 45 to 60 days for us to install MRIdian and perform on-site testing of the system, including the completion of acceptance test procedures.

We generated product, service and distribution rights revenues of $102.2 million, $70.1 million and $57.0 million, and had net losses of $107.3 million, $110.0 million and $107.9 million during the years ended December 31, 2022, 2021, and 2020, respectively.

We expect to continue to incur significant expenses and operating losses for the foreseeable future. We expect our expenses will increase substantially in connection with our ongoing activities, as we:

•navigate our business activities through the impacts of the COVID-19 pandemic;

•manage delays experienced by our third-party suppliers and distributors;

•continue our research and development efforts;

•seek regulatory approval for MRIdian in certain foreign countries; and

•operate as a public company.

Accordingly, we may seek to fund our operations through public or private equity, debt financings or other sources. However, we may be unable to raise additional funds or enter into such other arrangements when needed on favorable terms or at all. Our failure to raise capital or enter into such other arrangements as and when needed would have a negative impact on our financial condition and our ability to develop enhancements to and integrate new technologies into MR Image-Guided radiation therapy systems.


                                       60

--------------------------------------------------------------------------------

Table of Contents

November 2021 Public Offering of Common Stock

On November 16, 2021, we entered into an underwriting agreement with Piper Sandler & Co. and Stifel, Nicolaus & Company, Incorporated, as representatives of the several underwriters named therein (the "November 2021 Underwriters"), with respect to the issuance and sale of 14,375,000 shares of our common stock, which included the full exercise of the November 2021 Underwriters' option to purchase additional shares, at a price to the public of $5.60 per share. We completed the offering on November 18, 2021 and received net proceeds of approximately $75.1 million, after deducting the underwriting discounts and commissions and estimated offering expenses payable by us.

January 2021 Public Offering of Common Stock

On January 4, 2021, we entered into an underwriting agreement with Piper Sandler & Co., as representative of the several underwriters named therein, with respect to the issuance and sale of 11,856,500 shares of our common stock, which included the full exercise of the underwriters' option to purchase additional shares, at a price to the public of $4.85 per share. We completed the offering on January 7, 2021 and received net proceeds of approximately $53.5 million, after deducting the underwriting discounts and commissions and offering expenses payable by us.

Term Loan

In December 2018, we entered into a term loan agreement with SVB (the "SVB Term Loan"). The SVB Term Loan was subsequently amended, and on May 31, 2022, we entered into the Fourth Amendment (the "Fourth Amendment") to SVB Term Loan. As noted below, the SVB Term Loan was repaid in full as part of the Credit Agreement.

Credit Agreement

On November 14, 2022, we entered into a new five-year loan facility agreement with MidCap Financial ("MidCap") and Silicon Valley Bank ("SVB") (the "Credit Agreement"). The Credit Agreement consists of a term loan of up to $100 million and a revolving credit facility of up to $25 million.

Term Loan

The key elements of the term loan include (i) a term loan commitment up to $100 million, of which $25 million may be accessed upon achievement of a gross margin target for the 2023 fiscal year; (ii) an annual interest rate of the Wall Street Journal ("WSJ") Prime rate plus 3.5% with a floor of 9.25%; (iii) an exit fee payment of 4.00% of the aggregate principal amount, and (iv) a maturity date of November 1, 2027, with three years of interest only payments, with the option to extend the interest only period for one additional year at our election. At close, we drew $75 million, of which $60 million was used to retire its existing SVB Term Loan.

Revolving Credit Facility

The key elements of the revolving line of credit under the Credit Agreement include (i) a revolving line of credit of up to $25 million, comprised of an initial $15 million commitment, with the option to increase the line by an additional $10 million, subject to lender approval and borrowing base availability; (ii) an annual interest rate of the WSJ Prime rate plus 0.5% with a floor of 6.25%; (iii) a maturity date of November 1, 2027. At close, we drew $5.0 million.

Additional details regarding the Credit Agreement are included in the section entitled "Notes to Consolidated Financial Statements - Note 5 - Debt" in the consolidated financial statements included elsewhere in this Form 10-K.

The Credit Agreement is secured by substantially all assets of the Company, except that the collateral does not include any intellectual property held by the Company, provided, however, the collateral does include all accounts and proceeds of such intellectual property.

The Credit Agreement contains customary representations and warranties and customary affirmative and negative covenants applicable to the Company and its subsidiaries, including, among other things, restrictions on indebtedness, liens, investments, mergers, dispositions, prepayment of other indebtedness, dividends and other distributions and transactions with affiliates. The Credit Agreement also contains financial covenants that require the Company to maintain a minimum net revenue threshold and a minimum backlog balance.

Impact of the COVID-19 Pandemic

The COVID-19 pandemic and its follow-on effects have impacted and will continue to impact business activity across industries worldwide, including ViewRay.

Due to pandemic-related factors including delays in service from our global supply chain partners and travel and quarantine restrictions imposed by government agencies and our customers in response to the spread of COVID-19, we have experienced delays in installation of systems in the United States, Asia and Europe. Similarly, our ability to conduct


                                       61

--------------------------------------------------------------------------------

Table of Contents

commercial efforts with our customers has been disrupted due to the impact of COVID-19 on our customers. If the economic effects of the COVID-19 pandemic persist or travel restrictions are reinstated, our ability to conduct our business and access capital markets will be negatively impacted. Capital equipment sales, which make up the majority of our revenue and which were negatively impacted by the pandemic, may take longer than other areas of the economy to return to pre-pandemic levels, and this may continue to have a material impact on our business. The impacts of the COVID-19 pandemic have slowed, but they persist globally and may negatively impact our operations in areas that we are not aware of currently. See Item 1A "Risk Factors" for a discussion of certain risks related to COVID-19.

Impact of Inflation

In recent years, inflation has not had a significant impact on our operations. However, as inflation has increased over the past year, we are monitoring the potential impact on our business, including increases in product cost in connection with the parts used in our manufacturing process, freight and transportation costs, and wage pressure. Should the increase in inflation persist, it will likely increase the costs of conducting our operations, which would adversely impact our profitability. See Item 1A "Risk Factors" for a discussion of certain risks related to inflation.

New Orders and Backlog

New orders are defined as the sum of gross product orders, representing MRIdian contract price, recorded in backlog during the period. Backlog is the accumulation of all orders for which revenue has not been recognized and which we consider valid. Backlog includes customer deposits or letters of credit, except when the sale is to a customer where a deposit is not deemed necessary or customary. Deposits received are recorded in a customer deposit liability account on the balance sheet. Orders may be revised or cancelled according to their terms or upon mutual agreement between the parties. Therefore, it is difficult to predict with certainty the amount of backlog that will ultimately result in revenue. The determination of backlog includes objective and subjective judgment about the likelihood of an order contract becoming revenue. We perform a quarterly review of backlog to verify that outstanding orders in backlog remain valid, and based upon this review, orders that are no longer expected to result in revenue are removed from backlog. Among other criteria to consider for a transaction to be in backlog, we must possess both an outstanding and effective written agreement for the delivery of a MRIdian signed by a customer with a minimum customer deposit or a letter of credit requirement except when the sale is to a customer where a deposit is not deemed necessary or customary (i.e. sale to a government entity, a large hospital, group of hospitals or cancer care group that has sufficient credit, sales via tender awards, or indirect channel sales that have signed contracts with end-customers). We decide whether to remove or add back an order from or to our backlog by evaluating the following criteria: changes in customer or distributor plans or financial conditions; the customer's or distributor's continued intent and ability to fulfill the order contract; changes to regulatory requirements; the status of regulatory approval required in the customer's jurisdiction, if any; the length of time the order has been on our backlog; and other reasons for potential cancellation of order contracts.

During the years ended December 31, 2022, 2021 and 2020, our new orders were $191.0 million, $158.9 million and $94.6 million, respectively. Based on our assessment, we removed $36.4 million, $30.4 million and $36.1 million from the backlog for fiscal years 2022, 2021 and 2020, respectively. At December 31, 2022, we had a backlog with a total value of $380.2 million.

Components of Statements of Operations

Revenue

Product Revenue. Product revenue consists of revenue recognized from sales of MRIdian systems, as well as optional components, such as additional planning workstations and body coils.

Following execution of an order contract, it generally takes nine to 15 months for a customer to customize an existing facility or construct a new vault for the purchased system. Upon the commencement of installation at a customer's facility, it typically takes approximately 45 to 60 days to complete the installation and on-site testing of the system, including the completion of customer test procedures. On-site training can take up to multiple weeks and can be conducted concurrently with installation and acceptance testing. Order contracts generally include customer deposits upon execution of the agreement, and in certain cases, additional amounts due at shipment or commencement of installation, and final payment due generally upon customer acceptance.

The Company recognizes revenue for the system at the point in time when delivery and inspection has occurred and installation revenue over a period of time as control of the installation services is transferred. For all contracts in which control transfers upon post-installation customer acceptance, revenue for the system and installation will continue to be recognized upon customer acceptance. For sales of MRIdian systems for which we are not responsible for installation, revenue is recognized when the entire system is delivered, which is when the control of the system is transferred to the customer.


                                       62

--------------------------------------------------------------------------------

Table of Contents

Service Revenue. Our contracts typically include a twelve-month warranty. In addition, we offer multi-year, post-installation maintenance and support contracts that provide various levels of service support, which enables our customers to select the level of on-going support services, including parts and labor, which they require. These post-installation contracts are for a period of one to five years and provide services ranging from on-site parts and labor, and preventative maintenance to labor only with a longer response time. We also offer technology upgrades to our MRIdian systems, when and if available, for an additional fee. Service revenue is recognized ratably over the term during which the contracted services are provided.

Distribution Rights Revenue. In December 2014, we entered into a distribution agreement with Itochu Corporation, or Itochu, pursuant to which we appointed Itochu as our exclusive distributor for the promotion, sale and delivery of MRIdian products within Japan. As consideration for the exclusive distribution rights granted, we received $4.0 million, which was recorded as deferred revenue. Beginning in August 2016, distribution rights revenue has been recognized ratably over the remaining term of the distribution agreement, which expires in December 2023. A time-elapsed method is used to measure progress because the control is transferred evenly over the contractual period.

Cost of Revenue

Product Cost of Revenue. Product cost of revenue primarily consists of the cost of materials, installation and services associated with the manufacturing and installation of MRIdian systems, and royalty payments to the University of Florida Research Foundation. Product cost of revenue also includes lower of cost or net realizable value inventory, or LCNRV, adjustments if the carrying value of the inventory is greater than its net realizable value. We recorded LCNRV charges of nil, $0.9 million and $0.2 million for the years ended December 31, 2022, 2021, and 2020, respectively.

We expect our materials, installation and service costs to decrease as we continue to scale our operations, improve product designs and work with our third-party suppliers to lower costs. We expect to continue to lower costs and increase sales prices over the coming years.

Service Cost of Revenue. Service cost of revenue is comprised primarily of personnel costs, training and travel expenses to service and perform maintenance on installed MRIdian systems. Service cost of revenue also includes the costs of replacement parts under maintenance and support contracts.

Operating Expenses

Research and Development. Research and development expenses consist primarily of compensation and related costs for personnel, including stock-based compensation, employee benefits and travel expenses. Other significant research and development costs arise from third-party consulting services, laboratory supplies, research materials, medical equipment, computer equipment and licensed technology, and related depreciation and amortization. We expense research and development costs as incurred. As we continue to invest in improving MRIdian and developing new technologies, we expect our research and development expenses to increase.

Selling and Marketing. Selling and marketing expenses consist primarily of compensation and related costs for our direct sales force, sales management, and marketing and customer support personnel, and include stock-based compensation, employee benefits and travel expenses. Selling and marketing expenses also include costs related to trade shows and marketing programs. We expense selling and marketing costs as incurred. We expect selling and marketing expenses to increase in future periods as we expand our sales force and our marketing and customer support organizations and increase our participation in trade shows and marketing programs.

General and Administrative. Our general and administrative expenses consist primarily of compensation and related costs for our operations, finance, human resources, regulatory, and other administrative personnel, and include stock-based compensation, employee benefits and travel expenses. In addition, general and administrative expenses include third-party consulting, legal, audit, accounting services, quality and regulatory functions and facilities costs, and gain or loss on the disposal of property and equipment. We expect our general and administrative expenses to increase as our business grows and as we invest in the development of our MRIdian Linac.

Impairment Charges. We assess our right-of-use ("ROU") assets for impairment when there are indicators and compare the carrying amount of the ROU asset to its estimated undiscounted future cash flows. If the estimated undiscounted future cash flows are less than the carrying amount of the ROU asset, an impairment calculation is performed. An impairment loss is recorded for the difference of the ROU asset's carrying value that exceeds its estimated discounted cash flows. In connection with our sublease of one of our Mountain View, California office space locations, we recorded an impairment charge of $1.5 million on our ROU asset and $0.3 million on the related furniture and fixtures in 2022.


                                       63

--------------------------------------------------------------------------------

Table of Contents

Interest Income

Interest income consists primarily of interest income received on our cash and cash equivalents.

Interest Expense

Interest expense consists primarily of interest and amortization related to our indebtedness.

Other Income (Expense), Net

Other (expense) income, net consists primarily of changes in the fair value of the warrants to purchase 1,720,512 shares of common stock that we issued in a private placement in January 2017 (the "2017 Placement Warrants") and the warrants to purchase 1,380,745 shares of common stock that we issued in a private placement in August 2016 (the "2016 Placement Warrants") and foreign currency exchange gains and losses.

The outstanding 2017 and 2016 Placement Warrants are re-measured to fair value at each balance sheet date with the corresponding gain or loss from the adjustment recorded as a component of other (expense) income, net.

Additional Financial Measures

We regularly review a number of metrics to evaluate our business, measure our progress and make strategic decisions. Adjusted EBITDA (the "non-GAAP financial measure") is currently utilized by management and may be used by our competitors to assess performance. We believe this measure assists our investors in gaining a meaningful understanding of our performance. Because not all companies use identical calculations, our presentation of this measure may not be comparable to other similarly titled measures of other companies. Refer "Non-GAAP Financial Measure" below for a definition and a reconciliation of net loss to adjusted EBITDA.


                                       64

--------------------------------------------------------------------------------

Table of Contents

Results of Operations

The analysis presented below is organized to provide the information we believe will be helpful for understanding of our historical performance and relevant trends going forward and should be read in conjunction with our consolidated financial statements, including the notes thereto, in Part II, Item 8 "Financial Statements and Supplementary Data" of this Annual Report on Form 10-K. Also included in the following analysis are measures that are not in accordance with U.S. GAAP. A reconciliation of the non-GAAP measures to U.S. GAAP is provided below.



The following tables set forth our results of operations for the periods
presented (in thousands):

                                                     Year Ended December 31,
                                               2022            2021            2020
Revenue:
Product                                    $   79,325      $   51,865      $   42,742
Service                                        22,368          17,779          13,800
Distribution rights                               513             475             475
Total revenue                                 102,206          70,119          57,017
Cost of revenue:
Product                                        71,238          51,780          49,347
Service                                        20,923          18,004          11,729
Total cost of revenue                          92,161          69,784          61,076
Gross profit (loss)                            10,045             335          (4,059)
Operating expenses:
Research and development                       32,431          31,849          25,008
Selling and marketing                          30,488          16,044          15,181
General and administrative                     52,437          56,091          61,729
Impairment charges                              1,816               -               -
Total operating expenses                      117,172         103,984         101,918
Loss from operations                         (107,127)       (103,649)       (105,977)
Interest income                                 1,686              13             791
Interest expense                               (5,057)         (4,241)         (3,307)
Other income (expense), net                     3,168          (2,171)            585

Loss before provision for income taxes (107,330) (110,048) (107,908) Provision for income taxes

                          -               -               -
Net loss                                   $ (107,330)     $ (110,048)     $ (107,908)

Comparison of the years ended December 31, 2022 and 2021



Revenue

                              Year Ended December 31,
                                 2022                2021        Change ($)       Change (%)
                                   (in thousands)
Product                 $      79,325             $ 51,865      $    27,460           52.9  %
Service                        22,368               17,779            4,589           25.8  %
Distribution rights               513                  475               38            8.0  %
Total revenue                 102,206               70,119           32,087           45.8  %

Total revenue during the year ended December 31, 2022 increased by $32.1 million, or 45.8% compared to the year ended December 31, 2021. The increase was due to an increase in product revenue of $27.5 million as well as an increase in service revenue of $4.6 million during the year ended December 31, 2022 as compared to December 31, 2021.

Product Revenue. Product revenue increased by $27.5 million, or 52.9%, in fiscal year 2022 compared to fiscal year 2021. The increase was primarily attributable to additional MRIdian Linac systems recognized as revenue in fiscal


                                       65

--------------------------------------------------------------------------------

Table of Contents

year 2022 as compared to fiscal year 2021. The Company recognized revenue for 16 MRIdian Linac systems, including one upgrade, during the fiscal year 2022, as compared to 10 MRIdian Linac systems during the fiscal year 2021.



Service Revenue. Service revenue increased by $4.6 million, or 25.8%, in fiscal
year 2022 compared to fiscal year 2021 primarily due to the increase in
installed base.

Cost of Revenue

                              Year Ended December 31,
                                 2022                2021        Change ($)       Change (%)
                                   (in thousands)
Product                 $      71,238             $ 51,780      $    19,458           37.6  %
Service                        20,923               18,004            2,919           16.2  %
Total cost of revenue          92,161               69,784           22,377           32.1  %

Product Cost of Revenue. Product cost of revenue increased by $19.5 million, or 37.6%, in fiscal year 2022 compared to fiscal year 2021. The increase was primarily attributable to the additional MRIdian Linac systems recognized in fiscal year 2022 as compared to fiscal year 2021.

Service Cost of Revenue. Service cost of revenue increased by $2.9 million, or 16.2%, in fiscal year 2022 compared to fiscal year 2021. The increase in service cost of revenue was primarily due to the increase in installed base.



Operating Expenses

                                   Year Ended December 31,
                                      2022                2021        Change ($)      Change (%)
                                        (in thousands)
Research and development     $      32,431             $ 31,849      $      582            1.8  %
Selling and marketing               30,488               16,044          14,444           90.0  %
General and administrative          52,437               56,091          (3,654)          (6.5) %
Impairment charges                   1,816                    -           1,816          100.0  %
Total operating expenses           117,172              103,984          13,188           12.7  %

Research and Development. Research and development expenses increased by $0.6 million, or 1.8%, in fiscal year 2022 compared to fiscal year 2021. This increase was a result of increased personnel expenses related to clinical studies, partially offset by a decrease in consulting expenses.

Selling and Marketing. Selling and marketing expenses increased by $14.4 million, or 90.0%, in fiscal year 2022 compared to fiscal year 2021. This increase was primarily attributable to a $9.9 million increase in personnel expenses as a result of the expansion of the sales team and an increase in commission compensation due to higher order volume and revenue in 2022. Additionally, there was a $4.3 million increase in travel and marketing expenses for in-person events.

General and Administrative. General and administrative expenses decreased by $3.7 million, or 6.5%, in fiscal year 2022 compared to fiscal year 2021. This decrease was primarily attributable to a $3.7 million decrease in stock compensation expense due to a one-time expense recognized during 2021.

Impairment Charges. In 2022, the Company recorded impairment charges of $1.8 million on its ROU asset and related furniture and fixtures in connection with its sublease of one of its Mountain View, California office space locations.



Interest Income

                          Year Ended December 31,
                               2022                  2021      Change ($)       Change (%)
                               (in thousands)
Interest income   $          1,686                  $ 13      $     1,673       12,869.2  %

Interest income increased by $1.7 million in fiscal year 2022 compared to fiscal year 2021 due to an overall increase in interest rates during 2022.


                                       66

--------------------------------------------------------------------------------


  Table of Contents

Interest Expense

                           Year Ended December 31,
                              2022                2021        Change ($)       Change (%)
                                (in thousands)
Interest expense     $      (5,057)            $ (4,241)     $      (816)          19.2  %


Interest expense increased by $0.8 million in fiscal year 2022 compared to
fiscal year 2021. The increase in interest expense is due to an increase in
interest rates combined with higher principal amounts following the debt
amendment that occurred in June 2022 and the entry into the Credit Agreement in
November 2022.

Other Income (Expense), Net

                                    Year Ended December 31,
                                       2022                2021        Change ($)       Change (%)
                                         (in thousands)
Other income (expense), net   $      3,168              $ (2,171)     $     5,339          245.9  %

Other income (expense), net for fiscal year 2022 consisted primarily of a $2.6 million decrease in the fair value of warrant liabilities related to the 2017 and 2016 Placement Warrants. Other income (expense), net for fiscal year 2021 consisted primarily of a $2.3 million increase in the fair value of warrant liabilities related to the 2017 and 2016 Placement Warrants.



Non-GAAP Adjusted EBITDA

                                 Year Ended December 31,
                                   2022               2021         Change ($)       Change (%)
Non-GAAP adjusted EBITDA   $     (78,230)          $ (73,681)     $    (4,549)          (6.2) %

Non-GAAP adjusted EBITDA for the full year 2022 was a loss of $78.2 million compared to a loss of $73.7 million for the full year 2021. We define adjusted EBITDA as EBITDA (defined as net income before net interest expense, depreciation, and amortization), adjusted for impairment of assets, non-cash equity-based compensation, non-cash changes in warrant liability valuations, and non-recurring costs. The change in adjusted EBTIDA was primarily attributable to the change in the warrant liabilities and the decrease in stock-based compensation, offset by a decrease in net loss and the impairment charge recognized in fiscal year 2022. Refer "Non-GAAP Financial Measure" below for the reconciliation of GAAP net loss to Non-GAAP adjusted EBITDA.

Non-GAAP Financial Measure

Management uses a non-GAAP measure of adjusted earnings before interest, taxes, depreciation, amortization and stock-based compensation ("adjusted EBITDA"). We define adjusted EBITDA as EBITDA (defined as net income before net interest expense, depreciation, and amortization), adjusted for impairment of assets, non-cash equity-based compensation, non-cash changes in warrant liability valuations, and non-recurring costs.

Adjusted EBITDA has important limitations as an analytical tool, and you should not consider it in isolation or as a substitute for analysis of our results as reported under GAAP. Some of these limitations are that Adjusted EBITDA:

•does not reflect any charges for the assets being depreciated and amortized that may need to be replaced in the future;

•does not reflect the significant interest expense or the cash requirements necessary to service interest or, if any, principal payments on our debt;

•does not reflect the impact of write-downs of long-lived assets;

•does not reflect the impact of share-based compensation upon our results of operations;

•does not reflect the impact of changes in fair value of our warrant liabilities; and

•does not include certain expenses that are non-recurring, infrequent and unusual in nature.



                                       67

--------------------------------------------------------------------------------

Table of Contents The following table provides a reconciliation of adjusted EBITDA to net income, the most directly comparable GAAP measure, for each of the periods presented:



Reconciliation of GAAP Net Loss to Adjusted EBITDA (in
thousands)                                                            Year Ended December 31,
                                                                     2022                  2021
GAAP net loss                                                  $    (107,330)         $  (110,048)
Depreciation and amortization                                          4,922                5,984
Stock-based compensation                                              21,608               23,871
Interest expense                                                       5,057                4,241
Interest income                                                       (1,686)                 (13)
Loss (gain) on fair value of warrants (a)                             (2,617)               2,284
Impairment (b)                                                         1,816                    -
Adjusted EBITDA                                                      (78,230)             (73,681)


_________________

(a) consists of non-cash gain/losses related to our 2017 and 2016 Placement Warrants. (b) consists of a one-time non-cash impairment charge on the right-of-use assets and related furniture and fixtures of one of our Mountain View, California office space locations.

Liquidity and Capital Resources

Since our inception in 2004, we have incurred significant net losses and negative cash flows from operations. During the years ended December 31, 2022, 2021 and 2020, we had a net loss of $107.3 million, $110.0 million and $107.9 million, respectively. At December 31, 2022 we had an accumulated deficit of $844.5 million.

At December 31, 2022 and 2021, we had a cash and cash equivalents and restricted cash balance of $142.5 million and $219.8 million, respectively. To date, we have financed our operations principally through offerings of our capital stock, issuances of warrants, use of term loans and our new revolving credit facility, receipts of customer deposits for new orders, and payments from customers for systems installed and delivered. We may, from time to time, seek to raise capital through a variety of sources, including the public equity market, private equity financing, and public or private debt.

We expect that our existing cash and cash equivalents, together with proceeds from the sales of MRIdian systems, will be adequate to meet anticipated working capital needs, anticipated levels of capital expenditures, and contractual obligations for at least the next twelve months. However, we continue to critically review our liquidity and anticipated capital requirements in light of the significant uncertainty created by the COVID-19 pandemic and current economic conditions.

We could potentially use our available financial resources sooner than we currently expect, and we may incur additional indebtedness to meet long-term operating needs. Adequate additional funding may not be available to us on acceptable terms or at all. In addition, although we anticipate being able to obtain additional financing, we may be unable to do so. Our failure to raise capital as and when needed could have significant negative consequences for our business, financial condition and results of operations. Our future capital requirements and the adequacy of available funds will depend on many factors, including those set forth in the section titled "Risk Factors."

The following table summarizes our cash flows for the periods presented (in thousands):



                                                            Year Ended December 31,
                                                      2022           2021           2020
Cash used in operating activities                  $ (91,708)     $ (62,091)     $ (63,474)
Cash used in investing activities                     (3,898)        (1,559)        (6,183)
Cash provided by (used in) financing activities       18,293        125,278           (350)


Operating Activities

We have historically experienced cash outflows as we developed MRIdian with Cobalt-60 and MRIdian Linac and expanded our business. Our primary source of cash flow from operating activities is cash receipts from customers including sales of MRIdian systems and, to a lesser extent, up-front payments from customers. Our primary uses of cash in operating activities are amounts due to vendors for purchased components and employee-related expenditures.


                                       68

--------------------------------------------------------------------------------

Table of Contents

During fiscal year 2022, cash used in operating activities was $91.7 million, resulting from our net loss of $107.3 million, offset by a net change of $10.3 million in our working capital, and the aggregate non-cash charges of $25.9 million.

During fiscal year 2021, cash used in operating activities was $62.1 million, resulting from our net loss of $110.0 million, offset by a net change $12.9 million in our working capital, and the aggregate non-cash charges of $35.0 million.

Investing Activities

Cash used in investing activities during the year ended December 31, 2022 and 2021 of $3.9 million and $1.6 million, respectively, primarily resulted from capital expenditures to purchase property and equipment.

Financing Activities

During the year ended December 31, 2022, net cash provided by financing activities was $18.3 million, which consisted of net proceeds from debt modifications of $20.1 million, proceeds from the exercise of stock options of $0.1 million, and proceeds from the employee stock purchase plan of $0.6 million, partially offset by the cash used to pay taxes related to net share settlement of equity awards of $2.6 million.

During the year ended December 31, 2021, net cash provided by financing activities was $125.3 million, which consisted of net proceeds from the January and November common stock public offerings of $128.6 million, proceeds from the exercise of stock options of $0.8 million, and proceeds from the employee stock purchase plan of $0.6 million, partially offset by the cash used to pay taxes related to net share settlement of equity awards of $4.6 million.

Critical Accounting Policies and Estimates

Our consolidated financial statements are prepared in conformity with accounting principles generally accepted in the United States ("U.S. GAAP") which requires us to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. These estimates and assumptions are based on historical experience and on various other factors that we believe are reasonable under the circumstances. We evaluate our estimates and assumptions on an ongoing basis.

In addition to the accounting policies that are more fully described in the Notes to the Consolidated Financial Statements included in this Annual Report on Form 10-K, we consider the critical accounting policies described below to be affected by critical accounting estimates, and those estimates have the greatest potential impact on our consolidated financial statements. Such accounting policies require us to use judgments, often as a result of the need to make estimates and assumptions regarding matters that are inherently uncertain, and actual results could differ from these estimates.

Revenue Recognition

Our revenues are derived primarily from the sale of MRIdian systems, installation of the MRIdian system, and support and maintenance services on sold systems. The MRIdian system and installation of the MRIdian system are considered two distinct performance obligations.

For contracts in which control of the system transfers upon delivery and inspection, the Company recognizes revenue for the systems at the point in time when delivery and inspection by the customer has occurred. For these same contracts, the Company recognizes installation revenue over the period of installation as the installation services are performed and control is transferred to the customer. For all contracts in which control continues to transfer upon post-implementation customer acceptance, revenue for the system and installation is recognized upon customer acceptance.

Certain customer contracts with distributors do not require ViewRay installation at the ultimate user site, and the distributors may either perform the installation themselves or hire another party to perform the installation. For sales of MRIdian systems for which the Company is not responsible for installation, revenue recognition occurs when the system is shipped, which is when the control of the system is transferred to the customer.

For sales of the related support and maintenance services, a time-elapsed method is used to measure progress toward complete satisfaction of performance obligations and service revenue is recognized ratably over the service contract term, which is typically 12 months.

We frequently enter into sales arrangements that contain multiple performance obligations including MRIdian system and product support. Judgments as to the standalone selling price and allocation of consideration from an arrangement to the individual performance obligations, and the appropriate timing of revenue recognition are critical with respect to these arrangements. Changes to the performance obligations can impact the arrangement and amounts allocated to each performance obligation could affect the timing and amount of revenue recognition.


                                       69

--------------------------------------------------------------------------------

Table of Contents

Stock-Based Compensation

Stock-based compensation expense is measured and recognized in the consolidated financial statements based on the fair value of the awards granted. We use the Black-Scholes option-pricing model to estimate the fair value of our stock-based awards including: restricted stock units ("RSUs"), deferred stock units ("DSUs"), performance share units ("PSUs"), employee stock purchase plan ("ESPP"), and stock options. This valuation model requires the input of highly subjective assumptions, the most significant of which is our estimates of expected volatility and the forfeiture rate of the award. The Company determines volatility based on the Company's own historical volatility measurements. The forfeiture rate of stock awards is estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Forfeitures have been estimated by the Company based upon historical and expected forfeiture experience.

Furthermore, PSUs are based on our corporate financial performance targets of the Company's compound annual revenue growth rate over a three-year period. The number of PSUs that will ultimately be awarded are contingent on our actual level of achievement compared to the corporate financial target performance targets.

The assumptions used in calculating the fair value of stock-based payment awards represent management's best estimates. These estimates involve inherent uncertainties and the application of management's judgment. If factors change and different assumptions are used, our stock-based compensation expense could be materially different in the future.

Common Stock Warrants

We issued the 2017 and 2016 Placement Warrants in connection with the 2017 and 2016 Private Placements. The 2017 and 2016 Placement Warrants were accounted for as a liability with subsequent changes in fair value recorded in other income (expenses), net at each reporting date until the warrants are exercised or expired. The Company valued the 2017 and 2016 Placement Warrants at issuance using the Black-Scholes option pricing model and determined the fair value. The key inputs to the valuation model included expected volatility, risk-free rate, and an expected term.

Inventory Valuation

Inventory consists primarily of purchased components for assembling MRIdian systems and other direct costs associated with MRIdian system installation. Inventory is stated at the lower of cost or net realizable value. When the net realizable value of inventory is lower than related costs, we reduce the carrying value of inventory for the difference while recording a corresponding charge to cost of product revenues. The assumptions we used in estimating the net realizable value of the inventory primarily include the total cost to complete the applicable MRIdian system.

Recently Issued and Adopted Accounting Pronouncements

We review new accounting standards to determine the expected financial impact, if any, that the adoption of each such standard will have. For the recently issued accounting standards that we believe may have an impact on our consolidated financial statements, see the section entitled "Notes to Consolidated Financial Statements - Note 2 - Summary of Significant Accounting Policies" in the consolidated financial statements.

© Edgar Online, source Glimpses