Revenue Performance - Revenues for Q2 2024 decreased by $886,596 or 53.5% compared to Q2 2023, primarily due to a decline in DPNCheck sales attributed to adverse CMS reimbursement changes[57] - Revenues for the first half of 2024 decreased by $1.5 million or 44.9% compared to the first half of 2023, primarily due to a decline in DPNCheck sales[63] Gross Profit and Margin - Gross profit for Q2 2024 was $491,919, reflecting a decrease of $627,339 or 56.0% from Q2 2023, with a gross margin rate of 64.0% compared to 67.6% in the prior year[59] - Gross profit for the first half of 2024 decreased by $1.3 million or 56.5%, with a gross margin of 54.2%, down from 68.6% in the same period last year[64] Operating Expenses - Operating expenses in Q2 2024 decreased by $422,139 or 15.4% from Q2 2023, driven by employee headcount restructuring[61] - Operating expenses increased by $440 thousand or 7.8% in the first half of 2024, driven by higher G&A spending[65] Net Loss - The net loss for Q2 2024 was $1.5 million, a decrease of $49 thousand from Q2 2023, with net loss per share improving to ($0.74) from ($1.56) per share[62] - The net loss for the first half of 2024 increased by $1.4 million compared to 2023, with net loss per share at ($2.37) versus ($3.20) in the prior year[66] Sales Performance - DPNCheck sales were the primary contributor to the revenue decline in Q2 2024, with international sales also affected by excess inventory at the Japan distributor[58] - Quell sales provided a small offset to the decline in DPNCheck sales during Q2 2024[58] - DPNCheck sales in Asian markets remain unaffected by recent reimbursement changes in the Medicare Advantage market[54] Strategic Initiatives - The Company plans to reactivate promotion of Quell OTC for lower extremity chronic pain in Q4 2024[51] - A De Novo application for marketing Quell-CIPN is planned for filing in the second half of 2024, expanding the portfolio of Quell-based Rx wearable therapeutics[52] - The Company has initiated a strategic review to promote growth of Quell and DPNCheck, considering various options including potential acquisitions and marketing strategy changes[56] - The company is exploring strategic options to maximize shareholder value, including changes in marketing strategies and potential mergers or acquisitions[67] Cash and Working Capital - As of June 30, 2024, the company had working capital of $16.9 million and cash, cash equivalents, and marketable securities totaling $16.4 million[68] - Cash used in operating activities increased by $873 thousand in the first half of 2024, reflecting a higher net loss[69] - Investing activities in the first half of 2024 included $18.7 million in purchases of AFS securities, offset by $20.5 million from the maturity of AFS securities[70] - Equity sales contributed $1.5 million in the first half of 2024, compared to $700 thousand in the same period of 2023[71]

Revenue Performance - Quell revenue increased by 47% to $192,000 in Q2 2024 from $131,000 in Q2 2023, driven entirely by growth in the fibromyalgia indication[4] - A total of 540 Quell starter kits were sold in Q2 2024, representing a 165% increase from Q2 2023, while 3,682 1-month refills were ordered, reflecting a 13% growth[4] - DPNCheck revenue declined by 62% to $536,000 in Q2 2024, primarily due to changes in Medicare Advantage risk-adjustment compensation[5] - Total revenue in Q2 2024 was $0.8 million, a decrease of 54% from Q2 2023, attributed to the decline in the DPNCheck product line[8] - Revenues for H1 2024 totaled $1.9 million, down 45% from H1 2023, with a net loss of $4.5 million, or $2.37 per share[9] Profitability and Expenses - The gross margin rate in Q2 2024 was 64%, down from 68% in Q2 2023, due to an unfavorable shift in product mix and lower production volumes[8] - Operating expenses in Q2 2024 were $2.3 million, a decrease of $0.4 million from the same period in 2023, driven by reduced personnel costs[8] - The net loss for Q2 2024 was $1.5 million, or $0.74 per share, compared to a net loss of $1.5 million, or $1.56 per share, in Q2 2023[8] Future Plans and Approvals - The company plans to submit a De Novo application for a chemotherapy-induced peripheral neuropathy indication for Quell technology in Q4 2024, potentially enabling a commercial launch in Q4 2025[4] - The company received Health Canada approval to market DPNCheck 2.0, the latest generation of its point-of-care neurodiagnostic technology[6]

WOBURN, Mass., July 31, 2024 (GLOBE NEWSWIRE) -- NeuroMetrix, Inc. (Nasdaq: NURO) announced today that it plans to issue its 2024 second quarter business and financial highlights before the opening of the market on August 6, 2024. The Company will host a conference call at 8:00 a.m., Eastern Time on August 6, 2024. For participants who wish to access the Q2 2024 Conference Call live via telephone and be able to ask questions, please register in advance here. Upon registering, a dial-in and unique PIN will b ...

WOBURN, Mass., July 31, 2024 (GLOBE NEWSWIRE) -- NeuroMetrix, Inc. (Nasdaq: NURO) announced today that it plans to issue its 2024 second quarter business and financial highlights before the opening of the market on August 6, 2024. The Company will host a conference call at 8:00 a.m., Eastern Time on August 6, 2024. For participants who wish to access the Q2 2024 Conference Call live via telephone and be able to ask questions, please register in advance here. Upon registering, a dial-in and unique PIN will b ...

WOBURN, Mass., May 15, 2024 (GLOBE NEWSWIRE) -- NeuroMetrix, Inc. (NASDAQ:NURO) today reported financial and business highlights for the quarter ended March 31, 2024. The Company's mission is to reduce the impact of neurological disorders and pain syndromes through innovative non-invasive medical devices. Dr. Gozani continued, "Quell® Fibromyalgia has posted sequential revenue growth in each quarter since launch in late 2022. We have two primary sales channels; commercial health care providers which is cash ...

[PART I – FINANCIAL INFORMATION](index=4&type=section&id=PART%20I%20%E2%80%93%20FINANCIAL%20INFORMATION) This section presents the unaudited financial statements and management's analysis for NeuroMetrix, Inc. for the quarter ended March 31, 2024 [Item 1. Financial Statements](index=4&type=section&id=Item%201.%20Financial%20Statements) NeuroMetrix, Inc.'s unaudited financial statements for Q1 2024 detail assets, liabilities, equity, operations, cash flows, and accompanying notes [Balance Sheets](index=4&type=section&id=Balance%20Sheets) The balance sheets present the company's financial position, highlighting changes in assets, liabilities, and stockholders' equity Balance Sheets | Metric | March 31, 2024 | December 31, 2023 | Change | | :-------------------------------- | :--------------- | :---------------- | :----- | | Total Assets | $20,664,128 | $21,424,441 | $(760,313) | | Total Liabilities | $1,908,116 | $1,333,124 | $574,992 | | Total Stockholders' Equity | $18,756,012 | $20,091,317 | $(1,335,305) | | Cash and cash equivalents | $1,259,930 | $1,731,946 | $(472,016) | | Available-for-sale securities | $16,339,180 | $16,265,205 | $73,975 | | Total current liabilities | $1,847,170 | $1,240,639 | $606,531 | [Statements of Operations](index=5&type=section&id=Statements%20of%20Operations) The statements of operations detail the company's revenues, costs, and net loss for the reporting periods Statements of Operations | Metric | Q1 2024 | Q1 2023 | Change (YoY) | Change (%) | | :-------------------------------- | :---------- | :---------- | :----------- | :--------- | | Revenues | $1,093,556 | $1,724,771 | $(631,215) | (36.6)% | | Cost of revenues | $576,539 | $526,372 | $50,167 | 9.5% | | Gross profit | $517,017 | $1,198,399 | $(681,382) | (56.9)% | | Operating expenses | $3,771,008 | $2,908,468 | $862,540 | 29.7% | | Loss from operations | $(3,253,991) | $(1,710,069) | $(1,543,922) | 90.3% | | Net loss | $(3,029,574) | $(1,574,174) | $(1,455,400) | 92.5% | | Net loss per common share, basic and diluted | $(1.67) | $(1.64) | $(0.03) | 1.8% | [Statements of Comprehensive Loss](index=5&type=section&id=Statements%20of%20Comprehensive%20Loss) The statements of comprehensive loss report the net loss and other comprehensive income items, such as unrealized gains on securities Statements of Comprehensive Loss | Metric | Q1 2024 | Q1 2023 | Change (YoY) | | :-------------------------------- | :---------- | :---------- | :----------- | | Net loss | $(3,029,574) | $(1,574,174) | $(1,455,400) | | Unrealized gain on available-for-sale securities | $212,261 | $65,874 | $146,387 | | Reclassification of realized gain on available-for-sale securities to other income | $(205,255) | — | $(205,255) | | Comprehensive loss | $(3,022,568) | $(1,508,300) | $(1,514,268) | [Statements of Changes in Stockholders' Equity](index=6&type=section&id=Statements%20of%20Changes%20in%20Stockholders%27%20Equity) The statements of changes in stockholders' equity outline the changes in equity components, including net loss and stock issuances Statements of Changes in Stockholders' Equity | Metric | Dec 31, 2023 Balance | Q1 2024 Activity | March 31, 2024 Balance | | :-------------------------------- | :------------------- | :----------------- | :------------------- | | Total Stockholders' Equity | $20,091,317 | $(1,335,305) | $18,756,012 | | Net loss | N/A | $(3,029,574) | N/A | | Issuance of common stock under ATM offering | N/A | $1,471,099 | N/A | | Stock-based compensation expense | N/A | $216,164 | N/A | | Unrealized gain on available-for-sale securities | N/A | $212,261 | N/A | | Realized gain on available-for-sale securities | N/A | $(205,255) | N/A | [Statements of Cash Flows](index=8&type=section&id=Statements%20of%20Cash%20Flows) The statements of cash flows summarize cash inflows and outflows from operating, investing, and financing activities Statements of Cash Flows | Cash Flow Activity | Q1 2024 | Q1 2023 | Change (YoY) | | :-------------------------------- | :---------- | :---------- | :----------- | | Net cash used in operating activities | $(2,081,401) | $(1,121,417) | $(959,984) | | Net cash provided by (used in) investing activities | $138,286 | $(836,984) | $975,270 | | Net cash provided by financing activities | $1,471,099 | — | $1,471,099 | | Net decrease in cash and cash equivalents | $(472,016) | $(1,958,401) | $1,486,385 | | Cash and cash equivalents, end of period | $1,259,930 | $2,376,619 | $(1,116,689) | [Notes to Unaudited Financial Statements](index=9&type=section&id=Notes%20to%20Unaudited%20Financial%20Statements) This section provides detailed explanations and disclosures supporting the financial statements [1. Business and Basis of Presentation](index=9&type=section&id=1.%20Business%20and%20Basis%20of%20Presentation) This note describes NeuroMetrix's core business, products, and financial position as of March 31, 2024 - NeuroMetrix develops and commercializes health care products utilizing non-invasive neurostimulation, with revenues from medical devices and after-market consumables[23](index=23&type=chunk) - The Company's primary products are DPNCheck (point-of-care test for diabetic peripheral neuropathy) and Quell (app-enabled, wearable device for chronic pain and fibromyalgia symptoms)[23](index=23&type=chunk) - As of March 31, 2024, the Company held **$17.6 million in cash, cash equivalents, and investment grade securities**, believed to be sufficient to fund operations for at least the next twelve months[24](index=24&type=chunk) - In February 2024, the Company announced a review of strategic options to maximize shareholder value, including changes in marketing strategies, asset acquisition/sale, or a merger[25](index=25&type=chunk) [2. Comprehensive Income (Loss)](index=11&type=section&id=2.%20Comprehensive%20Income%20(Loss)) This note explains the components of comprehensive income, including net loss and unrealized gains on securities - For Q1 2024, comprehensive income was **$7,006**, primarily from net unrealized gains on available-for-sale (AFS) securities, in addition to a net loss of **$(3,029,574)**[38](index=38&type=chunk) - For Q1 2023, comprehensive income was **$65,874** from net unrealized gains on AFS securities, in addition to a net loss of **$(1,574,174)**[38](index=38&type=chunk) [3. Net Loss Per Common Share](index=11&type=section&id=3.%20Net%20Loss%20Per%20Common%20Share) This note details the calculation of net loss per common share and potentially dilutive equivalents Net Loss Per Common Share | Metric | Q1 2024 | Q1 2023 | | :------------------------------------------------ | :---------- | :---------- | | Net loss applicable to common stockholders | $(3,029,574) | $(1,574,174) | | Weighted average number of common shares outstanding | 1,812,455 | 961,153 | | Net loss per common share, basic and diluted | $(1.67) | $(1.64) | Potentially Dilutive Common Stock Equivalents | Potentially Dilutive Common Stock Equivalents | Q1 2024 | Q1 2023 | | :-------------------------------------------- | :------ | :------ | | Options | 63,755 | 65,683 | | Unvested restricted stock awards | 3,201 | 10,745 | | Unvested restricted stock units | 48,565 | 22,477 | | Convertible preferred stock | 8 | 8 | | Total | 115,529 | 98,913 | [4. Securities](index=11&type=section&id=4.%20Securities) This note provides a breakdown of available-for-sale securities and their fair value measurements Available-for-sale securities (March 31, 2024) | Available-for-sale securities (March 31, 2024) | Cost | Gross Unrealized Gains | Gross Unrealized Losses | Estimated Fair Value | | :------------------------------------- | :--------- | :--------------------- | :---------------------- | :------------------- | | U.S. government bonds | $7,842,359 | $51,676 | — | $7,894,035 | | Commercial paper | $8,249,644 | $196,488 | $(987) | $8,445,145 | | Total | $16,092,003 | $248,164 | $(987) | $16,339,180 | Available-for-sale securities (December 31, 2023) | Available-for-sale securities (December 31, 2023) | Cost | Gross Unrealized Gains | Gross Unrealized Losses | Estimated Fair Value | | :-------------------------------------- | :--------- | :--------------------- | :---------------------- | :------------------- | | U.S. government bonds | $4,412,935 | $5,665 | — | $4,418,600 | | Commercial paper | $11,612,099 | $234,506 | — | $11,846,605 | | Total | $16,025,034 | $240,171 | — | $16,265,205 | - Changes in fair value of securities at March 31, 2024, primarily resulted from interest rate fluctuations, with no credit losses recorded[42](index=42&type=chunk) [5. Fair Value Measurements](index=12&type=section&id=5.%20Fair%20Value%20Measurements) This note categorizes financial instruments by fair value hierarchy levels Financial Instruments (March 31, 2024) | Financial Instruments (March 31, 2024) | Total | Level 1 | Level 2 | Level 3 | | :----------------------------------- | :---------- | :---------- | :---------- | :------ | | Money market funds | $1,255,736 | $1,255,736 | — | — | | U.S. government bonds | $7,894,035 | $7,894,035 | — | — | | Commercial paper | $8,445,145 | — | $8,445,145 | — | | Total | $17,594,916 | $9,149,771 | $8,445,145 | — | Financial Instruments (December 31, 2023) | Financial Instruments (December 31, 2023) | Total | Level 1 | Level 2 | Level 3 | | :------------------------------------ | :---------- | :---------- | :---------- | :------ | | Money market funds | $1,284,290 | $1,284,290 | — | — | | U.S. government bonds | $4,418,600 | $4,418,600 | — | — | | Commercial paper | $11,846,605 | — | $11,846,605 | — | | Total | $17,549,495 | $5,702,890 | $11,846,605 | — | [6. Inventories](index=13&type=section&id=6.%20Inventories) This note details the composition of inventories and related write-down charges Inventories | Inventory Type | March 31, 2024 | December 31, 2023 | | :--------------- | :--------------- | :---------------- | | Purchased components | $1,093,201 | $1,151,381 | | Finished goods | $378,237 | $408,047 | | Total Inventories | $1,471,438 | $1,559,428 | - In Q1 2024, a **$74,209 charge** was recorded to write down ADVANCE inventory within cost of revenues[43](index=43&type=chunk) [7. Accrued Expenses and Compensation](index=13&type=section&id=7.%20Accrued%20Expenses%20and%20Compensation) This note itemizes accrued liabilities, including professional services, compensation, and severance Accrued Expenses and Compensation | Category | March 31, 2024 | December 31, 2023 | | :------------------------ | :--------------- | :---------------- | | Professional services | $547,498 | $298,534 | | Compensation | $202,424 | $346,245 | | Severance | $555,000 | — | | Clinical | $37,383 | $39,000 | | Warranty | $8,000 | $9,400 | | Sales Tax | $143,185 | $141,672 | | Other | $60,736 | $41,888 | | Total | $1,554,226 | $876,739 | - In Q1 2024, a **$50,000 estimated liability** was recorded for additional costs related to a discontinued product line, and a **$555,000 severance accrual** was recorded[44](index=44&type=chunk) [8. Operating Leases](index=13&type=section&id=8.%20Operating%20Leases) This note outlines the company's lease obligations and related rent expenses - The Company's corporate office and manufacturing facility lease extends through mid-September 2025, with a monthly base rent of **$13,846**[45](index=45&type=chunk) Lease Maturity Analysis (March 31, 2024) | Lease Maturity Analysis (March 31, 2024) | Amount | | :-------------------------- | :---------- | | 2024 | $124,339 | | 2025 | $117,431 | | Total minimum lease payments | $241,770 | | Discount rate, 15% | $32,433 | | Lease obligation, current portion | $148,391 | | Lease obligation, net of current portion | $60,946 | - Total recorded rent expense was **$50,377** for Q1 2024, compared to **$49,232** for Q1 2023[46](index=46&type=chunk) [9. Stockholders' Equity](index=14&type=section&id=9.%20Stockholders%27%20Equity) This note describes changes in stockholders' equity, including ATM program activities and restricted stock - In January and February 2024, the Company issued **458,380 shares of common stock** under an at-the-market (ATM) program for net proceeds of **$1,471,099**, which was terminated as of April 18, 2024[48](index=48&type=chunk) - In March 2024, **1,015 restricted stock awards** and **5,912 restricted stock units** were forfeited due to employee reduction[49](index=49&type=chunk) - As of March 31, 2024, **3,201 restricted stock awards** and **48,565 restricted stock units** remained unvested[49](index=49&type=chunk) [10. Employee Reduction](index=14&type=section&id=10.%20Employee%20Reduction) This note details severance charges incurred due to a reduction in workforce - The Company incurred severance charges related to a reduction of **10 full-time employees** in Q1 2024 to align staffing and reduce operating expenses[52](index=52&type=chunk) - Total severance charges of **$580,427** were recorded in Q1 2024, allocated across research and development (**$310,200**), sales and marketing (**$234,527**), general and administrative (**$4,200**), and cost of revenues (**$31,500**)[54](index=54&type=chunk) Severance Activity (Q1 2024) | Severance Activity (Q1 2024) | Amount | | :------------------- | :---------- | | Beginning balance | — | | Additions | $580,427 | | Amounts paid out | $(25,427) | | Ending balance | $555,000 | [Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations](index=15&type=section&id=Item%202.%20Management%27s%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) This section analyzes NeuroMetrix's business, strategic initiatives, and financial performance for Q1 2024, including liquidity and cash flows [Business Overview](index=15&type=section&id=Business%20Overview) This overview describes NeuroMetrix's neurotechnology focus, principal products, and market context for chronic pain and peripheral neuropathies - NeuroMetrix is a commercial-stage neurotechnology company focused on innovative medical devices and technology solutions for pain syndromes and neurological disorders[56](index=56&type=chunk) - The company's principal product categories are therapeutic wearable neuromodulation for chronic pain (Quell) and diagnostic point-of-care peripheral neuropathy assessment (DPNCheck)[57](index=57&type=chunk) - Chronic pain affects nearly **100 million adults** in the United States, with an estimated incremental impact of over **$250 billion per year** on healthcare costs and over **$300 billion per year** in lost productivity[58](index=58&type=chunk) - Peripheral neuropathies affect about **10% of U.S. adults**, with diabetic peripheral neuropathy (DPN) being the most common long-term complication of diabetes, affecting over **50% of the diabetic population**[60](index=60&type=chunk)[61](index=61&type=chunk) [Business Strategy](index=17&type=section&id=Business%20Strategy) This section outlines the company's strategic focus on Quell and DPNCheck, including recent commercial and operational changes - The company's strategic attention is focused on Quell and DPNCheck, with Quell being leveraged into a portfolio of prescription (Rx) wearable neurotherapeutics[63](index=63&type=chunk)[64](index=64&type=chunk) - Quell received FDA Breakthrough Device Designation for fibromyalgia in 2021 and obtained De Novo marketing authorization in 2022, with a strategic commercial launch in late 2022[65](index=65&type=chunk) - In Q1 2024, Quell – Fibromyalgia introduced a telemedicine option, increased refill pricing, and expanded its target market to Veterans Administration patients[65](index=65&type=chunk) - DPNCheck sales significantly declined due to adverse CMS reimbursement changes in the Medicare Advantage market, leading to a reduction in the commercial sales team[68](index=68&type=chunk)[69](index=69&type=chunk) - The legacy ADVANCE neurodiagnostic technology product line is being discontinued in Q2 2024, with related inventory write-down and exit liability charges recorded in Q1 2024[70](index=70&type=chunk) - In February 2024, the company initiated a review of strategic options to maximize shareholder value, including marketing strategy changes, asset acquisition/sale, or a merger[71](index=71&type=chunk) [Results of Operations](index=18&type=section&id=Results%20of%20Operations) This section provides a comparative analysis of the company's financial performance for the first quarters of 2024 and 2023 Results of Operations | Metric | Q1 2024 | Q1 2023 | Increase (Decrease) | Percent Change | | :---------------- | :---------- | :---------- | :------------------ | :------------- | | Revenues | $1,093,556 | $1,724,771 | $(631,215) | (36.6)% | | Gross profit | $517,017 | $1,198,399 | $(681,382) | (56.9)% | | – % of revenues | 47.3 % | 69.5 % | (22.2)% | N/A | | Operating expenses | $3,771,008 | $2,908,468 | $862,540 | 29.7 % | | Net loss | $(3,029,574) | $(1,574,174) | $(1,455,400) | 92.5 % | | Net loss per common share | $(1.67) | $(1.64) | $0.03 | 1.8 % | [Revenues](index=18&type=section&id=Revenues) This section explains the decrease in revenues, primarily driven by DPNCheck sales decline - Revenues for Q1 2024 decreased by **$631 thousand (36.6%)** from Q1 2023, primarily due to a decline in DPNCheck sales[73](index=73&type=chunk) - The DPNCheck sales decline was mainly attributable to adverse CMS reimbursement changes in the Medicare Advantage market[73](index=73&type=chunk) [Gross Profit](index=18&type=section&id=Gross%20Profit) This section details the reduction in gross profit and margin rate due to revenue decline and specific charges - Gross profit for Q1 2024 decreased by **$681 thousand (56.9%)** from Q1 2023, with the gross margin rate contracting from **69.5% to 47.3%**[74](index=74&type=chunk) - The decline was due to reduced DPNCheck revenue (the highest margin product), lower absorption of indirect manufacturing costs, and charges for ADVANCE inventory write-down (**$74,209**) and discontinuation liability (**$50,000**)[74](index=74&type=chunk) [Operating Expenses](index=19&type=section&id=Operating%20Expenses) This section discusses the increase in operating expenses, mainly due to personnel and severance costs - Operating expenses increased by **$863 thousand (29.7%)** in Q1 2024 compared to Q1 2023, primarily due to increased personnel costs, including employee severance costs[75](index=75&type=chunk) - Research and development spending increased by **$244 thousand**, mainly due to **$310 thousand** in employee severance costs, partially offset by reduced clinical work[75](index=75&type=chunk) - Sales and marketing spending increased by **$245 thousand**, primarily due to **$235 thousand** in employee severance costs[75](index=75&type=chunk) - General and administrative costs increased by **$373 thousand**, driven by increased professional fees (**$268 thousand**) and taxes, licenses, and fees (**$164 thousand**)[75](index=75&type=chunk) [Net loss](index=19&type=section&id=Net%20loss) This section reports the significant increase in net loss for the first quarter of 2024 - The net loss in Q1 2024 increased by **$1.5 million** from Q1 2023, resulting in a net loss per common share of **$(1.67)** compared to **$(1.64)** in the prior year[76](index=76&type=chunk) [Liquidity and Capital Resources](index=19&type=section&id=Liquidity%20and%20Capital%20Resources) This section assesses the company's financial position, including cash, working capital, and debt Liquidity and Capital Resources | Metric | March 31, 2024 | December 31, 2023 | | :-------------------------------- | :--------------- | :---------------- | | Cash, cash equivalents and marketable securities | $17,599,110 | $17,997,151 | | Working capital | $18,304,763 | $19,613,803 | | Current ratio | 10.9 | 16.8 | | Net debt position | $(15,690,994) | $(16,664,027) | - The company had **$18.3 million** in working capital and **$17.6 million** in cash, cash equivalents, and marketable securities as of March 31, 2024[78](index=78&type=chunk) - The company has no term debt or borrowings, maintaining a **negative net debt position**[78](index=78&type=chunk) - Days sales outstanding (DSO) increased in 2024 due to a greater weighting of sales with longer payment terms and extended terms for a DPNCheck customer[79](index=79&type=chunk) [Cash Flows](index=20&type=section&id=Cash%20Flows) This section analyzes cash movements from operating, investing, and financing activities Cash Flows | Cash Flow Activity | Q1 2024 | Q1 2023 | Change | | :-------------------------------- | :---------- | :---------- | :----------- | | Net cash used in operating activities | $(2,081,401) | $(1,121,417) | $(959,984) | | Net cash provided by (used in) investing activities | $138,286 | $(836,984) | $975,270 | | Net cash provided by financing activities | $1,471,099 | — | $1,471,099 | - Operations cash usage increased by **$960 thousand** in Q1 2024, reflecting a **$1.5 million** increase in net loss, partially offset by working capital benefits[82](index=82&type=chunk) - Investing activities in Q1 2024 included **$7.4 million** in purchases and **$7.5 million** in proceeds from maturities of available-for-sale securities[82](index=82&type=chunk) - Financing activities provided **$1.5 million** from the sale of common stock under an ATM program in Q1 2024, which was terminated on April 18, 2024[83](index=83&type=chunk) [Cautionary Note Regarding Forward-Looking Statements](index=21&type=section&id=Cautionary%20Note%20Regarding%20Forward-Looking%20Statements) This note warns about the inherent risks and uncertainties in forward-looking statements within the report - The report contains forward-looking statements regarding future expectations, financial performance, strategic plans, and regulatory matters, which are subject to risks and uncertainties[84](index=84&type=chunk) - Actual results may differ materially from those projected due to various risks, including those described in the 'Risk Factors' section of the Annual Report on Form 10-K[84](index=84&type=chunk) [Item 3. Quantitative and Qualitative Disclosures About Market Risk](index=21&type=section&id=Item%203.%20Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) This section outlines the company's exposure to market risks, primarily interest rate risk on its investment portfolio - The company's financial instruments consist of cash, cash equivalents, and available-for-sale debt securities[85](index=85&type=chunk) - The primary objectives of the investment strategy are to preserve principal, maintain liquidity, and maximize yields, with investments typically having maturities of twelve months or less[85](index=85&type=chunk) - A hypothetical **10% change in interest rates** is not expected to have a material impact on the fair value of the investment portfolio or interest income[85](index=85&type=chunk) [Item 4. Controls and Procedures](index=22&type=section&id=Item%204.%20Controls%20and%20Procedures) The principal executive and financial officers have evaluated the effectiveness of the company's disclosure controls and procedures, concluding they were effective as of March 31, 2024 - Disclosure controls and procedures were evaluated and deemed effective as of March 31, 2024[86](index=86&type=chunk) - No material changes in internal control over financial reporting occurred during the quarter ended March 31, 2024[87](index=87&type=chunk) [PART II – OTHER INFORMATION](index=23&type=section&id=PART%20II%20%E2%80%93%20OTHER%20INFORMATION) This section presents additional information not covered in the financial statements, including legal, risk, and equity matters [Item 1. Legal Proceedings](index=23&type=section&id=Item%201.%20Legal%20Proceedings) The company is not currently involved in any material legal proceedings and does not anticipate any significant financial impact from potential future legal issues - The company is not currently a party to any material legal proceedings[88](index=88&type=chunk) - No significant impact on financial position is expected from potential future legal issues in the ordinary course of business[88](index=88&type=chunk) [Item 1A. Risk Factors](index=23&type=section&id=Item%201A.%20Risk%20Factors) This section supplements the annual report's risk factors, focusing on uncertainties from the strategic options review - The company's review of strategic options (marketing changes, asset acquisition/sale, merger) creates significant uncertainty regarding future plans and funding requirements[90](index=90&type=chunk) - Perceived uncertainties related to the strategic review may lead to loss of business opportunities, stock price volatility, and difficulty attracting/retaining personnel and partners[91](index=91&type=chunk) - The company cannot provide assurance that the strategic alternatives review process will result in the successful realization of any particular alternative, transaction, or value[90](index=90&type=chunk) [Item 2. Unregistered Sales of Equity Securities and Use of Proceeds](index=23&type=section&id=Item%202.%20Unregistered%20Sales%20of%20Equity%20Securities%20and%20Use%20of%20Proceeds) This section reports no unregistered sales of equity securities or use of proceeds during the period - No unregistered sales of equity securities or use of proceeds occurred during the period[92](index=92&type=chunk) [Item 3. Defaults Upon Senior Securities](index=23&type=section&id=Item%203.%20Defaults%20Upon%20Senior%20Securities) This section confirms no defaults upon senior securities occurred during the period - No defaults upon senior securities occurred during the period[93](index=93&type=chunk) [Item 4. Mine Safety Disclosures](index=23&type=section&id=Item%204.%20Mine%20Safety%20Disclosures) This disclosure item is not applicable to the company's operations - This disclosure item is not applicable to the company[94](index=94&type=chunk) [Item 5. Other Information](index=23&type=section&id=Item%205.%20Other%20Information) This section provides updates on Rule 10b5-1 trading plans and executive employment agreements - No Rule 10b5-1 trading arrangements were adopted or terminated by directors or executive officers in Q1 2024[95](index=95&type=chunk) - Employment agreements for Dr. Shai N. Gozani (Chairman, President, CEO) and Thomas T. Higgins (SVP, CFO, Treasurer) were extended for one year beyond December 31, 2023[96](index=96&type=chunk)[102](index=102&type=chunk) [Item 6. Exhibits](index=24&type=section&id=Item%206.%20Exhibits) This section lists all supporting documents and certifications filed with the Form 10-Q - Exhibits include addenda to employment agreements for key executives, certifications (Rule 13a-14(a), Section 302, 18 U.S.C. 1350), and Inline XBRL documents[97](index=97&type=chunk) [Signatures](index=25&type=section&id=Signatures) This section confirms the official signing of the report by authorized executive officers - The report was signed by Thomas T. Higgins (SVP, CFO, Treasurer) and Shai N. Gozani (Chairman, President, CEO) on May 15, 2024[101](index=101&type=chunk)[102](index=102&type=chunk)

UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 10-K _____________________________ (Mark One) ☒ ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the fiscal year ended December 31, 2023 OR ☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from to Commission File Number 001-33351 NEUROMETRIX, INC. (Exact name of registrant as specified in its charter) Delaware 04-3308180 (Sta ...

[Executive Summary & CEO Commentary](index=1&type=section&id=Executive%20Summary%20%26%20CEO%20Commentary) NeuroMetrix's mission and product portfolio are presented, along with the CEO's Q4 2023 performance commentary on Quell's growth and DPNCheck's market pressures [Company Mission and Overview](index=1&type=section&id=Company%20Mission%20and%20Overview) NeuroMetrix, Inc. is a commercial-stage healthcare company focused on developing and commercializing neurotechnology devices to address chronic pain and diabetes, with key products being the Quell neuromodulation platform and DPNCheck for peripheral neuropathy screening - NeuroMetrix's mission is to reduce the impact of neurological disorders and pain syndromes through innovative non-invasive medical devices[1](index=1&type=chunk) - The company's commercial brands include **Quell** (wearable neuromodulation platform) and **DPNCheck** (point-of-care screening test for peripheral neuropathy)[8](index=8&type=chunk) [CEO Commentary on Q4 2023 Performance and Outlook](index=1&type=section&id=CEO%20Commentary%20on%20Q4%202023%20Performance%20and%20Outlook) The CEO highlighted accelerated growth for Quell Fibromyalgia in Q4 2023 due to expanded sales and telemedicine capabilities, and the successful FDA 510(k) filing for Quell in chemotherapy-induced peripheral neuropathy (CIPN). Conversely, the DPNCheck market faces significant pressure from CMS reimbursement changes, including the discontinuation of compensation for patient screening in 2025 - **Quell Fibromyalgia** growth accelerated in **Q4 2023**, supported by the addition of field business development managers, optimized clinical messaging, direct-to-patient telemedicine, direct-to-physician sales, and reimbursement at select Veterans Administration (VA) facilities[2](index=2&type=chunk) - NeuroMetrix achieved its goal of filing a premarket notification (510(k)) with the FDA for **Quell** for chemotherapy-induced peripheral neuropathy (CIPN) during **Q4 2023**, following its FDA breakthrough device designation in January 2022[2](index=2&type=chunk) - The **DPNCheck** market, primarily Medicare Advantage (MA), is under pressure due to CMS risk adjustment changes implemented in **2023**, with compensation for patient screening for peripheral neuropathy to be discontinued in **2025**[2](index=2&type=chunk) [Business Highlights](index=1&type=section&id=Business%20Highlights) This section covers Quell's strong Q4 2023 performance and development, along with corporate strategic initiatives such as a reverse stock split, capital raise, and a strategic options review [Quell Product Performance and Development](index=1&type=section&id=Quell%20Product%20Performance%20and%20Development) Quell Fibromyalgia demonstrated solid growth in Q4 2023, with substantial increases across key operating metrics such as unique prescribers, prescriptions written, and refill months. Additionally, encouraging results were reported from a pilot clinical trial of Quell for post-acute COVID-19 Syndrome (Long COVID) Quell Fibromyalgia Key Operating Metrics (Q4 2023 vs Q3 2023) | Metric | Q4 2023 | Q3 2023 | Change (%) | | :-------------------- | :------ | :------ | :--------- | | Unique Prescribers | 199 | - | +59% | | Prescriptions Written | 583 | - | +123% | | Refill Months | 525 | - | +73% | | Prescription Fill Rate | ~60% | - | - | - Encouraging results from a pilot clinical trial of **Quell** in post-acute COVID-19 Syndrome (Long COVID) were reported on **December 12, 2023**, conducted by the Baylor College of Medicine[4](index=4&type=chunk) [Corporate and Strategic Initiatives](index=1&type=section&id=Corporate%20and%20Strategic%20Initiatives) NeuroMetrix executed a 1:8 reverse stock split to maintain Nasdaq listing compliance and raised approximately $1.9 million net through its ATM facility to support future operating expenses. The company also initiated a review of strategic options to enhance growth and shareholder value, engaging Ladenburg Thalmann as a financial advisor - A **1:8 reverse split** of common stock was successfully executed on **November 21, 2023**, to increase the trading price and comply with Nasdaq minimum bid requirements[4](index=4&type=chunk) - Common stock sales under the ATM facility generated approximately **$1.9 million (net)** during **Q4 2023**, intended to offset future operating expenses, including potential expansion of Quell marketing efforts[4](index=4&type=chunk) - The company ended **Q4 2023** with **$18 million** in cash and securities[4](index=4&type=chunk) - NeuroMetrix announced an initiative to review strategic options to promote growth and maximize shareholder value, retaining **Ladenburg Thalmann** as a financial advisor[4](index=4&type=chunk) [Financial Results](index=2&type=section&id=Financial%20Results) This section presents NeuroMetrix's Q4 and full year 2023 financial performance, detailing revenue declines, increased net losses, and the underlying factors impacting profitability [Q4 2023 Financial Performance](index=2&type=section&id=Q4%202023%20Financial%20Performance) NeuroMetrix experienced a significant decline in Q4 2023 financial performance, with revenue decreasing by 29% year-over-year to $1.3 million, primarily due to reduced DPNCheck sales. Gross margin also declined, and operating expenses increased, resulting in a net loss of $1.6 million ($1.43 per share), a substantial increase from the prior year Q4 2023 Financial Performance (Year-over-Year) | Metric | Q4 2023 | Q4 2022 | Change ($) | Change (%) | | :-------------------- | :---------- | :---------- | :--------- | :--------- | | Revenue | $1.3 million | $1.8 million | -$0.5 million | -29% | | Gross Margin Rate | 64% | 67% | -3% pts | - | | Operating Expenses | $2.7 million | $2.1 million | +$0.6 million | +29% | | Net Loss | $1.6 million | $0.7 million | +$0.9 million | +129% | | Net Loss Per Share | $1.43 | $0.73 | +$0.70 | +96% | - The primary reason for the revenue decline was reduced sales volume for **DPNCheck**, attributed to CMS risk-adjustment reimbursement changes in the Medicare Advantage market[5](index=5&type=chunk) - Increased operating expenses were driven by outside engineering services for R&D, sales force expansion for **Quell Fibromyalgia**, and higher personnel costs due to inflation[5](index=5&type=chunk) [Full Year 2023 Financial Performance](index=2&type=section&id=Full%20Year%202023%20Financial%20Performance) For the full year 2023, NeuroMetrix reported revenues of $5.9 million, a 29% decrease compared to 2022. The net loss for the year significantly increased to $6.5 million ($6.27 per share) from $4.4 million ($4.97 per share) in the prior year Full Year Financial Performance (Year-over-Year) | Metric | FY 2023 | FY 2022 | Change ($) | Change (%) | | :-------------------- | :---------- | :---------- | :--------- | :--------- | | Revenues | $5.9 million | $8.3 million | -$2.4 million | -29% | | Net Loss | $6.5 million | $4.4 million | +$2.1 million | +48% | | Net Loss Per Share | $6.27 | $4.97 | +$1.30 | +26% | [Corporate Information](index=2&type=section&id=Corporate%20Information) This section provides details on NeuroMetrix's Q4 and full year 2023 earnings conference call, an overview of the company's business, and a safe harbor statement regarding forward-looking information [Conference Call and Webcast](index=2&type=section&id=Conference%20Call%20and%20Webcast) NeuroMetrix hosted a conference call and webcast on February 22, 2024, to discuss its Q4 and full year 2023 results. Participants could register for live telephone access or view an audio-only webcast, with a replay available for one year on the company's investor relations website - NeuroMetrix hosted a conference call and webcast on **February 22, 2024**, at **8:00 a.m. Eastern**[7](index=7&type=chunk) - Live telephone access required advance registration, while an audio-only webcast was available in the 'Investors Relations' section of the company's website[7](index=7&type=chunk) - A replay of the call will be available for **one year** on the company's website under the 'Investor Relations' tab[7](index=7&type=chunk) [About NeuroMetrix](index=2&type=section&id=About%20NeuroMetrix) NeuroMetrix is a commercial-stage healthcare company that develops and commercializes neurotechnology devices for chronic pain and diabetes. Its product portfolio includes wearable or hand-held medical devices supported by proprietary consumables and software solutions, marketed under the Quell and DPNCheck brands - **NeuroMetrix** is a commercial-stage healthcare company focused on developing and commercializing neurotechnology devices[8](index=8&type=chunk) - The company addresses unmet needs in the **chronic pain** and **diabetes** markets[8](index=8&type=chunk) - Products include wearable or hand-held medical devices enabled by proprietary consumables and software solutions, such as mobile apps, enterprise software, and cloud-based systems[8](index=8&type=chunk) [Safe Harbor Statement](index=2&type=section&id=Safe%20Harbor%20Statement) This section serves as a cautionary statement regarding forward-looking statements within the press release, emphasizing that actual events or results may differ materially due to various risks and uncertainties. The company explicitly disclaims any obligation to update the information or revise any forward-looking statements - The press release contains **forward-looking statements** subject to risks, uncertainties, and other factors that could cause actual events or results to differ materially[9](index=9&type=chunk) - Such factors include estimates of future performance and the ability to successfully develop, receive regulatory clearance, commercialize, and achieve market acceptance for products[9](index=9&type=chunk) - The company provides information only as of the date of the press release and expressly disclaims any intent or obligation to update or revise any forward-looking statements[10](index=10&type=chunk) [Unaudited Financial Statements](index=5&type=section&id=Unaudited%20Financial%20Statements) This section presents NeuroMetrix's unaudited financial statements, including detailed Statements of Operations and Condensed Balance Sheets for Q4 and full year 2023, compared to the prior year [Statements of Operations](index=5&type=section&id=Statements%20of%20Operations) The unaudited Statements of Operations provide a detailed breakdown of NeuroMetrix's financial performance for the fourth quarter and full year ended December 31, 2023, compared to the corresponding periods in 2022, covering revenues, cost of revenues, gross profit, operating expenses, and net loss NeuroMetrix, Inc. Statements of Operations (Unaudited) | Metric | Q4 2023 | Q4 2022 | FY 2023 | FY 2022 | | :-------------------------- | :---------- | :---------- | :---------- | :---------- | | Revenues | $1,317,746 | $1,847,378 | $5,901,425 | $8,256,073 | | Cost of revenues | $469,772 | $617,267 | $1,954,012 | $2,505,833 | | Gross profit | $847,974 | $1,230,111 | $3,947,413 | $5,750,240 | | Research and development | $732,372 | $538,395 | $2,777,960 | $3,239,725 | | Sales and marketing | $860,635 | $629,969 | $3,365,265 | $2,865,615 | | General and administrative | $1,112,066 | $918,214 | $4,955,709 | $4,386,666 | | Total operating expenses | $2,705,073 | $2,086,578 | $11,098,934 | $10,492,006 | | Loss from operations | $(1,857,099) | $(856,467) | $(7,151,521) | $(4,741,766) | | Other income | $207,552 | $164,597 | $622,034 | $325,157 | | Net loss | $(1,649,547) | $(691,870) | $(6,529,487) | $(4,416,609) | [Condensed Balance Sheets](index=5&type=section&id=Condensed%20Balance%20Sheets) The unaudited Condensed Balance Sheets present NeuroMetrix's financial position as of December 31, 2023, and December 31, 2022, detailing assets including cash and securities, liabilities such as current liabilities and lease obligations, and stockholders' equity NeuroMetrix, Inc. Condensed Balance Sheets (Unaudited) | Metric | Dec 31, 2023 | Dec 31, 2022 | | :-------------------------------- | :----------- | :----------- | | Cash, cash equivalents and securities | $17,997,151 | $21,199,727 | | Other current assets | $2,857,291 | $2,907,260 | | Noncurrent assets | $569,999 | $562,628 | | Total assets | $21,424,441 | $24,669,615 | | Current liabilities | $1,240,639 | $1,106,412 | | Lease Obligation, net of current portion | $92,485 | $207,516 | | Stockholders' equity | $20,091,317 | $23,355,687 | | Total liabilities and stockholders' equity | $21,424,441 | $24,669,615 |

Financial Data and Key Metrics Changes - The company reported Q3 revenue of $1.2 million, down 39% from $2 million in Q3 of the previous year [5] - The net loss was $1.8 million or a negative $0.21 per share compared to a net loss of $1.6 million or a negative $0.23 per share in Q3 of last year [8] - Gross profit for Q3 was $800,000, down from $1.3 million in Q3 last year, with a gross margin rate of 65%, consistent with the previous year [26] Business Line Data and Key Metrics Changes - DPNCheck business experienced a net revenue reduction of $512,000 or 35% in Q3 compared to the same quarter last year, with a cumulative revenue decline of $1.1 million or 23% year-to-date [6] - Quell fibromyalgia prescriptions increased to 752 in Q3 from 419 in Q2, with over 60% of prescriptions filled by patients [30] - Operating expenses totaled $2.7 million, down from $3 million last year [26] Market Data and Key Metrics Changes - The company has expanded its Quell direct sales presence in Texas, Florida, and California [24] - The cumulative number of month refills for Quell fibromyalgia almost doubled from 348 in Q2 to 663 in Q3 [14] Company Strategy and Development Direction - The growth strategy focuses on establishing and growing the Quell fibromyalgia indication, advancing the Quell Neurotherapeutics program, and revising the DPNCheck business strategy [28] - The company plans to finalize a new commercial strategy to address changes in the Medicare Advantage sector by the end of Q4 [18] Management's Comments on Operating Environment and Future Outlook - Management noted substantial uncertainty in the Medicare Advantage sector due to policy changes announced by CMS, which have impacted the DPNCheck business [17] - The company expects continued progress in Quell fibromyalgia leading to material revenue in 2024 [14] Other Important Information - The company holds $17.6 million in liquid assets, which are expected to support the next phase of Quell growth initiatives [27] - NeuroMetrix received a delisting notice from NASDAQ for noncompliance with minimum bid price rules, with a 180-day grace period to regain compliance [9] Q&A Session Summary Question: No questions were raised during the Q&A session - The operator indicated that there were no questions at this time and handed the conference back to Dr. Gozani for closing remarks [21]

[PART I – FINANCIAL INFORMATION](index=4&type=section&id=PART%20I%20%E2%80%93%20FINANCIAL%20INFORMATION) This section provides NeuroMetrix's unaudited interim financial information for the reported periods [Item 1. Financial Statements](index=4&type=section&id=Item%201.%20Financial%20Statements) This section presents NeuroMetrix's unaudited interim financial statements, including balance sheets, operations, comprehensive loss, equity, cash flows, and notes [Balance Sheets](index=4&type=section&id=Balance%20Sheets%20as%20of%20September%2030%2C%202023%20(unaudited)%20and%20December%2031%2C%202022) Summarizes the company's financial position, assets, liabilities, and equity at key reporting dates Balance Sheet Highlights (September 30, 2023 vs. December 31, 2022) | Metric | Sep 30, 2023 | Dec 31, 2022 | Change | % Change | | :-------------------------------- | :----------- | :----------- | :------- | :------- | | Total Assets | $21,286,772 | $24,669,615 | $(3,382,843) | -13.7% | | Cash and cash equivalents | $1,460,553 | $4,335,020 | $(2,874,467) | -66.3% | | Held-to-maturity securities | $0 | $16,864,707 | $(16,864,707) | -100.0% | | Available-for-sale securities | $16,177,122 | $0 | $16,177,122 | N/A | | Total Current Liabilities | $1,260,366 | $1,106,412 | $153,954 | 13.9% | | Total Stockholders' Equity | $19,903,536 | $23,355,687 | $(3,452,151) | -14.7% | [Statements of Operations](index=5&type=section&id=Statements%20of%20Operations%20(unaudited)%20for%20the%20Quarters%20and%20Nine%20Months%20Ended%20September%2030%2C%202023%20and%202022) Presents the company's revenues, expenses, and net loss for the reported quarters and nine-month periods Statements of Operations Highlights (Quarter Ended September 30, 2023 vs. 2022) | Metric | Q3 2023 | Q3 2022 | Change | % Change | | :-------------------------------- | :---------- | :---------- | :------- | :------- | | Revenues | $1,203,164 | $1,968,003 | $(764,839) | -38.9% | | Gross profit | $781,782 | $1,274,432 | $(492,650) | -38.7% | | Total operating expenses | $2,742,680 | $2,987,423 | $(244,743) | -8.2% | | Net loss | $(1,768,737) | $(1,606,254) | $(162,483) | 10.1% | | Net loss per common share | $(0.21) | $(0.23) | $0.02 | -8.7% | Statements of Operations Highlights (Nine Months Ended September 30, 2023 vs. 2022) | Metric | 9M 2023 | 9M 2022 | Change | % Change | | :-------------------------------- | :---------- | :---------- | :------- | :------- | | Revenues | $4,583,679 | $6,408,695 | $(1,825,016) | -28.5% | | Gross profit | $3,099,439 | $4,520,129 | $(1,420,690) | -31.4% | | Total operating expenses | $8,393,861 | $8,405,428 | $(11,567) | -0.1% | | Net loss | $(4,879,940) | $(3,724,739) | $(1,155,201) | 31.0% | | Net loss per common share | $(0.61) | $(0.53) | $(0.08) | 15.1% | [Statements of Comprehensive Loss](index=5&type=section&id=Statements%20of%20Comprehensive%20Loss%20(unaudited)%20for%20the%20Quarters%20and%20Nine%20Months%20Ended%20September%2030%2C%202023%20and%202022) Details the company's net loss and other comprehensive income/loss components for the reported periods Comprehensive Loss Highlights (Quarter Ended September 30, 2023 vs. 2022) | Metric | Q3 2023 | Q3 2022 | Change | | :------------------------------------------------------- | :---------- | :---------- | :------- | | Net loss | $(1,768,737) | $(1,606,254) | $(162,483) | | Unrealized gain on available-for-sale securities | $204,931 | $0 | $204,931 | | Reclassification of realized gain on available-for-sale securities to other income | $(166,783) | $0 | $(166,783) | | Comprehensive loss | $(1,730,589) | $(1,606,254) | $(124,335) | Comprehensive Loss Highlights (Nine Months Ended September 30, 2023 vs. 2022) | Metric | 9M 2023 | 9M 2022 | Change | | :------------------------------------------------------- | :---------- | :---------- | :------- | | Net loss | $(4,879,940) | $(3,724,739) | $(1,155,201) | | Unrealized gain on available-for-sale securities | $373,652 | $0 | $373,652 | | Reclassification of realized gain on available-for-sale securities to other income | $(166,783) | $0 | $(166,783) | | Comprehensive loss | $(4,673,071) | $(3,724,739) | $(948,332) | [Statements of Changes in Stockholders' Equity](index=6&type=section&id=Statements%20of%20Changes%20in%20Stockholders'%20Equity%20(unaudited)%20for%20the%20Quarters%20and%20Nine%20Months%20Ended%20September%2030%2C%202023%20and%202022) Outlines changes in stockholders' equity, including net loss, stock-based compensation, and share issuances Stockholders' Equity Changes (Nine Months Ended September 30, 2023) | Item | Amount | | :------------------------------------ | :------- | | Balance at December 31, 2022 | $23,355,687 | | Stock-based compensation expense | $519,374 | | Issuance of common stock (ATM & ESPP) | $700,146 | | Unrealized gain on AFS securities | $373,652 | | Realized gain on AFS securities | $(166,783) | | Net loss | $(4,879,940) | | Balance at September 30, 2023 | $19,903,536 | Common Stock Shares Outstanding | Date | Shares | | :-------------------- | :------- | | December 31, 2022 | 7,771,938 | | September 30, 2023 | 8,588,455 | [Statements of Cash Flows](index=8&type=section&id=Statements%20of%20Cash%20Flows%20(unaudited)%20for%20the%20Nine%20Months%20Ended%20September%2030%2C%202023%20and%202022) Summarizes cash inflows and outflows from operating, investing, and financing activities for the reported periods Cash Flow Summary (Nine Months Ended September 30, 2023 vs. 2022) | Activity | 9M 2023 | 9M 2022 | Change | | :-------------------------------- | :---------- | :---------- | :----------- | | Net cash used in operating activities | $(4,634,367) | $(3,806,422) | $(827,945) | | Net cash used in investing activities | $1,058,354 | $(18,944,558) | $20,002,912 | | Net cash provided by financing activities | $701,546 | $1,950,881 | $(1,249,335) | | Net decrease in cash and cash equivalents | $(2,874,467) | $(20,800,099) | $17,925,632 | | Cash and cash equivalents, end of period | $1,460,553 | $1,772,005 | $(311,452) | [Notes to Unaudited