CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities
Net loss	$ (54,639)	$ (57,534)	$ (65,649)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	18,546	15,542	13,728
Allowance for trade receivables and estimated credit losses	812	614	155
Provision for excess and obsolete inventories	10,113	4,037	485
Loss on early extinguishment of debt		1,881
Stock-based compensation	13,017	12,364	10,365
Change in fair value of financial instruments	(778)	546	(57)
Other	1,244	984	704
Changes in other assets and liabilities, net of acquisitions:
Accounts receivable	(2,884)	(161)	(12,013)
Inventories	(11,143)	(32,628)	(21,852)
Accounts payable	(5,674)	6,742	1,895
Accrued expenses	4,298	6,428	2,317
Accrued legal settlement		(22,000)	22,000
Income tax receivable/payable	(504)	(50)	391
Other assets and liabilities	444	(655)	(1,650)
Net cash used in operating activities	(27,148)	(63,890)	(49,181)
Cash flows from investing activities
Purchase of office building			(18,300)
Purchases of property and equipment	(15,797)	(26,716)	(22,813)
Proceeds from sale of property and equipment	1,264	1,043	897
Purchases of intangible assets	(1,152)	(1,314)	(1,973)
Acquisitions, net of cash received			(18,504)
Net cash used in investing activities	(15,685)	(26,987)	(60,693)
Cash flows from financing activities
Proceeds from draw on term loan			20,000
Proceeds from issuance of long-term debt		100,000	16,000
Payments on long-term debt	(640)	(30,727)	(570)
Payments of debt issuance costs	(18)	(4,423)	(732)
Proceeds from issuance of common stock, net of issuance costs		68,453
Proceeds from exercise of options	3,132	2,406	5,271
RSU vesting, taxes paid	(856)
Proceeds from employee stock purchase plan	675	944	518
Payments on earnout liability	(2,000)	(8,000)	(1,000)
Net cash provided by financing activities	293	128,653	39,487
Effect of exchange rate changes on cash and cash equivalents	1,481	(605)	(497)
Net (decrease) increase in cash and cash equivalents	(41,059)	37,171	(70,884)
Cash and cash equivalents at beginning of period	75,639	38,468	109,352
Cash and cash equivalents at end of period	34,580	75,639	38,468
Supplemental disclosures of cash flow information:
Restricted cash		1,000
Cash paid for income taxes	2,097	908	1,103
Cash paid for interest	11,973	4,271	3,073
Purchase of property and equipment included in accounts payable	$ 2,226	$ 3,402	$ 3,402

Paragon 28, Inc. 10-K