Cash flow generation remains unreliable, highlighted by an OCF/NI ratio that fluctuated from -36.42 in 2024Q2 to 5.95 in 2025Q4, complicating the assessment of true operational performance.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'11 | Dec'10 |
|---|
| Cash from Operations | 272.68M | 248.13M | 23.15M | 1.26M | 50.61M | 173.43M | 86.67M | 12.12M | -480.05K | -714.62K | -274.22K | 44.91K | -664.57K | -889.1K |
| Operating CF Margin % | - | 28.35% | 4.82% | 0.51% | 23.08% | 52.31% | 31.63% | 12.49% | -525.37% | -1332.08% | - | - | -26.08% | -70.21% |
| Operating CF Growth % | 133081.19% | 971.64% | 1742.79% | -97.52% | -70.82% | 100.1% | 614.84% | 2625.71% | 32.82% | -160.6% | -710.65% | 106.76% | 25.25% | - |
| Net Income | 96.38M | 180.36M | 95.27M | -43.42M | -432.74M | 168.53M | 145.56M | 32.09M | -950.13K | -6.01M | -451.06K | -536.13K | -383.39K | 158.14K |
| Depreciation & Amortization | 26.49M | 20.53M | 18.97M | 17.59M | 13.13M | 7.66M | 5.96M | 2.48M | 522 | 535.02K | 473 | 662 | 5.92K | 1.5K |
| Stock-Based Compensation | 121.54M | 117M | 16.63M | 2.84M | 189.58K | 0 | 0 | 0 | 208.03K | 924.33K | 0 | 0 | 815 | 5.83K |
| Deferred Taxes | 16.14M | 17.08M | -13.13M | -5.71M | 5M | 0 | 0 | 0 | -123.43K | -115.22K | 0 | 0 | -184.19K | -161.39K |
| Other Non-Cash Items | -61.55M | 902K | 9.81M | 31.62M | 400.71M | -5.51M | 1.18M | -596.94K | -160.67K | 5.52M | -316.72K | 563.79K | 104.01K | -1.05M |
| Working Capital Changes | -57.41M | -87.74M | -104.4M | -1.66M | 64.32M | 2.75M | -66.02M | -21.85M | 310.99K | 193.65K | 307K | -116.58K | -207.73K | 161.39K |
| Change in Receivables | -46.15M | -89.32M | -173.41M | -4.58M | 58.08M | -6.62M | -71.23M | -24.74M | -82.09K | -4K | 0 | 56.7K | -144.7K | -67.91K |
| Change in Inventory | -1.56M | -16K | 540.77K | 142.7K | -719.11K | -1.09M | -825.77K | -486.27K | 127 | 0 | 0 | 0 | 0 | 0 |
| Change in Payables | 27.92M | 37.85M | -10.72M | -2.25M | 9.69M | 6.27M | 6.23M | 1.63M | 402.25K | 119.22K | 187.03K | 77.79K | -63.03K | 229.3K |
| Cash from Investing | -6.38M | -5.24M | -2.67M | -11.24M | -4.34M | -36.98M | -61.19M | -31.23M | -116.96K | 2.05K | -9.99K | 1.83K | 18.1K | -477.69K |
| Capital Expenditures | -1.12M | 0 | -2.3M | -9.5M | -14.63M | -36.93M | -61.19M | -32.28M | 0 | 0 | 0 | 0 | -19.39K | -5.69K |
| CapEx % of Revenue | 0.13% | 0.29% | 0.48% | 3.83% | 6.67% | 11.14% | 22.33% | 33.25% | - | - | - | - | 0.76% | 0.45% |
| Acquisitions | 0 | 0 | -361.32K | -1.74M | 10.3M | -48.85K | 0 | 1.04M | -116.96K | -30.8K | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -5.26M | -5.24M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 32.85K | -9.99K | 1.83K | 37.49K | -472K |
| Cash from Financing | -140.69M | -97.95M | 1.09M | -2.27M | -48.13M | -125.85M | -7.97M | 21.71M | 704.57K | 711.5K | 172.44K | -51.28K | 0 | 22.89K |
| Debt Issued (Net) | -19.99M | -19.44M | -7.4M | 2.65M | -5.59M | -3.22M | 41.27M | 35.57M | 0 | 461K | 0 | 0 | 0 | 0 |
| Equity Issued (Net) | -5M | -5M | 9.2M | 0 | 4.76M | 0 | 120K | 0 | 0 | 275K | 0 | 0 | 0 | 0 |
| Dividends Paid | -42.17M | 0 | -6.44M | -5.21M | -51.23M | -144.34M | -59.05M | -18.9M | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -5M | -5M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | -73.52M | -73.51M | 5.73M | 298.03K | 3.93M | 21.71M | 9.69M | 5.05M | 756.39K | -24.5K | 172.44K | -51.28K | 0 | 22.89K |
| Net Change in Cash | 122.92M | 144.93M | 21.58M | -12.25M | -1.86M | 10.6M | 17.51M | 2.6M | 109.82K | -1.07K | -111.77K | -4.54K | -240.75K | -391.52K |
| Free Cash Flow | 270.22M | 245.6M | 20.85M | -8.24M | 35.97M | 136.51M | 25.48M | -20.15M | -480.05K | -714.62K | -274.22K | 44.91K | -683.97K | -894.79K |
| FCF Margin % | 30.71% | 28.06% | 4.34% | -3.33% | 16.4% | 41.17% | 9.3% | -20.76% | -525.37% | -1332.08% | - | - | -26.84% | -70.66% |
| FCF Growth % | 289.18% | 1077.94% | 353.02% | -122.91% | -73.65% | 435.67% | 226.46% | -4097.63% | 32.82% | -160.6% | -710.65% | 106.57% | 23.56% | - |
| FCF per Share | 37.65 | 36.35 | 4.09 | -1.87 | 8.50 | 34.54 | 5.94 | -4.87 | -0.07 | -0.17 | -0.13 | 0.02 | -0.57 | -0.75 |
| FCF Conversion (FCF/Net Income) | 2.80x | 3.51x | 0.44x | -0.03x | -0.12x | 1.31x | 0.82x | 0.58x | 0.17x | -1.23x | 0.04x | 0.54x | 1.73x | -5.62x |
| Interest Paid | 11.86M | 0 | 3.47M | 1.64M | 4.62M | 4.1M | 3.25M | 427.4K | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 66.8M | 0 | 798.99K | 849.36K | 8.23M | 335.34K | 181.34K | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Earnings and cash divergence
As reported in financial statements, the relationship between net income and operating cash flow is highly erratic, evidenced by an OCF/NI ratio that swung from -36.42 in 2024Q2 to 5.95 in 2025Q4, indicating that reported earnings are not currently reliable proxies for actual cash generation.
The extreme volatility in the OCF/NI ratio suggests that non-cash items and working capital adjustments are significantly distorting the company's bottom line. Investors should monitor this divergence closely, as it implies that the reported net income may be subject to accounting noise rather than sustainable operational cash flow.
Based on the provided cash flow data, Nutex Health's free cash flow margins have demonstrated extreme instability, ranging from a negative 1.4% in 2023Q4 to a peak of 45.5% in 2025Q4, reflecting a business model that struggles to maintain consistent cash conversion across its reporting periods.
The lack of a stable FCF trajectory suggests that the company's operational scaling has not yet translated into predictable cash inflows. This inconsistency warrants further investigation into whether the recent spikes in FCF are sustainable or merely the result of temporary working capital timing differences.
According to recent SEC filings, working capital changes have been a primary driver of cash flow volatility, with a massive $109.1 million outflow in 2024Q4 followed by a $56.9 million inflow in 2025Q4, highlighting significant instability in the company's ability to manage its operational cash cycle.
These dramatic shifts in working capital suggest that the company's cash position is highly sensitive to the timing of collections and payments. Such fluctuations may indicate underlying challenges in managing accounts receivable or the impact of large, non-recurring adjustments within the population health management segment.
Based on reported figures, stock-based compensation has been a major source of volatility, reaching a peak of $106.4 million in 2025Q2, which significantly complicates the interpretation of the company's true cash-generating capacity and masks the underlying operational performance of the business.
The substantial and irregular nature of these non-cash adjustments suggests that investors should be cautious when evaluating the company's cash flow health. This reliance on equity-based compensation as a primary adjustment to net income warrants further investigation into the company's long-term compensation strategy and its impact on shareholder dilution.
Quick answers to the most common questions about buying NUTX stock.
Nutex Health, Inc. (NUTX) generated $248.1M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Nutex Health, Inc. (NUTX) generated $245.6M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Nutex Health, Inc. (NUTX) spent $0.0M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, Nutex Health, Inc. (NUTX) spent $5.0M on share repurchases. This shows the company's commitment to returning capital to its equity investors.