11. Commitments and Contingencies

Legal Proceedings — The Company is subject to legal proceedings and claims which have arisen in the ordinary course of business and have not been fully adjudicated. As discussed in Note 18, Prudential has expressed its intention to collect on the $3 million portion of the amount due them together with accrued interest in connection with the MediGain purchase.

Leases — The Company leases certain office space and other facilities under operating leases expiring through 2021. Certain of these leases contain renewal options.

Future minimum lease payments under non-cancelable operating leases for office space as of December 31, 2016 are as follows:

Total rental expense, included in direct operating costs and general and administrative expense in the consolidated statements of operations amounted to approximately $1 million and $938,000 for the years ended December 31, 2016 and 2015, respectively. During January 2017, the Company entered into 2 new domestic leases at a combined monthly cost of approximately $19,000. The leases expire in January and December, 2019.

Acquisitions — In connection with the Acquisitions, contingent consideration is payable in the form of common stock or cash with payment terms through 2018. If the performance measures are not achieved, the Company may pay less than the recorded amount, depending on the terms of the agreement and if the performance measures are exceeded, the Company may pay more than the recorded amount. If the price of the Company’s common stock increases, or if the performance measures exceed the Company’s estimate the Company may pay more than the recorded amount.