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        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>CARL MCMINIMY</PersonNm>
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        <OfficerInd>X</OfficerInd>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SARAH ARMSTRONG</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DONNA AUSTIN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>RON BEECHER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER CHRISTENSEN</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ANN DARE</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>GREG HELBLING</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>LINDA JOHANN</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BRINNON MANDEL</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL SCHMIDT</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>CHERI ZAO</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <TotalOtherCompensationAmt>261603</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>54</IndivRcvdGreaterThan100KCnt>
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      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ATHENA HEALTH</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 415615</AddressLine1Txt>
            <CityNm>BOSTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>EFFICIENT CARE</BusinessNameLine1Txt>
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          <USAddress>
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            <StateAbbreviationCd>CA</StateAbbreviationCd>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SMITH &amp; MALEK</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>601 E FRONT AVENUE</AddressLine1Txt>
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            <StateAbbreviationCd>ID</StateAbbreviationCd>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ALSC ARCHITECTS</BusinessNameLine1Txt>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>203 N WASHINGTON STREET 400</AddressLine1Txt>
            <CityNm>SPOKANE</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>99201</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TIMEDOC HEALTH</BusinessNameLine1Txt>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>815 W WEED STREET</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60642</ZIPCd>
          </USAddress>
        </ContractorAddress>
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        <CompensationAmt>337413</CompensationAmt>
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      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>16817</FundraisingAmt>
      <GovernmentGrantsAmt>9539720</GovernmentGrantsAmt>
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        <Desc>PATIENT REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>29890675</TotalRevenueColumnAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>OTHER MEDICAL REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>57999</RelatedOrExemptFuncIncomeAmt>
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        <TotalRevenueColumnAmt>434080</TotalRevenueColumnAmt>
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      <NetRentalIncomeOrLossGrp>
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        <UnrelatedBusinessRevenueAmt>-54266</UnrelatedBusinessRevenueAmt>
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      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-7195</TotalRevenueColumnAmt>
        <ExclusionAmt>-7195</ExclusionAmt>
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        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1438357</TotalRevenueColumnAmt>
        <ExclusionAmt>1438357</ExclusionAmt>
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        <UnrelatedBusinessRevenueAmt>-54266</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1865242</ExclusionAmt>
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        <ProgramServicesAmt>156934</ProgramServicesAmt>
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        <ProgramServicesAmt>120038</ProgramServicesAmt>
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        <ProgramServicesAmt>2299898</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1097053</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1323959</ProgramServicesAmt>
        <ManagementAndGeneralAmt>648260</ManagementAndGeneralAmt>
        <FundraisingAmt>26514</FundraisingAmt>
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        <ManagementAndGeneralAmt>580813</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>192527</TotalAmt>
        <ManagementAndGeneralAmt>192527</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>3021046</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1072401</ManagementAndGeneralAmt>
        <FundraisingAmt>5487</FundraisingAmt>
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      <AdvertisingGrp>
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        <ProgramServicesAmt>71805</ProgramServicesAmt>
        <ManagementAndGeneralAmt>238055</ManagementAndGeneralAmt>
        <FundraisingAmt>29356</FundraisingAmt>
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        <ProgramServicesAmt>417105</ProgramServicesAmt>
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        <FundraisingAmt>57832</FundraisingAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>1545316</ProgramServicesAmt>
        <ManagementAndGeneralAmt>560827</ManagementAndGeneralAmt>
        <FundraisingAmt>28870</FundraisingAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>113125</ProgramServicesAmt>
        <ManagementAndGeneralAmt>132115</ManagementAndGeneralAmt>
        <FundraisingAmt>291</FundraisingAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>47244</TotalAmt>
        <ProgramServicesAmt>10000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>33156</ManagementAndGeneralAmt>
        <FundraisingAmt>4088</FundraisingAmt>
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        <ProgramServicesAmt>8295</ProgramServicesAmt>
        <ManagementAndGeneralAmt>99032</ManagementAndGeneralAmt>
        <FundraisingAmt>74</FundraisingAmt>
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        <ProgramServicesAmt>637496</ProgramServicesAmt>
        <ManagementAndGeneralAmt>316450</ManagementAndGeneralAmt>
        <FundraisingAmt>28932</FundraisingAmt>
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        <ProgramServicesAmt>21182</ProgramServicesAmt>
        <ManagementAndGeneralAmt>72001</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>4011686</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>CONTINUING EDUCATION</Desc>
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        <ProgramServicesAmt>119756</ProgramServicesAmt>
        <ManagementAndGeneralAmt>594457</ManagementAndGeneralAmt>
        <FundraisingAmt>2054</FundraisingAmt>
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        <FundraisingAmt>9073</FundraisingAmt>
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      <OtherExpensesGrp>
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        <ManagementAndGeneralAmt>91269</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
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        <ManagementAndGeneralAmt>20859</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>32390434</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14418957</ManagementAndGeneralAmt>
        <FundraisingAmt>555496</FundraisingAmt>
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        <EOYAmt>12733583</EOYAmt>
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        <EOYAmt>148335</EOYAmt>
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        <EOYAmt>3514842</EOYAmt>
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        <EOYAmt>312214</EOYAmt>
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        <EOYAmt>250007</EOYAmt>
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        <EOYAmt>25397597</EOYAmt>
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        <EOYAmt>1560</EOYAmt>
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        <EOYAmt>6096237</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>0</EOYAmt>
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      <PriorPeriodAdjustmentsAmt>-74425</PriorPeriodAdjustmentsAmt>
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      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
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        <CurrentTaxYearMinus3YearsAmt>9729012</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>14923032</CurrentTaxYearMinus2YearsAmt>
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        <CurrentTaxYearMinus3YearsAmt>9729012</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>14923032</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10188579</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10836089</CurrentTaxYearAmt>
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      <PublicSupportTotal170Amt>55192869</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>1464</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1098</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>44572</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>6310</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>434080</CurrentTaxYearAmt>
        <TotalAmt>487524</TotalAmt>
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      <UnrelatedBusinessNetIncm170Grp>
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        <CurrentTaxYearMinus1YearAmt>14042</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>52434</TotalAmt>
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      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>604814</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>412544</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>980882</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>358202</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1438357</CurrentTaxYearAmt>
        <TotalAmt>3794799</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>59527626</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>155967587</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.92720</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.94580</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME SPECIAL FUNDRAISING EVENTS</ExplanationTxt>
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    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>1105496</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1105496</BookValueAmt>
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      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>3644198</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>201796</DepreciationAmt>
        <BookValueAmt>3442402</BookValueAmt>
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      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>2329281</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1304736</DepreciationAmt>
        <BookValueAmt>1024545</BookValueAmt>
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      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3229133</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1722643</DepreciationAmt>
        <BookValueAmt>1506490</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>7078933</TotalBookValueLandBuildingsAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE 2B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HOLDS TENANT SECURITY DEPOSITS FOR RENTAL SPACES. THE DEPOSIT, LESS REPAIRS FOR DAMAGES, WILL BE RETURNED TO THE TENANT WHEN THE LEASE IS TERMINATED.</ExplanationTxt>
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        <Event1Nm>MUDDY MILE</Event1Nm>
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        <CharitableContriEvent1Amt>16817</CharitableContriEvent1Amt>
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        <FoodAndBeverageEvent1Amt>320</FoodAndBeverageEvent1Amt>
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        <OtherDirectExpensesEvent1Amt>3355</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>16817</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>16817</CharitableContributionsTotAmt>
        <RentFcltyCostsTotalEventsAmt>2325</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>320</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>1195</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>3355</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>7195</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-7195</NetIncomeSummaryAmt>
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    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
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      <CompBasedOnRevenueOfFlngOrgInd>1</CompBasedOnRevenueOfFlngOrgInd>
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      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
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      <InitialContractExceptionInd>0</InitialContractExceptionInd>
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        <PersonNm>MICHAEL BAKER</PersonNm>
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        <BonusFilingOrganizationAmount>20410</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <NontaxableBenefitsFilingOrgAmt>26495</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>371987</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <TotalCompensationFilingOrgAmt>366919</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HOLLI HANSEN</PersonNm>
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        <BonusFilingOrganizationAmount>36400</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9545</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>329418</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DANIEL HENBEST</PersonNm>
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        <BaseCompensationFilingOrgAmt>272092</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>19178</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10042</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25879</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>327191</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID ATKINS</PersonNm>
        <TitleTxt>CBHO</TitleTxt>
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        <BonusFilingOrganizationAmount>12837</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8958</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>17623</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>295611</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TIFFANY KUGLER</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>219009</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>28403</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7796</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7418</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>262626</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JADE EAST</PersonNm>
        <TitleTxt>CAO</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>256</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>4598</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>26398</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>247523</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LEANNE ROUSSEAU</PersonNm>
        <TitleTxt>NP/PA RESIDENCY CLINICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>205117</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>6150</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>229297</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ELIZABETH HALL-DREMANN</PersonNm>
        <TitleTxt>PHARMACY MANAGER</TitleTxt>
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        <PersonNm>MARK HAMPE</PersonNm>
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        <TotalCompensationFilingOrgAmt>176970</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDES ALL EMPLOYEES WITH A DISCOUNT AT TWO LOCAL HEALTH CLUBS. THE ORGANIZATION MAINTAINS A CORPORATE MEMBERSHIP AT A LOCAL GOLF CLUB, WHICH THE EXECUTIVES AND BOARD MEMBERS CAN USE FOR BUSINESS PURPOSES. USE OF THE GOLF CLUB IS NOT INCLUDED IN TAXABLE COMPENSATION.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>SOME PHYSICIANS ARE COMPENSATED BASED ON INDIVIDUALS SERVED AND AMOUNTS COLLECTED.</ExplanationTxt>
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    </IRS990ScheduleJ>
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        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>20</ContributionCnt>
        <NoncashContributionsRptF990Amt>2685939</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>COST</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
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      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>1</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, COLUMN (B):</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNTS REPORTED IN PART I, COLUMN B REPRESENT THE NUMBER OF CONTRIBUTIONS RECEIVED.</ExplanationTxt>
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    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE COMPRISED OF THE OFFICERS OF THE BOARD AND THE CHAIRS OF EACH COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE HAS THE POWERS OF THE BOARD WHEN THE BOARD IS NOT IN SESSION. THE EXECUTIVE COMMITTEE IS EMPOWERED TO ACT FOR THE FULL BOARD IN MATTERS THAT REQUIRE IMMEDIATE ACTION OR DO NOT INVOLVE MAJOR QUESTIONS OF POLICY OR FUNDING. IT IS ALSO THE COORDINATING COMMITTEE THAT ORGANIZES THE BOARD'S WORK AND THE ACTIVITIES OF THE OTHER COMMITTEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIOR TO FILING, THE FORM 990 WAS REVIEWED BY THE CEO, THEN IT WAS PRESENTED TO THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL POTENTIAL DIRECTOR CONFLICTS OF INTEREST ARE DISCLOSED TO THE BOARD. WHEN ANY SUCH INTEREST BECOMES A MATTER OF BOARD ACTION, THE DIRECTOR DOES NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER AND ISN'T COUNTED IN DETERMINING WHETHER A QUORUM EXISTS. THE DIRECTOR MAY, HOWEVER, BRIEFLY STATE A POSITION ON THE MATTER AND ANSWER PERTINENT QUESTIONS. FOR EMPLOYEES, THE CEO OR THEIR DESIGNEE(S) REVIEWS ALL REPORTS OF CONFLICTS OF INTEREST AND CONDUCTS WHATEVER INVESTIGATION AND/OR TAKES WHATEVER ACTION HE OR SHE, IN THEIR JUDGEMENT, DETERMINES TO BE APPROPRIATE UNDER THE CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CEO'S COMPENSATION IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. SEVERAL MARKET RATE STUDIES ARE REVIEWED INCLUDING NWRPCA AND NACHC DATA. THIS INFORMATION IS GIVEN TO THE BOARD EXECUTIVE COMMITTEE TO DECIDE ANNUAL COMPENSATION FOR THE UPCOMING YEAR ALONG WITH MERIT CONSIDERATIONS. THE CEO'S COMPENSATION WAS LAST REVIEWED IN 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>