<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-05-14T14:51:48-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>923320348</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>EAG GULF COAST LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>215 ST PATRICK ST</AddressLine1Txt>
        <CityNm>DONALDSONVILLE</CityNm>
        <StateAbbreviationCd>LA</StateAbbreviationCd>
        <ZIPCd>70346</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>451536101</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>LOUISIANA AMBULANCE ALLIANCE INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>LOUI</BusinessNameControlTxt>
      <PhoneNum>2256123177</PhoneNum>
      <USAddress>
        <AddressLine1Txt>301 MAIN STREET SUITE 600</AddressLine1Txt>
        <CityNm>BATON ROUGE</CityNm>
        <StateAbbreviationCd>LA</StateAbbreviationCd>
        <ZIPCd>70825</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>CURRY LANDRY</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <PhoneNum>2256123177</PhoneNum>
      <SignatureDt>2024-05-14</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>CURRY</PersonFirstNm>
        <PersonLastNm>LANDRY</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>HEIDI MABILE</PreparerPersonNm>
      <PTIN>P01945615</PTIN>
      <PhoneNum>2254734179</PhoneNum>
      <PreparationDt>2024-05-14</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2023</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>CURRY LANDRY</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>301 MAIN ST SUITE 600</AddressLine1Txt>
        <CityNm>BATON ROUGE</CityNm>
        <StateAbbreviationCd>LA</StateAbbreviationCd>
        <ZIPCd>70825</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>25560133</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501cInd organization501cTypeTxt="6">X</Organization501cInd>
      <WebsiteAddressTxt>WWW.LOUISIANAAMBULANCEALLIANCE.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2011</FormationYr>
      <LegalDomicileStateCd>LA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROMOTE EMERGENCY MEDICAL TRANSPORT AS A DISTINCT CONCERN IN LOUISIANA. TO SERVE AS A FORUM FOR A UNIFIED VOICE FOR HEALTHCARE PROVIDERS, PUBLIC OFFICIALS, HEALTHCARE WORKERS, EDUCATORS AND CONSUMERS WORKING TO IMPROVE EMERGENCY MEDICAL TRANSPORT IN LOUISIANA, TO PROVIDE A FORUM FOR THE EXCHANGE AND DISTRIBUTION OF IDEAS AND INFORMATION RELATED TO THE IMPROVEMENT OF EMERGENCY MEDICAL TRANSPORT. TO SERVE AS AN ADVOCATE FOR EMERGENCY MEDICAL TRANSPORT, PROMOTING IMPROVED HEALTH STATUS AND IMPROVEMENTS TO THE HEALTH SYSTEM FOR RESIDENTS OF LOUISIANA AND TO ENCOURAGE THE DEVELOPMENT OF APPROPRIATE HEALTH RESOURCES FOR LOUISIANA.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>6</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>6</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>10</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>0</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>2758939</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>-696351</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>0</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>0</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>82950314</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>26256484</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>85709253</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>25560133</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>675493</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>583990</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>83563688</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>24954232</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>84239181</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>25538222</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>1470072</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>21911</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>7139729</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>10931380</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>147986</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>3917726</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>6991743</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>7013654</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TO PROMOTE EMERGENCY MEDICAL TRANSPORT AS A DISTINCT CONCERN IN LOUISIANA. TO SERVE AS A FORUM FOR A UNIFIED VOICE FOR HEALTHCARE PROVIDERS, PUBLIC OFFICIALS, HEALTHCARE WORKERS, EDUCATORS AND CONSUMERS WORKING TO IMPROVE EMERGENCY MEDICAL TRANSPORT IN LOUISIANA, TO PROVIDE A FORUM FOR THE EXCHANGE AND DISTRIBUTION OF IDEAS AND INFORMATION RELATED TO THE IMPROVEMENT OF EMERGENCY MEDICAL TRANSPORT. TO SERVE AS AN ADVOCATE FOR EMERGENCY MEDICAL TRANSPORT, PROMOTING IMPROVED HEALTH STATUS AND IMPROVEMENTS TO THE HEALTH SYSTEM FOR RESIDENTS OF LOUISIANA. AND TO ENCOURAGE THE DEVELOPMENT OF APPROPRIATE HEALTH RESOURCES FOR LOUISIANA.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <Desc>TO SERVE AS AN ADVOCATE FOR EMERGENCY MEDICAL TRANSPORT, PROMOTING IMPROVED HEALTH STATUS AND IMPROVEMENTS TO THE HEALTH SYSTEM FOR RESIDENTS OF LOUISIANA. AND TO ENCOURAGE THE DEVELOPMENT OF APPROPRIATE HEALTH RESOURCES FOR LOUISIANA.SAID ORGANIZATION IS ORGANIZED EXCLUSIVELY FOR THE PURPOSE OF PROMOTING THE COMMON BUSINESS INTERESTS OF ITS MEMBERS AND THE EMERGENCY MEDICAL TRANSPORTATION INDUSTRY IN LOUISIANA.THE CORPORATION IS NOT ORGANIZED FOR, NOR SHALL IT BE, CONDUCTED FOR PROFIT, AND IT IS NOT TO ENGAGE IN REGULAR BUSINESS OF A KIND ORDINARILY CARRIED ON FOR PROFIT.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>25538222</ExpenseAmt>
        <RevenueAmt>25560133</RevenueAmt>
        <Desc>LOUISIANA AMBULANCE ALLIANCE - IPAA PASS-THROUGH ENTITY FOR LOUISIANA AMBULANCE ALLIANCE WHICH WAS ORGANIZED TO SERVE AS AN ADVOCATE FOR EMERGENCY MEDICAL TRANSPORT, PROMOTING IMPROVED HEALTH STATUS AND IMPROVEMENTS TO THE HEALTH SYSTEM FOR RESIDENTS OF LOUISIANA. AND TO ENCOURAGE THE DEVELOPMENT OF APPROPRIATE HEALTH RESOURCES FOR LOUISIANA.</Desc>
      </ProgSrvcAccomActy2Grp>
      <TotalProgramServiceExpensesAmt>25538222</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">0</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">1</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">1</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">1</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>10</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>6</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>6</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>0</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>LA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>EAG GULF COAST LLC</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>2254734179</PhoneNum>
        <USAddress>
          <AddressLine1Txt>PO BOX 1190</AddressLine1Txt>
          <CityNm>DONALDSONVILLE</CityNm>
          <StateAbbreviationCd>LA</StateAbbreviationCd>
          <ZIPCd>70346</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFF WATSON</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY PETERS</PersonNm>
        <TitleTxt>IMMEDIATE PAST PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TRACY WOLD</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRADY DIAGLE</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PORTER TAYLOR</PersonNm>
        <TitleTxt>MEMBER AT LARGE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CURRY LANDRY</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>150010</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>150010</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>UPL</Desc>
        <BusinessCd>611600</BusinessCd>
        <TotalRevenueColumnAmt>-696351</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-696351</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>-696351</TotalProgramServiceRevenueAmt>
      <OtherRevenueMiscGrp>
        <Desc>IPA - HEALTH PLAN REVENUE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>24911926</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24911926</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>676824</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>676824</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>IPA - AFFILIATION FEE REVENUE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>667734</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>667734</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>26256484</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>25560133</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>25560133</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>487911</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>14860</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>18886</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>62333</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>83736</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>52375</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>44880</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>24237363</TotalAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>21856</TotalAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>69041</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>1325</TotalAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>2804</TotalAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>39086</TotalAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>19129</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>FICTICIOUS VENDOR LOSS`</Desc>
        <TotalAmt>130217</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEMBER SERVICES</Desc>
        <TotalAmt>116786</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OPIOID EXPENSE</Desc>
        <TotalAmt>83942</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PROFESSIONAL SERVICES</Desc>
        <TotalAmt>27215</TotalAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>24477</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>25538222</TotalAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3410023</BOYAmt>
        <EOYAmt>6949300</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>466489</BOYAmt>
        <EOYAmt>371259</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>1000</BOYAmt>
        <EOYAmt>1000</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>6015</BOYAmt>
        <EOYAmt>4043</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>616358</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>124803</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>530642</BOYAmt>
        <EOYAmt>491555</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>2725560</BOYAmt>
        <EOYAmt>3114223</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <TotalAssetsGrp>
        <BOYAmt>7139729</BOYAmt>
        <EOYAmt>10931380</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <EOYAmt>3878585</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>147986</BOYAmt>
        <EOYAmt>39141</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>147986</BOYAmt>
        <EOYAmt>3917726</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowFASB117Ind>X</OrgDoesNotFollowFASB117Ind>
      <CapStkTrPrinCurrentFundsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </CapStkTrPrinCurrentFundsGrp>
      <PdInCapSrplsLandBldgEqpFundGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PdInCapSrplsLandBldgEqpFundGrp>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>6991743</BOYAmt>
        <EOYAmt>7013654</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>6991743</BOYAmt>
        <EOYAmt>7013654</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>7139729</BOYAmt>
        <EOYAmt>10931380</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>21911</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>0</FSAuditedInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>46201739</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>52177964</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>30262915</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>85695346</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24667300</CurrentTaxYearAmt>
        <TotalAmt>239005264</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>46201739</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>52177964</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>30262915</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>85695346</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24667300</CurrentTaxYearAmt>
        <TotalAmt>239005264</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>239005264</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>41538</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>119115</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>155452</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>77937</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>434079</CurrentTaxYearAmt>
        <TotalAmt>828121</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>239833385</TotalSupportAmt>
      <PublicSupportCY170Pct>0.99650</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99820</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <SubstantiallyAllDuesNondedInd>0</SubstantiallyAllDuesNondedInd>
      <OnlyInHouseLobbyingInd>0</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>0</AgreeCarryoverPriorYearInd>
      <DuesAssessmentsAmt>333904</DuesAssessmentsAmt>
      <NonDeductibleLbbyngPltclCYAmt>44880</NonDeductibleLbbyngPltclCYAmt>
      <NonDeductibleLbbyngPltclTotAmt>44880</NonDeductibleLbbyngPltclTotAmt>
      <CarriedOverAmt>0</CarriedOverAmt>
      <TaxableAmt>44880</TaxableAmt>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>223517</InvestmentCostOrOtherBasisAmt>
        <BookValueAmt>223517</BookValueAmt>
      </LandGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>392841</InvestmentCostOrOtherBasisAmt>
        <DepreciationAmt>124803</DepreciationAmt>
        <BookValueAmt>268038</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>491555</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>NFSLLC VALIC INVESTMENT</Desc>
        <BookValueAmt>848149</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>VALIC INVESTMENT</Desc>
        <BookValueAmt>611490</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>FIRST HORIZON - F3U-030655</Desc>
        <BookValueAmt>1641697</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>FIRST HORIZON - F3U-030684</Desc>
        <BookValueAmt>12887</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>3114223</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>PAYROLL LIABILITIES</Desc>
        <Amt>3452</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>UNSPENT OPIOD ABUSE PREVENTION</Desc>
        <Amt>20829</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>PROFIT SHARING LIABILITY</Desc>
        <Amt>14860</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>39141</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CURRY LANDRY</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>150010</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>150010</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEWED BY GOVERNING BODY PRIOR TO FILING</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUAL DISCUSSION WITH GOVERNING BOARD</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>UPON REQUEST</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONSULTING 18,830. IPA - PROVIDER EXPENSE 24,911,926. REBATE 21,676. AFFILIATION COST EXPENSE -715,069.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>LOUISIANA AMBULANCE ALLIANCE IPA LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5010 HWY 1</AddressLine1Txt>
          <CityNm>NAPOLEONVILLE</CityNm>
          <StateAbbreviationCd>LA</StateAbbreviationCd>
          <ZIPCd>70390</ZIPCd>
        </USAddress>
        <EIN>811339637</EIN>
        <LegalDomicileStateCd>LA</LegalDomicileStateCd>
      </IdDisregardedEntitiesGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
