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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>false</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAL TRANSPORTATION</Desc>
        <BusinessCd>621300</BusinessCd>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RADIOLOGY</Desc>
        <BusinessCd>621300</BusinessCd>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CLAIMSCAPE FEES</Desc>
        <BusinessCd>621300</BusinessCd>
        <TotalRevenueColumnAmt>8941806</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8941806</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PHYSICIAN</Desc>
        <BusinessCd>621300</BusinessCd>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>LABORATORY</Desc>
        <BusinessCd>621300</BusinessCd>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>8941806</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>3004</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3004</RelatedOrExemptFuncIncomeAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>ID CARD FEE INCOME</Desc>
        <BusinessCd>621300</BusinessCd>
        <TotalRevenueColumnAmt>1565</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1565</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>FACILITY FEES</Desc>
        <BusinessCd>621300</BusinessCd>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>BOST FEES AND MEMBERSHI</Desc>
        <BusinessCd>621300</BusinessCd>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>1565</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>8946375</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8946375</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>175877</TotalAmt>
        <ProgramServicesAmt>175877</ProgramServicesAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>3217</TotalAmt>
        <ProgramServicesAmt>3217</ProgramServicesAmt>
      </PensionPlanContributionsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>12343</TotalAmt>
        <ProgramServicesAmt>12343</ProgramServicesAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>394</TotalAmt>
        <ProgramServicesAmt>394</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>1709</TotalAmt>
        <ProgramServicesAmt>1709</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>27000</TotalAmt>
        <ProgramServicesAmt>27000</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>1521</TotalAmt>
        <ProgramServicesAmt>1521</ProgramServicesAmt>
      </AdvertisingGrp>
      <OccupancyGrp>
        <TotalAmt>24501</TotalAmt>
        <ProgramServicesAmt>24501</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>2820</TotalAmt>
        <ProgramServicesAmt>2820</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>3467</TotalAmt>
        <ProgramServicesAmt>3467</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>4373</TotalAmt>
        <ProgramServicesAmt>4373</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>8911</TotalAmt>
        <ProgramServicesAmt>8911</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <OtherExpensesGrp>
        <Desc>CLAIMSCAPE</Desc>
        <TotalAmt>8619403</TotalAmt>
        <ProgramServicesAmt>8619403</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>COMMUNITY HEALTH PARTNERS</Desc>
        <TotalAmt>12104</TotalAmt>
        <ProgramServicesAmt>12104</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>83605</TotalAmt>
        <ProgramServicesAmt>83605</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>8981245</TotalAmt>
        <ProgramServicesAmt>8981245</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>727466</BOYAmt>
        <EOYAmt>517307</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>530</BOYAmt>
        <EOYAmt>37379</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1538921</BOYAmt>
        <EOYAmt>1440965</EOYAmt>
      </AccountsReceivableGrp>
      <LandBldgEquipCostOrOtherBssAmt>185402</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>175501</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>17340</BOYAmt>
        <EOYAmt>9901</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>2284257</BOYAmt>
        <EOYAmt>2005552</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>15911</BOYAmt>
        <EOYAmt>-9538</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>-9253</BOYAmt>
        <EOYAmt>2785</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>6658</BOYAmt>
        <EOYAmt>-6753</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2277599</BOYAmt>
        <EOYAmt>2012305</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2277599</BOYAmt>
        <EOYAmt>2012305</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>2284257</BOYAmt>
        <EOYAmt>2005552</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-34870</ReconcilationRevenueExpnssAmt>
      <PriorPeriodAdjustmentsAmt>-230424</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="990A">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>226</CurrentTaxYearMinus4YearsAmt>
        <TotalAmt>226</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>7101465</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8277561</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7597372</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7921783</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>8943371</CurrentTaxYearAmt>
        <TotalAmt>39841552</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>7101691</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8277561</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7597372</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7921783</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>8943371</CurrentTaxYearAmt>
        <TotalAmt>39841778</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>39841778</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>2402</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2916</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>953</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2717</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3004</CurrentTaxYearAmt>
        <TotalAmt>11992</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>2402</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2916</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>953</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2717</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3004</CurrentTaxYearAmt>
        <TotalAmt>11992</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>7104093</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8280477</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7598325</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7924500</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>8946375</CurrentTaxYearAmt>
        <TotalAmt>39853770</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99970</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99970</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="990D">
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>39041</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>175501</DepreciationAmt>
        <BookValueAmt>-136460</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>146361</OtherCostOrOtherBasisAmt>
        <BookValueAmt>146361</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>9901</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>PAYROLL LIABILITIES</Desc>
        <Amt>2785</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>2785</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="990O">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 governing body review Part VI line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEWED AT ANNUAL BOARD MEETING</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>CEO executive director top management comp Part VI line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEWED AT ANNUAL BOARD MEETING</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other officer or key employee compensation Part VI line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEWED AT ANNUAL BOARD MEETING</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Governing documents etc available to public Part VI line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>UPON REQUEST</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>