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        <OtherCompensationAmt>113999</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AIMAN BISHARA</PersonNm>
        <TitleTxt>PODIATRIST, DPM</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>211208</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38843</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEBBIE CAYABYAB</PersonNm>
        <TitleTxt>PEDIATRICIAN, MD</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>209972</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>64400</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELIE HELOU</PersonNm>
        <TitleTxt>INTERNAL MEDICINCE, MD</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>265643</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45170</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JILL BERNSTEIN</PersonNm>
        <TitleTxt>PEDIATRICIAN, MD</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>235433</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41838</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICARDO CUEVAS</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>195298</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42630</OtherCompensationAmt>
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      <TotalReportableCompFromOrgAmt>2666882</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>734706</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>44</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GREENWAY HEALTH</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4301 WEST BOY SCOUT BLVD SUITE 800</AddressLine1Txt>
            <CityNm>FLORIDA</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>33607</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EHR SERVICES</ServicesDesc>
        <CompensationAmt>602510</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WCS HEALTHCARE PARTNERS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>52 VANDERBILT AVE 17TH FLOOR</AddressLine1Txt>
            <CityNm>NEW YORK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10017</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTHCARE STAFFING AGENCY</ServicesDesc>
        <CompensationAmt>393856</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>EASTWOOD FINE FINISHES LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>9 TOWN LINE ROAD</AddressLine1Txt>
            <CityNm>WOLCOTT</CityNm>
            <StateAbbreviationCd>CT</StateAbbreviationCd>
            <ZIPCd>06716</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION SERVICES</ServicesDesc>
        <CompensationAmt>250450</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CLOUDMED SOLUTIONS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 208272</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75320</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>340B CONSULTING</ServicesDesc>
        <CompensationAmt>161677</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RXTRAIL CONSULTING LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>8918 W 21ST N SUIRE 200 244</AddressLine1Txt>
            <CityNm>WICHITA</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>67101</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>340B CONSULTING</ServicesDesc>
        <CompensationAmt>103311</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>10000</FederatedCampaignsAmt>
      <FundraisingAmt>21948</FundraisingAmt>
      <GovernmentGrantsAmt>8706349</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>371001</AllOtherContributionsAmt>
      <NoncashContributionsAmt>1373573</NoncashContributionsAmt>
      <TotalContributionsAmt>9109298</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAID</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>14594119</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>14594119</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>340B PHARMACY</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>7784438</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7784438</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>2286307</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2286307</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>THIRD-PARTY PAYORS</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>1489147</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1489147</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SELF-PAY PATIENTS</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>138053</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>138053</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>26292064</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>202037</TotalRevenueColumnAmt>
        <ExclusionAmt>202037</ExclusionAmt>
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      <GrossRentsGrp>
        <RealAmt>25440</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>25440</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>25440</TotalRevenueColumnAmt>
        <ExclusionAmt>25440</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>25000</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
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      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-25000</TotalRevenueColumnAmt>
        <ExclusionAmt>-25000</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>1868</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>21948</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>3112</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-1244</TotalRevenueColumnAmt>
        <ExclusionAmt>-1244</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>INCENTIVE PAYMENTS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>339996</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>339996</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>LEGAL SETTLEMENT</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>16758</TotalRevenueColumnAmt>
        <ExclusionAmt>16758</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MEDICARE SETTLEMENT</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>11771</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>11771</RelatedOrExemptFuncIncomeAmt>
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      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>24012</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24012</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>392537</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>35995132</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>26667843</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>217991</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1828216</TotalAmt>
        <ProgramServicesAmt>1624619</ProgramServicesAmt>
        <ManagementAndGeneralAmt>203597</ManagementAndGeneralAmt>
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      <OtherSalariesAndWagesGrp>
        <TotalAmt>16334950</TotalAmt>
        <ProgramServicesAmt>14701455</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1633495</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>89629</TotalAmt>
        <ProgramServicesAmt>62529</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27100</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2944701</TotalAmt>
        <ProgramServicesAmt>2054338</ProgramServicesAmt>
        <ManagementAndGeneralAmt>890363</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>1401386</TotalAmt>
        <ProgramServicesAmt>1261247</ProgramServicesAmt>
        <ManagementAndGeneralAmt>140139</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>116529</TotalAmt>
        <ManagementAndGeneralAmt>116529</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>89351</TotalAmt>
        <ManagementAndGeneralAmt>89351</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>3239800</TotalAmt>
        <ProgramServicesAmt>2310983</ProgramServicesAmt>
        <ManagementAndGeneralAmt>928817</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>1825</TotalAmt>
        <ProgramServicesAmt>1655</ProgramServicesAmt>
        <ManagementAndGeneralAmt>170</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>24459</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2521</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
        <TotalAmt>928677</TotalAmt>
        <ProgramServicesAmt>841916</ProgramServicesAmt>
        <ManagementAndGeneralAmt>86761</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>229560</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23657</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>38498</TotalAmt>
        <ProgramServicesAmt>34901</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3597</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>56854</TotalAmt>
        <ProgramServicesAmt>51542</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5312</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>376454</ProgramServicesAmt>
        <ManagementAndGeneralAmt>38795</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
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        <ProgramServicesAmt>162437</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16739</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>PROG. ACTIVITIES, SUPPL</Desc>
        <TotalAmt>5777204</TotalAmt>
        <ProgramServicesAmt>5101996</ProgramServicesAmt>
        <ManagementAndGeneralAmt>675208</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>DONATED VACCINES/ MEDIC</Desc>
        <TotalAmt>1373573</TotalAmt>
        <ProgramServicesAmt>1373573</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EQUIPMENTAL RENTAL AND</Desc>
        <TotalAmt>110174</TotalAmt>
        <ProgramServicesAmt>99881</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10293</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>57814</TotalAmt>
        <ProgramServicesAmt>52413</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5401</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>1169064</TotalAmt>
        <ProgramServicesAmt>1049647</ProgramServicesAmt>
        <ManagementAndGeneralAmt>119417</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>36432867</TotalAmt>
        <ProgramServicesAmt>31415605</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5017262</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>3118185</BOYAmt>
        <EOYAmt>1782913</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>8007463</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>906090</BOYAmt>
        <EOYAmt>603465</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>3327406</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>330568</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>10711454</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
        <BOYAmt>4829802</BOYAmt>
        <EOYAmt>5166529</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>38756</BOYAmt>
        <EOYAmt>38756</EOYAmt>
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      <InvestmentsProgramRelatedGrp>
        <BOYAmt>108333</BOYAmt>
        <EOYAmt>83333</EOYAmt>
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      <IntangibleAssetsGrp>
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        <EOYAmt>394506</EOYAmt>
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      <OtherAssetsTotalGrp>
        <BOYAmt>799719</BOYAmt>
        <EOYAmt>878766</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>22079294</BOYAmt>
        <EOYAmt>20613705</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1890170</BOYAmt>
        <EOYAmt>2370667</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>334024</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>2845911</BOYAmt>
        <EOYAmt>1285470</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>5018015</BOYAmt>
        <EOYAmt>3990161</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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        <BOYAmt>17061279</BOYAmt>
        <EOYAmt>16623544</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>17061279</BOYAmt>
        <EOYAmt>16623544</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>20613705</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-437735</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>11741183</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>13740694</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16084759</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>15178077</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>9109298</CurrentTaxYearAmt>
        <TotalAmt>65854011</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>11741183</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>13740694</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16084759</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>15178077</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>9109298</CurrentTaxYearAmt>
        <TotalAmt>65854011</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>65854011</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>39074</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>38521</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>89273</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>268698</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>227477</CurrentTaxYearAmt>
        <TotalAmt>663043</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>110368</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>220159</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>239130</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>415413</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>392537</CurrentTaxYearAmt>
        <TotalAmt>1377607</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>67894661</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>109978829</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.96990</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.97610</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MEANINGFUL USE INCENTIVE - 2020 AMOUNT: $ 104,185. 2021 AMOUNT: $ 213,131. 2022 AMOUNT: $ 239,130. 2023 AMOUNT: $ 387,278. 2024 AMOUNT: $ 339,996. MISCELLANEOUS - 2020 AMOUNT: $ 6,183. 2021 AMOUNT: $ 7,028. 2023 AMOUNT: $ 28,135. 2024 AMOUNT: $ 24,012. LEGAL SETTLEMENT - 2024 AMOUNT: $ 16,758. MEDICARE SETTLEMENT - 2024 AMOUNT: $ 11,771.</ExplanationTxt>
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        <ExplanationTxt>INFORMATION FROM NATIONAL AND STATEWIDE SURVEYS ARE USED AS CRITERIA TO DETERMINE THE SALARY OF THE CEO. THIS INFORMATION IS GIVEN TO THE PERSONNEL COMMITTEE FOR REVIEW. THE PERSONNEL COMMITTEE NEGOTIATES AND APPROVES THE SALARY OF THE CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
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