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          <BusinessName>
            <BusinessNameLine1Txt>Gastrointestinal Specialist AMC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3014 Knight Street</AddressLine1Txt>
            <CityNm>Shreveport</CityNm>
            <StateAbbreviationCd>LA</StateAbbreviationCd>
            <ZIPCd>71105</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>GI Contract Specialty</ServicesDesc>
        <CompensationAmt>4087212</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <CityNm>Grapevine</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>76051</ZIPCd>
          </USAddress>
        </ContractorAddress>
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        <CompensationAmt>707341</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <CityNm>Baton Rouge</CityNm>
            <StateAbbreviationCd>LA</StateAbbreviationCd>
            <ZIPCd>70817</ZIPCd>
          </USAddress>
        </ContractorAddress>
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        <CompensationAmt>2627500</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Digestive Health Group LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>840 Tchoupitoula S Street Unit 319</AddressLine1Txt>
            <CityNm>New Orleans</CityNm>
            <StateAbbreviationCd>LA</StateAbbreviationCd>
            <ZIPCd>70130</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>GI Specialty Contract</ServicesDesc>
        <CompensationAmt>3180505</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4845 Jamestown Avenue Ste 213</AddressLine1Txt>
            <CityNm>Baton Rouge</CityNm>
            <StateAbbreviationCd>LA</StateAbbreviationCd>
            <ZIPCd>70808</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Advertising</ServicesDesc>
        <CompensationAmt>425829</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>7249968</GovernmentGrantsAmt>
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      <TotalContributionsAmt>7272143</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient revenue</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>13465965</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <ProgramServiceRevenueGrp>
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        <TotalRevenueColumnAmt>11004720</TotalRevenueColumnAmt>
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        <ExclusionAmt>0</ExclusionAmt>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <OtherRevenueMiscGrp>
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        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>880039</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>880039</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <FeesForServicesLegalGrp>
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        <ProgramServicesAmt>52862</ProgramServicesAmt>
        <ManagementAndGeneralAmt>233352</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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        <ProgramServicesAmt>63104</ProgramServicesAmt>
        <ManagementAndGeneralAmt>101532</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
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        <TotalAmt>127834</TotalAmt>
        <ProgramServicesAmt>69475</ProgramServicesAmt>
        <ManagementAndGeneralAmt>58359</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
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      <OtherExpensesGrp>
        <Desc>Bank Charges</Desc>
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        <ProgramServicesAmt>60765</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45334</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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        <EOYAmt>516852</EOYAmt>
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      <ReconcilationRevenueExpnssAmt>-2181771</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>118909</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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      <TenPctFactsCrcmstncsTestCYInd>X</TenPctFactsCrcmstncsTestCYInd>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Pt II Ln 17a</FormAndLineReferenceDesc>
        <ExplanationTxt>Required for return completion</ExplanationTxt>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Pt II Ln 10</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Income Part II, Line 10 Description: Patient service revenue 2020: 5110410. 2021: 6385076. 2022: 9483280. 2023: 11733307. 2024: 13465965. Description: Other Income 2020: 271008. 2021: 321296. 2022: 442839. 2023: 4321502. 2024: 880039. Description: 340B Income 2020: 14794212. 2021: 15161815. 2022: 12518193. 2023: 11200282. 2024: 11004720. Description: Rent income 2020: 0. 2021: 0. 2022: 0. Description: Forgiveness of Debt 2020: 1370030. 2021: 0. 2022: 0.</ExplanationTxt>
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      <BuildingsGrp>
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      <EquipmentGrp>
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      <OtherLandBuildingsGrp>
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        <BookValueAmt>9101</BookValueAmt>
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      <InvstProgramRelatedOrgGrp>
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        <MethodValuationCd>C</MethodValuationCd>
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      <InvstProgramRelatedOrgGrp>
        <Desc>Investment in Lotus Village</Desc>
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        <MethodValuationCd>C</MethodValuationCd>
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        <Desc>Other receivable</Desc>
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        <Desc>Right-of-use assets</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Other liabilities</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Lease liability_current</Desc>
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      <OtherLiabilitiesOrgGrp>
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      <FootnoteTextInd>X</FootnoteTextInd>
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      <RevenueSubtotalAmt>32804983</RevenueSubtotalAmt>
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      <TotalExpensesPerForm990Amt>34986754</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization is exempt from corporate Federal income taxes under Section 501(c)(3) of the Internal Revenue Code and from state income taxes. Therefore, no provision has been made for Federal or state corporate income taxes in the accompanying financial statements. The Organization has analyzed its tax positions taken for filings with the Internal Revenue. It believes that its tax filing positions will be sustained upon examination and does not anticipate any adjustments that would result in a material adverse effect on its financial condition, results of operations, or cash flows. The Organizations federal and state income tax returns for 2020, 2019, and 2018 are subject to examination by the federal, state and local taxing authorities, generally for three years after they are filed.</ExplanationTxt>
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      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>218713</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Matthew Valliere</PersonNm>
        <BaseCompensationFilingOrgAmt>418065</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>32830</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>450895</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Pamela Daniel</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <DeferredCompensationFlngOrgAmt>51356</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>213865</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kabrina Smith</PersonNm>
        <BaseCompensationFilingOrgAmt>198378</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>28117</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>226495</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Gregory Garner</PersonNm>
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        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>54703</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>272144</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jonathan M Coakham</PersonNm>
        <BaseCompensationFilingOrgAmt>241812</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <DeferredCompensationFlngOrgAmt>6576</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>14217</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>262605</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Charlie Bridges</PersonNm>
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        <TotalCompensationFilingOrgAmt>239692</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Shanna R Warner</PersonNm>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kevin Robinette</PersonNm>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23610</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>158192</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="24020153">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors make the decision based on current</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>market data and NACHC compensation and benefit reports.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The draft is reviewed by the CFO. A copy is also</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>forwarded to the Finance Committee for their review.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors hold a public meeting on the last</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Monday of each month. This documentation is dicussed</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>and made available during monthly Finance meetings.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO and HR make the decision for a key employees</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>compensation based on the market data for the area and</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>years of experience.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization regularly monitors and enforces compliance</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>by enforcing the importance of following and complying</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>with the Organizations policy.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>