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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
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      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
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      <ProgramServiceRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>4755649</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Capitation</Desc>
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      <ProgramServiceRevenueGrp>
        <Desc>Program Fees</Desc>
        <BusinessCd>621300</BusinessCd>
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      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>0</ExclusionAmt>
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        <ProgramServicesAmt>6958932</ProgramServicesAmt>
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        <FundraisingAmt>176041</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>635156</TotalAmt>
        <ProgramServicesAmt>542185</ProgramServicesAmt>
        <ManagementAndGeneralAmt>63711</ManagementAndGeneralAmt>
        <FundraisingAmt>29260</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>614875</TotalAmt>
        <ProgramServicesAmt>476011</ProgramServicesAmt>
        <ManagementAndGeneralAmt>124515</ManagementAndGeneralAmt>
        <FundraisingAmt>14349</FundraisingAmt>
      </PayrollTaxesGrp>
      <AdvertisingGrp>
        <TotalAmt>4482</TotalAmt>
        <ManagementAndGeneralAmt>3992</ManagementAndGeneralAmt>
        <FundraisingAmt>490</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>202743</TotalAmt>
        <ProgramServicesAmt>191054</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10427</ManagementAndGeneralAmt>
        <FundraisingAmt>1262</FundraisingAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>2174420</TotalAmt>
        <ProgramServicesAmt>2124805</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49615</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>16684</TotalAmt>
        <ProgramServicesAmt>3874</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12810</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>124674</TotalAmt>
        <ProgramServicesAmt>76254</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48420</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>892615</TotalAmt>
        <ProgramServicesAmt>731944</ProgramServicesAmt>
        <ManagementAndGeneralAmt>160671</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>301749</TotalAmt>
        <ProgramServicesAmt>126517</ProgramServicesAmt>
        <ManagementAndGeneralAmt>175232</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Patient Supplies</Desc>
        <TotalAmt>58057</TotalAmt>
        <ProgramServicesAmt>58057</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Patient labs and pharmacy co</Desc>
        <TotalAmt>3601992</TotalAmt>
        <ProgramServicesAmt>3601992</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Building maintenance</Desc>
        <TotalAmt>321459</TotalAmt>
        <ProgramServicesAmt>298487</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22972</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Professional fees</Desc>
        <TotalAmt>792043</TotalAmt>
        <ProgramServicesAmt>570752</ProgramServicesAmt>
        <ManagementAndGeneralAmt>199142</ManagementAndGeneralAmt>
        <FundraisingAmt>22149</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>1260386</TotalAmt>
        <ProgramServicesAmt>928764</ProgramServicesAmt>
        <ManagementAndGeneralAmt>320736</ManagementAndGeneralAmt>
        <FundraisingAmt>10886</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>19153547</TotalAmt>
        <ProgramServicesAmt>16689628</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2209482</ManagementAndGeneralAmt>
        <FundraisingAmt>254437</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>19981401</BOYAmt>
        <EOYAmt>24238727</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>3539517</BOYAmt>
        <EOYAmt>3448351</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>347107</BOYAmt>
        <EOYAmt>1601055</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>180725</BOYAmt>
        <EOYAmt>110429</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>16519967</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>11133083</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>5870493</BOYAmt>
        <EOYAmt>5386884</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <EOYAmt>538131</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>29919243</BOYAmt>
        <EOYAmt>35323577</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1483081</BOYAmt>
        <EOYAmt>1735217</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>2539650</BOYAmt>
        <EOYAmt>2867596</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>4022731</BOYAmt>
        <EOYAmt>4602813</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>25896512</BOYAmt>
        <EOYAmt>30720764</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>25896512</BOYAmt>
        <EOYAmt>30720764</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>29919243</BOYAmt>
        <EOYAmt>35323577</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>4824252</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="990A">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>8404486</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8501454</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10678000</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12476664</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10901165</CurrentTaxYearAmt>
        <TotalAmt>50961769</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>8404486</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8501454</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10678000</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12476664</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10901165</CurrentTaxYearAmt>
        <TotalAmt>50961769</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>5797232</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>45164537</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>1549</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8041</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7650</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>6406</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>23646</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>20280</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>106543</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>339459</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>180002</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>918544</CurrentTaxYearAmt>
        <TotalAmt>1564828</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>52550243</TotalSupportAmt>
      <PublicSupportCY170Pct>0.85950</PublicSupportCY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="990B">
      <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>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="990D">
      <LandGrp>
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        <BookValueAmt>1126507</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>11969671</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>7885193</DepreciationAmt>
        <BookValueAmt>4084478</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>2994042</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2843995</DepreciationAmt>
        <BookValueAmt>150047</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>429747</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>403895</DepreciationAmt>
        <BookValueAmt>25852</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>5386884</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Operating lease</Desc>
        <BookValueAmt>216870</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Operating lease-net of current port</Desc>
        <BookValueAmt>321261</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>538131</TotalBookValueOtherAssetsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>23977799</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>23977799</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>23977799</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>19153547</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>19153547</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>19153547</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="990J">
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kenneth Burnett</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>236841</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>236841</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Olatunji Akintilo</PersonNm>
        <TitleTxt>Chief Medical Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>208820</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>208820</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Angela Walker</PersonNm>
        <TitleTxt>OBGYN</TitleTxt>
        <BaseCompensationFilingOrgAmt>184575</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>184575</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="990O">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Amended return information</FormAndLineReferenceDesc>
        <ExplanationTxt>Financials were updated.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 governing body review Part VI line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is prepared by an independent CPA Firm and reviewed in detail by the organizationss top management. The reviewed Form 990 is then provided to the board of directors prior to filing with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Conflict of interest policy compliance Part VI line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization requires all officers and board members to annually complete and sign a conflict of interest questionnaire. The Director of Compliance is responsible for reviewing the signed statements with the conflict of interest policy. Should any potential conflicts of interest be disclosed, the board member or officer would be asked to refrain from participation in any deliberation or decision with regard to matters affected by the relationship.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>CEO executive director top management comp Part VI line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The executive committee determines the Chief Financial Officers Salary. Comparability data and a compensation consultant are used, and the approval process is documented in the minutes.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other officer or key employee compensation Part VI line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation for the other officers is approved by the Chief Executive Officer. Comparability data is used, and the approval process is documented.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Governing documents etc available to public Part VI line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents, conflict of interest policy and financial statements are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>