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      <EscrowAccountLiabilityGrp>
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      <UnsecuredNotesLoansPayableGrp>
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      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>1883870</BOYAmt>
        <EOYAmt>1845670</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>17977749</BOYAmt>
        <EOYAmt>18393607</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
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        <BOYAmt>17977749</BOYAmt>
        <EOYAmt>18393607</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>20239277</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-254512</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>670370</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp />
      <BuildingsGrp />
      <LeaseholdImprovementsGrp />
      <EquipmentGrp />
      <OtherLandBuildingsGrp />
      <TotalRevEtcAuditedFinclStmtAmt>41118865</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>670370</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>670370</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>40448495</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>37207</InvestmentExpensesNotIncldAmt>
      <RevenueNotReportedFinclStmtAmt>37207</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>40485702</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>40703007</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>40703007</ExpensesSubtotalAmt>
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      <ExpensesNotRptFinclStmtAmt>37207</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>40740214</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TRUST ESTABLISHED TO HOLD THE PLANS'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND ACCORDING, THE PLAN'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN HAS OBTAINED AN EXEMPTION LETTER DATED OCTOBER 23, 1980 FROM THE INTERNAL REVENUE SERVICE, AND THE SPONSOR BELIEVES THAT THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE PLAN'S FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS, HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINSTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATION FOR YEARS PRIOR TO 2013.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
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      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SCOTT ELLNER CEO BILLINGS</PersonNm>
        <TitleTxt>CLINIC/BOARD MEMBER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>797492</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>37531</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>4485</OtherCompensationRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>22157</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>861665</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PRISCILLA NEEDHAM CFO</PersonNm>
        <TitleTxt>BILLINGS CLINIC/BOARD MEMBER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>123128</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>45000</BonusRelatedOrganizationsAmt>
        <NontaxableBenefitsRltdOrgsAmt>5413</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>173541</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JONATHAN MCDERMOTT</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>272923</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>22080</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>1236</OtherCompensationRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>17602</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>313841</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ELLEN LAYTON</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>410202</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>31334</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>24775</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>26437</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>492748</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BENJAMIN FRASIER</PersonNm>
        <TitleTxt>VP of Human Resources</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>226376</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>1474</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>694</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>18189</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>31118</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>277851</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CONNIE PREWITT FORMER CFO BILLIN</PersonNm>
        <TitleTxt>CLINIC/BOARD MEMBER-PART YEAR</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>249435</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>573444</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>22126</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>19953</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>864958</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBERT MERCHANT FORMER BILLINGS</PersonNm>
        <TitleTxt>CLINIC INTERIM-CO-CEO/BOARD</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>457402</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>74879</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>22294</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>26537</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>581112</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>SEVERANCE OR CHANGE OF CONTROL PAYMENTS: CONNIE PREWITT, FORMER BILLINGS CLINIC CFO, AND PART-YEAR EMPLOYEE BENEFIT TRUST OFFICER AND DIRECTOR, RECEIVED A QUALIFYING PAYMENT OF $262,400 IN 2020. THIS PAYMENT IS INCLUDED IN THE AMOUNT OF OTHER REPORTABLE COMPENSATION REPORTED ON FORM 990 PART VII AND SCHEDULE J, PART II.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BILLINGS CLINIC EMPLOYEE BENEFIT TRUST HAS AN EXECUTIVE BENEFITS COMMITTEE THAT HAS THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. THIS COMMITTEE HAS THE AUTHORITY TO MAKE AND APPROVE ALL DECISION/CHANGES RELATED TO THE TRUST; HOWEVER, THEY ARE ALL EMPLOYEES OF AND MEMBERS OF THE SENIOR EXECUTIVE TEAM OF THE BILLINGS CLINIC (A RELATED ORGANIZATION)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE CFO, DIRECTOR OF ACCOUNTING, AND THE DIRECTOR OF HUMAN RESOURCES OF BILLINGS CLINIC (PLAN SPONSOR) BEFORE THE RETURN IS FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>BILLINGS CLINIC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2800 10TH AVENUE NORTH</AddressLine1Txt>
          <CityNm>BILLINGS</CityNm>
          <StateAbbreviationCd>MT</StateAbbreviationCd>
          <ZIPCd>59107</ZIPCd>
        </USAddress>
        <EIN>810231784</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MT</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) 3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>true</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
