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        <Explanation>MADE AVAILABLE UPON REQUEST</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES</Identifier>
        <ReturnReference>FORM 990, PART IX, LINE 11G</ReturnReference>
        <Explanation>CONTRACTED MEDICAL SERVICES 166,605 0 0</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>