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      <NetGainOrLossInvestments>
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      <NetIncomeFromFundraisingEvents>
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      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
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      </NetIncomeFromGaming>
      <NetIncomeOrLoss>
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      </NetIncomeOrLoss>
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        <ExclusionAmount>1100</ExclusionAmount>
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      <OtherRevenueMisc>
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      <OtherRevenueMisc>
        <Description>Miscellaneous Income</Description>
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      <GrantsToDomesticOrgs>
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      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
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      </GrantsToDomesticIndividuals>
      <ForeignGrants>
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      <BenefitsToMembers>
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      <CompDisqualPersons>
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      <OtherEmployeeBenefits>
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      <PayrollTaxes>
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        <ManagementAndGeneral>24071</ManagementAndGeneral>
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      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
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        <ManagementAndGeneral>8555</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>19702</Total>
        <ManagementAndGeneral>19702</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
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      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
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      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
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      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>477445</Total>
        <ProgramServices>425930</ProgramServices>
        <ManagementAndGeneral>51515</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>37536</Total>
        <ProgramServices>37536</ProgramServices>
      </Advertising>
      <OfficeExpenses>
        <Total>951013</Total>
        <ProgramServices>873201</ProgramServices>
        <ManagementAndGeneral>77812</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>0</Total>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>102182</Total>
        <ProgramServices>102182</ProgramServices>
      </Occupancy>
      <Travel>
        <Total>96909</Total>
        <ProgramServices>96909</ProgramServices>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>98579</Total>
        <ProgramServices>87134</ProgramServices>
        <ManagementAndGeneral>11445</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>45232</Total>
        <ManagementAndGeneral>45232</ManagementAndGeneral>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>107188</Total>
        <ProgramServices>107188</ProgramServices>
      </DepreciationDepletion>
      <Insurance>
        <Total>34883</Total>
        <ProgramServices>29658</ProgramServices>
        <ManagementAndGeneral>5225</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>Printing and Publications</Description>
        <Total>28365</Total>
        <ProgramServices>28365</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Postage and Shipping</Description>
        <Total>16963</Total>
        <ProgramServices>16963</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Non-Medical registration fees</Description>
        <Total>18786</Total>
        <ManagementAndGeneral>18786</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Licenses and fees</Description>
        <Total>17163</Total>
        <ProgramServices>17163</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Bad debts</Description>
        <Total>1403547</Total>
        <ProgramServices>1403547</ProgramServices>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>25099</Total>
        <ProgramServices>23665</ProgramServices>
        <ManagementAndGeneral>1434</ManagementAndGeneral>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>7692108</Total>
        <ProgramServices>7050823</ProgramServices>
        <ManagementAndGeneral>641285</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>275876</BOY>
        <EOY>689315</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <EOY>125000</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
        <BOY>76494</BOY>
        <EOY>556880</EOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
        <BOY>148221</BOY>
        <EOY>195977</EOY>
      </AccountsReceivable>
      <ReceivablesFromOfficersEtc>
        <EOY>0</EOY>
      </ReceivablesFromOfficersEtc>
      <ReceivablesFromDisqualPersons>
        <EOY>0</EOY>
      </ReceivablesFromDisqualPersons>
      <OtherNotesLoansReceivableNet>
        <EOY>0</EOY>
      </OtherNotesLoansReceivableNet>
      <InventoriesForSaleOrUse>
        <BOY>20108</BOY>
        <EOY>22567</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>2853</BOY>
        <EOY>28700</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>3081256</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>1040828</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>1928231</BOY>
        <EOY>2040428</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
        <EOY>0</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsOtherSecurities>
        <EOY>0</EOY>
      </InvestmentsOtherSecurities>
      <InvestmentsProgramRelated>
        <EOY>0</EOY>
      </InvestmentsProgramRelated>
      <IntangibleAssets>
        <EOY>0</EOY>
      </IntangibleAssets>
      <OtherAssetsTotal>
        <EOY>0</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>2451783</BOY>
        <EOY>3658867</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>294323</BOY>
        <EOY>565879</EOY>
      </AccountsPayableAccruedExpenses>
      <DeferredRevenue>
        <BOY>68168</BOY>
        <EOY>374072</EOY>
      </DeferredRevenue>
      <MortNotesPyblSecuredInvestProp>
        <BOY>672655</BOY>
        <EOY>576204</EOY>
      </MortNotesPyblSecuredInvestProp>
      <TotalLiabilities>
        <BOY>1035146</BOY>
        <EOY>1516155</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>1416637</BOY>
        <EOY>2142712</EOY>
      </UnrestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>1416637</BOY>
        <EOY>2142712</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>2451783</BOY>
        <EOY>3658867</EOY>
      </TotalLiabNetAssetsFundBalances>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementSeparate>X</FinancialStatementSeparate>
      <FederalGrantAuditRequired>true</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>true</FederalGrantAuditPerformed>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="09000047" softwareVersion="2009v1.7">
      <PubliclySupportedOrg170b1Avi>X</PubliclySupportedOrg170b1Avi>
      <GiftsGrantsContribReceived170>
        <CurrentTaxYearMinus4Years>2401984</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>2974874</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>3977293</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>3528097</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>3676825</CurrentTaxYear>
        <Total>16559073</Total>
      </GiftsGrantsContribReceived170>
      <TaxRevLeviedForOrgBenefit170>
        <Total>0</Total>
      </TaxRevLeviedForOrgBenefit170>
      <ValueSrvcFcltsFurnishedByGovt>
        <Total>0</Total>
      </ValueSrvcFcltsFurnishedByGovt>
      <Total170>
        <CurrentTaxYearMinus4Years>2401984</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>2974874</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>3977293</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>3528097</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>3676825</CurrentTaxYear>
        <Total>16559073</Total>
      </Total170>
      <AmountsSubstContributorsTotal>0</AmountsSubstContributorsTotal>
      <PublicSupportTotal170>16559073</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <CurrentTaxYearMinus4Years>2107</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>1592</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>2029</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>149</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>1013</CurrentTaxYear>
        <Total>6890</Total>
      </GrossInvestmentIncome170>
      <NetUBI>
        <Total>0</Total>
      </NetUBI>
      <OtherIncome170>
        <Total>0</Total>
      </OtherIncome170>
      <TotalSupport>16565963</TotalSupport>
      <PublicSupportPertcentage170>0.99960</PublicSupportPertcentage170>
      <PublicSupportPertcentPriorYear>1.00000</PublicSupportPertcentPriorYear>
      <ThirtyThreePercntTestsCY170>X</ThirtyThreePercntTestsCY170>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="09000047" softwareVersion="2009v1.7">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="09000047" softwareVersion="2009v1.7">
      <Land>
        <OtherCostOrOtherBasis>93056</OtherCostOrOtherBasis>
        <BookValue>93056</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>2025085</OtherCostOrOtherBasis>
        <Depreciation>369960</Depreciation>
        <BookValue>1655125</BookValue>
      </Buildings>
      <Equipment>
        <OtherCostOrOtherBasis>963115</OtherCostOrOtherBasis>
        <Depreciation>670868</Depreciation>
        <BookValue>292247</BookValue>
      </Equipment>
      <TotalOfBookValueLandBuildings>2040428</TotalOfBookValueLandBuildings>
      <TotalRevenue>8418183</TotalRevenue>
      <TotalExpenses>7692108</TotalExpenses>
      <ExcessOrDeficitForYear>726075</ExcessOrDeficitForYear>
      <ExcessOrDeficitPerFS>726075</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>8418183</TotRevenueEtcAuditedFinclStmt>
      <RevenueSubtotal>8418183</RevenueSubtotal>
      <TotalRevenuePerForm990>8418183</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>7692108</TotExpensesEtcAuditedFinclStmt>
      <ExpensesSubtotal>7692108</ExpensesSubtotal>
      <TotalExpensesPerForm990>7692108</TotalExpensesPerForm990>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="09000047" softwareVersion="2009v1.7">
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
        <NamePerson>Ronald P Livingston MD</NamePerson>
        <BaseCompensationFilingOrg>175777</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>5237</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>6182</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>187196</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>John Garner DO</NamePerson>
        <BaseCompensationFilingOrg>152885</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>4244</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>6182</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>163311</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="IRS990ScheduleM" softwareId="09000047" softwareVersion="2009v1.7">
      <DrugsAndMedicalSupplies>
        <NonCashCheckbox>X</NonCashCheckbox>
        <NumberOfContributions>10</NumberOfContributions>
        <NoncashContribsRptdF990>566243</NoncashContribsRptdF990>
        <MethodOfDeterminingRevenues>Fair Mket Valu</MethodOfDeterminingRevenues>
      </DrugsAndMedicalSupplies>
      <AnyPropertyThatMustBeHeld>false</AnyPropertyThatMustBeHeld>
      <ReviewProcessUnusualNCGifts>false</ReviewProcessUnusualNCGifts>
      <ThirdPartiesUsed>false</ThirdPartiesUsed>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="09000047" softwareVersion="2009v1.7">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>Organizational governing documents, conflict of interest policy and financial statements are made available to the public upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>A benchmark salary range for all clinic positions is established based upon independent salary surveys done by professional medical management associations such as MGMA.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>Board members sign an agreement to comply with the terms of the Bylaws when they become board members. The Bylaws state if a director has a financial interest in a matter that comes before the Board, then the director must excuse him or herself from voting. Additionally, it states the clinic does not employ members of the Board of Directors or their family members.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: Form 990 Review Process</ReturnReference>
        <Explanation>Form 990 is reviewed by a board committee and is made available to the entire board for review prior to filing.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>